Frequently Asked Questions

In the absence of contraindications, the proximal humerus is recommended for:

  • Average flow rate of 5 L/hour via proximal humerus5
  • Medication and fluid will reach the heart in 3 seconds6
  • Well-tolerated by conscious/alert patients5
  • Less medication required for patient pain management5

Proximal tibia, distal tibia and distal femur (pediatrics only) are alternate insertion sites.

  • The patient needed vascular access
  • The patient had limited or no venous access
  • Due to limited time and resources
  • To prevent multiple IV sticks and minimize patient pain/anxiety
  • To minimize vascular access-related complications and facilitate vein preservation

There are three Arrow® EZ-IO® Needle Sets to choose from. All are 15 ga surgical stainless steel. The color of the catheter hub correlates to the catheter length; pink = 15 mm, blue = 25 mm, yellow = 45 mm. The site should be dressed with an EZ-Stabilizer Dressing.

Virtually any fluid and medication that can be safely infused via peripheral IV route may be safely infused through the IO route using the same dosage, rate and concentration. Adequate flow rates are dependent on periodically performing a syringe flush and infusing fluids and medications under pressure via infusion pump, pressure bag or syringe boluses.

Prior to administration of medications or fluids, confirm Arrow® EZ-IO® catheter placement:

  • Ability to aspirate blood
  • Stability of catheter in the bone

Caution: Before administering vesicant, toxic, or highly-concentrated drugs, check the IO catheter again for placement and patency.

Assess the IO site and if there is no evidence of complications, perform a rapid syringe flush of normal saline (5-10 mL adult, 2-5 mL infant/small child) into the IO space. This helps clear the intraosseous marrow and fibrin allowing for effective infusion rates. Periodic flushes may be necessary.

In some cases, anesthetics can be used for pain. For additional references, research and dosing charts, please visit www.eziocomfort.com.

The use of any medication, including lidocaine, given IV or IO is the responsibility of the treating physician, medical director, or qualified prescriber and not an official recommendation of Teleflex. Teleflex is not the manufacturer of lidocaine, and the user should be familiar with the manufacturers' instructions or directions for use for all indications, side effects, contraindications, precautions and warnings of lidocaine. Teleflex disclaims liability for the use, application or interpretation of the use of this information in the medical treatment of any patient.

Frequent assessment is essential for safe vascular access management. Verify placement prior to each infusion and assess frequently for complications, including extravasation which can lead to compartment syndrome. Assess for flow rates and physiologic or pharmacological effects of infusions. While an Arrow® EZ-IO® catheter is in place in the proximal humerus, movement to the affected arm should be minimized and the arm should not be elevated above shoulder level. Patients should not go to MRI with an Arrow® EZ-IO® catheter. This should be part of your MRI Checklist.

Remove any extension set and dressing and attach a luer-lock syringe to the hub. While maintaining axial alignment, twist the syringe and catheter clockwise while pulling straight out. Do not rock or bend during removal. Place the catheter into a designated sharps container for sharps containment and disposal. Apply gentle pressure as needed and apply a clean dressing to site. There are no activity restrictions after Arrow® EZ-IO® catheter removal.

Potential complications may include local or systemic infection, hematoma, extravasations, or other complications associated with percutaneous insertion of sterile devices.