Is there anything funny about humeral IO insertion?

This study set out to examine paramedic success of proximal humerus intraosseous (IO) placement, using the power assisted EZ-IO device, in out-of-hospital cardiac arrest in adult patients.

The researchers achieved this by retrospectively analysing data collected as part of a previous study that investigated the impact on patient outcomes of early use of adrenaline.

Paramedics who were skilled at tibial IO access participated in 90 minutes of training to learn about indications, contraindications, landmark identification and insertion techniques for humeral IO placement. This incorporated some practical work, as well as didactic delivery, to gain experience at humeral insertion in a simulated environment. To supplement this education, paramedics were given access to an online video for reference. In the study itself, although the protocol determined that humeral access was the preferred route (maximum of one attempt per bone), the paramedics maintained autonomy to make clinical decisions as to use of alternative access routes, if required, according to the patient's clinical situation.