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We have BIG on the car and EZ IO in ER. Both do a great job. Besides the advantage of BIG (no batteries) I prefere the EZ IO. Better Handling and no small fractures (proofen when using BIG). And in severe burned people or CPR an intraosseos line is faster and easier to establish. I did not give any endotracheal medication since BIG was bought.
I prefer a proper IV line. In 15 years on the ambulance I have never had to resort to a marrow needle. We do have it on board, just as we have the "jet-pistol" for jet ventilation through emergency needle cricothyreoidotomy. Both might be useful for non-anaesthetists!
a regular marrow needle, say 13g works just fine. NOT for use as old as 6, let alone in the elderly. Tibial stick ok up to about 18 months, after which go for hipbone, ASIS or PSIS. Don't need fancy 'guns' etc. If pt is concious, a little lidocaine for the periosteum first but is a good alternative for IV access when you need it not now but right now.
EZ-IO is fine if you want to spend twice as much per use. We couldn't afford the $450.00 per truck just to get them in service. Then it's around $110.00 per needle. We have great success with BIG for 1/2 the cost. Plus No Batteries Needed .....
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