Intraosseous emergency access by physicians wearing full protective gear

Objectives: To assess prospectively and randomly the feasibility, speed, and success rate of establishing an intraosseous access using the Bone Injection Gun (BIG) while wearing antichemical outfits. Methods: Attempts to introduce intraosseous injection with or without a full protective gear (antichemical body suit, face mask, and butyl gloves) were performed using a turkey bone model. Time to proper placement was measured. Results: The average time to successfully insert the BIG's needle while wearing a protective gear was 32 +/- 3 seconds compared with 22 +/- 2 seconds (p < 0.05) without the outfit. Success rate was greater than or equal to 80%. When failure occurred, a second attempt always proved successful. Conclusions: The intraosseous insertion of the BIG's needle is rapid and easy but requires 50% more time when wearing protective gear than without it. Its use during emergent treatment of toxic mass casualty is of potential benefit and needs further investigation.