Implementation of intraosseous infusion technique by aeromedical transport programs.

Aeromedical transport program implementation of intraosseous infusion (IOI) was ascertained by telephone survey. One hundred thirty-three programs were polled: 69.2% had never utilized IOI nor were considering its use; 13.5% had previously utilized IOI; 15.8% had not yet implemented IOI but had been in-serviced on the technique; and 1.5% were considering implementation. Of 39 programs previously in-serviced or presently utilizing the procedure, seven restricted IOI insertion to physicians while 32 permitted placement by nurses or paramedics. Half of the programs would pursue IOI immediately after a 5-minute trial of peripheral line placement in preference to cutdown or central venous line attempts. About 50 IOI were performed by aeromedical transport personnel in 1986. Rate of successful insertion was approximately 80%. Complications were few and minor. This survey demonstrates that the simple, safe technique of IOI is being grossly under-utilized and warrants further consideration.