CARDIAC ARREST AND CRITICAL SVT PATIENTS
REVIVED BY SAM IO DURING COVID-19 PANDEMIC
On the frontlines of the fight against COVID-19 within New Orleans - a hot spot area that was killing residents at higher rates than in other parts of the US - seasoned first responder with experience as a search and rescue paramedic, hoist operator and flight paramedic, Lane Abshire raced to help two different patients suffering from cardiac arrest and a serious supra-ventricular tachycardia (SVT) episode. In these cases, intravenous access was necessary, but both were unattainable with an IV. He recalls the scenes of the incidents:
“The first patient was an adult male suffering cardiac arrest. Based on his critical condition, I reached for the SAM IO to access the vascular system fast. The first insertion was a proximal tibia insertion. The device fit comfortably in my hand and the 25mm SAM IO needle was easy to seat on the device. I had no issues with insertion of the needle after identification of landmarks. The needle was successfully inserted after puncturing the skin and performing 2-3 full squeezes of the device.
I was impressed I could easily remove the needle while still attached to the device and securing the needle in the sharps device that came with the needle. I found that having the needle attached to the device during removal provided good leverage and safety as opposed to having to remove a needle bare-handed with the potential of having soiled gloves and slippery hands depending on the type of emergency. The SAM IO provided great flow of fluid administration resuscitation throughout the cardiac arrest, reviving the patient. I have not had to use a pressure bag to infuse fluids on any attempt that I have had with the SAM IO. To me, the SAM IO has a better flow rate than other IO devices I have used. The second incident was with an alert adult male experiencing supra-ventricular tachycardia (SVT). I had an additional medic on scene who was unable to establish intravenous access, so I made the decision to perform the awake IO procedure with the SAM IO in order to provide the necessary Adenosine administration quickly. This was a time-sensitive case requiring emergent intervention.
Given the patient was awake, I was concerned about the pain he was about to experience with the insertion, especially because the SAM IO is not a continuous rotation of the needle. I prepared all the equipment and identified landmarks without incident. I punctured the skin with the device and began squeezing the SAM IO device upon feeling the needle on the head of the humerus. I believe I squeezed a total of 4 times by the time the needle was inserted to an appropriate depth.