【Background】Access to the circulation is a critical component of resuscitation. However, Japanese paramedics are prohibited to perform intraosseous infusion (IOI) and only performing peripheral intravenous access. Previous survey showed more than 2/3 of out of hospital cardiac arrest (OHCA) patients could not receive peripheral intravenous access by paramedics in Japan.
【Purpose】We investigated the knowledge and the technical problems of Japanese paramedics performing IOI.
【Methods】Under the approval of the Ethics Committee, licensed Japanese paramedics with more than 5 years of experiences (n = 10) attempted IOI insertion to the humeral head and the proximal tibia of the cadavers. The time of each steps of needle insertion and success rate of the IOI were compared.【Results】There were no significant differences in time of each steps to insert needles (Total time,humerus (97.4±3.3seconds) and tibia (95.7±3.3seconds)) and success rate (humerus (82%) and tibia (86%)). Discrepancy of the time to detect the landmark of the insertion site was observed (coracoid process (21.6 ± 1.8 seconds) and tibial tuberosity (17.2 ± 1.8 seconds).
【Discussion】IOI insertion, to both humerus and tibia, showed higher success rate than peripheral venous catheter insertion, which war similar results from the previous studies of IOI in other countries. Japanese paramedics have equivalent knowledges and technique of IOI compare to the paramedics in other countries.
【Conclusion】We considered IOI is reliable method to establish infusion route in case of emergency, even for Japanese paramedics. We assumed that the proximal tibia is relatively safer and higher success rate to establish IOI route because it is easy to detect the anatomical landmark, if there are no contradictions.

6 - Comparison of the success rate of intraosseous infusion performed by Japanese paramedics.