IO's with Co-Inventor Scotty Bolleter


Steve, Dan, and Holly introduce Scotty Bolleter, one of the co-inventors of the EZ-IO. Steve begins by asking Scotty how he got started in EMS, and what led him to help create the EZ-IO. Scotty discusses his time as a flight paramedic, and how his time spent training in hospitals pushed him into EMS business ventures. Steve touches on his business ventures in EMS. 

Scotty walks the trio through his team’s process of modifying older devices to create their version of the EZ-IO. Scotty talks about his inter-disciplinary team of physicians, engineers, and others. The correct process of placing a humeral IO is discussed, from positioning the patient to proper placement for insertion. The process of IO flow is explained. Scotty discusses possible complications if an IO is placed wrong. 

Scotty discusses use of the distal femur IO placement in cardiac arrest at his department. IO placement in the femur versus the humerus or the tibia is compared. Pediatric IO placement is reviewed. Scotty highlights the open IO, and when it is indicated. Correct IO placement is recapped, and Scotty touches on why EMS providers should not bury an IO needle into the bone. Steve reviews a call on a patient in status seizure where an IO is used for access. 

Learning Points: 

  • Be inquisitive and question the status quo, medicine is always advancing 
  • Drilling patients is safer than hammering a device in
  • Confirm IO placement by aspirating bone marrow
  • Place patient in anatomically correct position prior to IO insertion
  • Once a provider feels the device drill through the compact bone, stop drilling 
  • Humeral IO: place thumb on greater tubercle and drill perpendicular at the base
  • It is advised not to place an IO if the patient’s humerus is going to be moved
  • Larry Miller was the principle inventor of the EZ-IO
  • Putting a needle into a growth plate will not harm the bone
  • In pediatrics, place needle below the growth plate
  • Practice inserting an IO into a raw egg for practice 
  • Never bury the IO into the bone, feel the IO push through the compact bone and stop
  • 15mm, 15g needle (pink needle) is too small for pediatric patients 

    Content Creator: Steve Williams
    CAPCE Course Number: 20-EMTP-F3-8202
    Total CE Hours: 1
    Level: Advanced