COMPARING A NEW SCREW-TIPPED INTRAOSSEOUS NEEDLE VERSUS A STANDARD BONE MARROW ASPIRATION NEEDLE FOR SPEED AND EASE OF ESTABLISHING INTRAOSSEOUS INFUSION IN TWO DIFFERENT BONE MODELS

Background: Intraosseous (IO) infusion is a method of establishing emergency vascular access. Standard bone marrow needles can be used, but several needles specifically designed for IO infusion are available. A screw-tipped IO needle has recently become available, requiring less downward pressure during IO needle insertion. The purpose of this study is to compare the speed and ease of establishing IO infusion using a standard bone marrow needle (SBMN, $8) and a new screw-tipped intraosseous needle (Sur-Fast, $42). Methods: The study is an experimental design. A total of 42 medical students, without prior IO experience, were recruited as study subjects. Subjects were randomized to perform the IO procedures in one of two models: 1) turkey femur or 2) pork ribs. Each subject performed an initial trial using both IO needles without practice (inexperienced attempt) and a second trial using both IO needles after practice (experienced attempt), such that in total, each subject completed 4 attempts (2 with each needle type). IO placement times were measured, and placement difficulty scores were measured using a 10 cm visual analog scale (VAS). Results: The averaged elapsed time to successful IO completion was significantly shorter for the SBMN in the initial "inexperienced" attempt (33 vs. 54 seconds, p=0.019), but there was no significant difference in the post-practice "experienced" attempt. VAS difficulty scores were lower (easier) for the SBMN for both inexperienced and experienced trials. Success rates were significantly higher for the Sur-Fast needle during the experienced attempt (95% vs. 79%, p [is less than] 0.05), but there was no significant difference in success rates during the inexperienced attempt. For each needle type, the placement times, VAS scores and success rates did not differ significantly between the two bone models which were used suggesting that the two bone models are similar, though this is inconclusive since the sample size is small. Conclusion: The Sur-Fast screw-tipped intraosseous needle does not demonstrate superiority over the standard bone marrow needle in this intraosseous model, therefore its higher cost is difficult to justify based on this study. The authors wish to thank the Chun Foundation for their financial support of this study and Cook Critical Care for supplying materials for this study.