This thing is frigging cool. The EZ-IO system is an incredibly fast and efficient way to get access on a patient in seconds.  I was trained using old fashioned intraosseous lines put in by hand – and generally only ever used on babies.  Now, this little drill puts one in in a flash to either the tibia, the humerus, or the ankle.  You can blast fluids, bloods, and most meds into them at a very rapid rate. The military just puts one into each of your shoulders through your uniform when you get shot in the field!

They can stay in for 24 hours and are a lifesaver. Also a time saver in cases where it is going to take a million years to put in an IJ line. Watch the video of this guy getting on in his humerus.

Often times a “DNR” on a patient is welcome news because you know that the family (and sometimes the patient themselves) have realized the futility of resuscitative measures. It helps prevent them from going through painful and futile medical procedures and endless tests.

However sometimes you breathe deep sign of relief for more selfish reasons (I wonder if this post will get flamed by some wackos – we’ll see I guess). This selfishness if because you just know that “doing everything” is going to be a huge amount of time consuming and likely difficult work – and all for naught.

Perfect example is when a 450 lb severely debilitated elderly patient (how they made it that far is beyond me) comes in very SOB with a huge bull neck and likely nightmarish airway. You find out they are DNR and DNI (appropriately so) and relax a little. You put them on BiPAP but don’t raise your own BP to 230 systolic trying to get a damn ET tube into their airway. You don’t need to put in that central line – which would have required puncturing the needle through an endless amount of edematous fat in the vague hope of finding the IJ vein. You know this futile case is not going to drain away all your energy and back the rest of the ED up while you are out of commission. They get admitted to the floor so no arguing with that arrogant ICU fellow.

It just is better – for both the patient AND the doctor.

So we all know the old saying “When it rains, it pours” to describe how crap keeps piling on even after you’ve already gotten totally screwed. Anyway, the other day I had to call an doctor for a consult – and I could immediately tell he was annoyed and was having a very bad weekend call.

After I finished with my case, I told him “Wait, Dr So and So next to me also has a case for you.”

He grumbled and asked why whenever we call him with a case, there is always a second case? I replied, “Well, I’m sorry but when it rains it pours.”

He corrected me, “No, when it rains I get fu**ed”!”