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To: mf160 who wrote (7323)	12/3/2004 10:15:20 AM
From: esxtarus	Read Replies (1) \| Respond to of 8117

A Brief History of Intraosseous Vascular Access Today, most people feel that the intravenous route is well understood. One of the reasons we are familiar with the procedure is that it has been used to administer fluids since the 1830’s. But, did you know that the intraosseous route has been studied since 1922? In that year, Dr. C.K. Drinker investigated the circulation of the sternum and proposed it as a route for blood administration. As early as 1936 Dr. L.M. Tocantins, one of the best known advocates of intraosseous access, and his associate Dr. O’Neill, confirmed that the marrow cavity of a long bone was a possible site for vascular access. In 1940, expanding on previous research, Dr. Henning—another early IO advocate—was able to use the sternum to transfuse a patient. The University of Texas Health Science Center at San Antonio, a partner in the EZ-IO™ development, serves San Antonio and the 50,000 square-mile area of South Texas. It extends to campuses in the metropolitan border communities of Laredo and the Rio Grande Valley. More than 3,000 students a year train in an environment that involves more than 100 affiliated hospitals, clinics and health care facilities in South Texas. In 1942 Dr. E.M. Papper demonstrated that circulation times of intraosseous and intravenous fluids were essentially the same and that it was a viable option to other infusion techniques. In 1944 Dr. H. Bailey wrote “Sternal puncture can be carried out in a comparatively poor light—a most important consideration under black out conditions”. He recognized that significant complications were possible utilizing the sternal route and thus went on to design a special trocar with a guard to prevent complete sternal puncture. With this body of knowledge, the 1940’s and 50’s saw intraosseous infusions extensively written about and used. Children and adults who required emergent or repeated blood transfusions or medication therapy were treated without hesitation via the IO route. Additionally, the United States Military considered the IO route as a standard approach to the treatment of seriously injured servicemembers. In fact, over 4,000 cases of IO use were documented during World War II alone. After WWII this valuable technique for vascular access was lost because pre-hospital care was non-existent in the U.S. The majority of those who had used IO “in the field of battle” did not continue to work in a similar civilian medical capacity. Thus, a completely acceptable, well understood procedure, simply faded from routine care. It wasn’t until the 1980’s that interest once again focused on intraosseous vascular access for emergency care. Initially, the IO procedure gained acceptance only in pediatric emergency medicine in part because the devices of the time were not capable of penetrating the thicker, harder adult bone. Dr. James P. Orlowski, wrote an editorial in the American Journal of Diseases in Children which was published in September of 1984. The editorial was titled, “My Kingdom for an Intravenous Line” and drew essential attention to the lost science of IO in the United States. This article, in concert with a profound need, was credited with rekindling the interest in IO vascular access and paved the way toward new aggressive pediatric protocols. Adult IO soon followed as technological improvements were made. Examples of IO vascular access advancement such as the BIG™ (Bone Injection Gun) and the PYNG - F.A.S.T 1™ exist and are currently in use. As today’s provider becomes more sophisticated, the need for improvement in patient care delivery systems increases. The EZ-IO™ is the latest step toward the future of emergency care. B-29 Crewman Save a Life in the Air by New Method The life of a 19 year old Detroiter was saved recently when comrades gave him blood plasma through a new type of needle as his superfortress sped homeward high over Japan. The successful injection showed that the new intra – sternal method of administrating plasma can be used safely by airmen, even though their medical ward is the crowded radio room of a shell punctured B-29, according to a United Press account. Before the airman’s injuries put the method to an emergency test, medical men believed it could only be used by physicians. A shell from a Japanese fighter plane exploded in the young mans lap a few seconds after his B-29, “Draggin Lady” dropped its bombs. Found Unconscious The airman was found by the pilot and gunner. They said he had at least 100 shell fragments in his hand, right arm and left leg. “We took him into the radio room” said another crewman. The trio splinted and dressed the injured man’s hand and gave him morphine. Usual Methods Fail But when they tried to give him plasma intravenously, they found he was suffering from shock and that his veins had collapsed, making it impossible to inject the intravenous needle. “We had been instructed on use of the intra-sternal needle” said one airman “but we’d never seen it used before”. The airman read over the instructions. They then measured and “jammed the needle in”. The airman was subsequently resuscitated and ultimately treated in Hawaii. This example is one of many indicating the efficacy of IO vascular access and the long history of its use. Excerpt courtesy of The Detroit News – Tuesday, March 13, 1945 Home \| Corporate \| Products \| Sales \| Training \| Research \| Contact Us \| News \| Site Map \| Purchase © 2004, VidaCare Corporation • 722-A Isom Road, San Antonio, TX 78216 TEL: 866-479-8500 • FAX: 210-375-8537• EMERGENCIES: 800-680-4911 Web Design, Graphic Design, Advertising, Marketing