San Diego EMS explores distal femur IO site for enhanced patient survival

The recent government meeting in San Diego focused on improving emergency medical services (EMS) for pediatric out-of-hospital cardiac arrest (OHCA). Key discussions revolved around the best practices for intravenous (IV) and intraosseous (IO) access in young patients, which are critical for increasing survival rates.

Ten large EMS systems are currently participating in this initiative, emphasizing the importance of effective compressions, ventilations, and access to fluids. The meeting highlighted the need for training in IO access, particularly in the context of pediatric care. The proximal tibia has traditionally been the preferred site for IO access; however, it has a high failure rate. As a result, many EMS agencies are now considering the distal femur as a more reliable option. This site has shown promising results in local emergency rooms, with practitioners advocating for its use.

The proximal humerus was also discussed, though its use in very young children remains controversial due to concerns about growth plates and the potential for movement during compressions. Despite these concerns, practitioners noted that it can be effective when performed correctly.

Training was identified as a crucial component of implementing these changes. The meeting underscored the necessity for hands-on education for EMS personnel, particularly in using the distal femur for IO access. Participants stressed the importance of practice drills to ensure that medics are comfortable and proficient in these techniques.

In conclusion, the meeting served as a platform for advancing pediatric emergency care in San Diego, with a focus on enhancing training and refining protocols for IO access. The discussions aim to improve outcomes for young patients experiencing cardiac arrest, ultimately contributing to higher survival rates in this vulnerable population.