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Emergency tool could help save lives

American Medical Response will help critical patients

Community is one of Marc Burnham's favorite words.

'One thing about AMR is that it is very family oriented and our employees are part of the community as coaches and troop leaders, and I'm on county boards and am executive vice chair for the Clackamas County Chamber of Commerce,' he said.

So that may explain why Burnham, who is operations manager for American Medical Response in Clackamas County, is so excited about a new device that AMR's EMTs and paramedics have been using for almost a year.

Ever since May 2006, when AMR's county contract was renewed, 'we've been upgrading and adding extra services to the county. We have the modular ambulance, the King Airway, the 12-lead cardiac ECG and now we have the EZ-IO, for faster and easier vascular access,' he said.

EZ-IO saves lives

'The IO in EZ-IO stands for intraosseous, and this and the other new tools have increased the total scope of EMT options,' said Jan Acebo, a paramedic and AMR's training officer for Multnomah County.

The product is made by Vidacare, and the company's Web site explains that 'the intraosseous space is a specialized area of the vascular system where blood flow is rapid and continues even during shock. Drugs and fluids infused via the intraosseous route reach the central circulation as quickly as those administered through standard IV access.'

Essentially, the EZ-IO allows EMTs or paramedics to use a drill-like tool to insert a needle into the bone to 'gain vascular access through the bones of a critical patient,' Acebo explained.

'The purpose of this in a field setting is to [introduce] life-saving fluids, like a normal saline solution, and medication' into the veins of a critical patient, Acebo said.

Examples where the EZ-IO has been used in the field include cardiac arrest, respiratory arrest, trauma from accidents and drug overdose cases, he added.

'When a critical patient needs vascular access immediately, this device can be deployed. In the case of cardiac arrest, the veins might have collapsed; in trauma, there might be no blood volume; in respiratory arrest or if the patient is obese, maybe we can't find the veins; or in the case of a drug-overdose patient, scar tissue from years of drug abuse might cover the veins,' Acebo said.

Before the invention of the EZ-IO, doctors had to use a manual device called the Jamshidi, he noted. It was difficult to use, and medical personnel had to exert considerable pressure to get the needle into the bone.

But the EZ-IO has a drill that is much easier to use, and technicians can have vascular access in critical patient in seconds, as compared to three to seven minutes, using other devices.

There are only two sites that the FDA has approved the use of the EZ-IO on the body, one below the kneecap and one near the ankle.

'Those are optimal sites, with [good] accessibility for the majority of patients,'

Acebo said, adding that in many emergency situations, the 'tense action' is near the head or heart, so 'the legs [provide] a site that doesn't interfere with anybody's work.'

Although it may seem that drilling into a patient's bone would be painful, Acebo said that the action 'only starts to hurt when we send in fluid, which starts tickling those nerve endings [in the bone].'

If the patient is unconscious, medical personnel don't worry about pain, but in a conscious patient 'we send a small amount of lidocaine through the needle' for pain relief, he noted.

The other advantage to the EZ-IO is that there are two sizes of needles, one for adult critical patients and one for children, so there 'is pediatric access' when children are involved in a medical situation, Acebo said.

He added that the EZ-IO has 'revolutionized care and has given us a tool to quickly and safely have vascular access in critical patients.'

In the community

Burnham is pleased with the new technology that allows medical personnel to more efficiently save lives in the county, but he pointed out that AMR is involved in other activities to help citizens.

Dale Miller, a Clackamas County supervisor for AMR, works with Oregon Impact, a group that stages accident simulations at area high schools before prom or graduation to discourage drinking and driving. The company's river rescue unit will be back at High Rocks, near Gladstone, in late May.

Last year, Burnham said, the river rescue team saved five lives and worked on 39 assists.

'It's a team effort with the Oregon City police and the Gladstone police. When we are there, people are better about drinking.'

River rescue units provide education about why it is not a good idea to jump into extremely cold water, and they let people know about the current of the river and where submerged logs are. They provide informational flyers in both English and Spanish, as well.

Burnham added, 'There have been no drownings since we've been there. We're very proud of that.'

For more information on the EZ-IO, visit http://www.vidacare.com

To contact Marc Burnham, AMR operations manager, call 503-659-8955.