History of EMS Intraosseous (IO) Access for Paramedics and EMTs

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On a recent MedicCast EMS Podcast episode, the subject of intraosseous (IO) devices  for paramedics was covered by host Jamie Davis, the Podmedic.

One of the the items covered was some review of the history of IO access.  Like so many advancements in emergency medical care, IO access grew to maturity during a time of war due to advancements in trauma care of injuries sustained in battle.  Paramedics and other advanced care providers in EMS today owe this skill to research and studies dating back over 60 years.

IO History

Over at the MedicCast site link above you will a very interesting PDF download link that I found having to do with the origins of I.O. access during World War Two and before. I.O. access was first investigated in the 1920’s and 1930’s when the understanding of the circulation nature of bone marrow was first kind of really described in detail in some medical journals.

Anesthesiologists were considering it as a good resource for them to administer anesthesia, and it was found that I.O. access was as faster than other routes for medication administration, in some cases even faster as a route of administration when compared to intravascular access—I.V. access.

In World War Two, in fact, as this was a brand new thing, it was found as reviewed documents from World War Two that there were four thousand documented instances of I.O. access being used in war time care of soldiers that were severely injured. Again, as a route of access for someone that is severely injured, critically injured, or in cardiac arrest there is really nothing like it.

It makes sense when you think about it.  You don’t have to try to find a vein or tie it up. You cleanse your general site. You’re talking about hitting the bone marrow in a bone that is several centimeters in diameter. You’re just going to find that landmark insertion point. If you can get to the center of the bone with your I.O. device, you’re going to hit marrow and you’re going to be able to rapidly get access into the vasculature and be able to administer medications and fluids, including blood products.

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More on IO access coming up soon here at EMTPodcast.com or check out the whole I.O. Paramedic Skills episode at MedicCast.com.  The MedicCast is a weekly online radio program or podcast for EMTs, paramedics, and EMS students.  Each episode features news, commentary, tips and more just for EMS providers at all levels.