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May 10, 2011

Pa. medics get bone drills for IV alternative

By Margaret Harding
Pittsburgh Tribune Review

PITTSBURGH, Pa. — When Pittsburgh paramedics try to treat a child in such extreme trauma they can't access veins for an intravenous line, they push and twist a needle until it goes into a bone to get the necessary medications flowing.

Starting in June, they'll have a quicker option.

City paramedics will finish their training at the end of this month with EZ-IO drills, which will allow them to quickly bore into the bone of an adult or child to place an IV. Doctors who ride with the medics already use them.

The department paid about $12,000 for 19 drills.

"The sound reminds you of being in the dentist, but it's very quick and very painless," said Brian Smouse, EMS crew chief and training officer. "We're able to hook up the IV and give fluids and medications."

Smouse said the drills will be used on patients in cardiac arrest — which medics see nearly every day — or other trauma that causes veins to collapse. The push-and-twist technique only works with children; the addition of the drills allows medics to treat adults similarly.

"If I can get an IV in a cardiac arrest patient, I'm going that route," Smouse said. "If I don't have an IV access, now with an adult, I can put this drill in."

The drill can get a needle in with no pressure in about 10 seconds, as medics learned recently when they practiced with synthetic flesh and bone at a Strip District training center.

"Once you get through your initial shock, you can really get used to it," paramedic Romayne Bendig said. "I'm a mom, and I have trouble drilling things into people, but I can do this."

Allegheny General Hospital in the North Side bought the drills for the rescue companies it commands in 2005. Robert Rathi, a spokesman for West Penn Allegheny Health System, said the drills have been a "tremendous success."

"This is a life-saving device," Rathi said. "There are times when you have to administer medicine to patients to save a life."

NorthWest EMS, which serves McKees Rocks, Stowe, Kennedy and other communities, uses its drills two to five times a month, District Chief Kevin Early said.

"They make things pretty smooth," Early said. "They're actually very convenient."

Jim Blosser, clinical manager of EZ-IO, based in San Antonio, Texas, trained the medics on the drills. He had a colleague use one on him.

"The insertion pain was minimal," said Blosser, a former Pittsburgh paramedic. "The same as sticking needles in the hand when you're in paramedic school."

Still, he said it was nerve-wracking.

"Anytime you're being stuck with a needle, you have that apprehension," he said.

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