Suzanne M., Vascular Access Team Lead, explains how the NIO™ simplifies central line establishment, especially in code situations.
"... we use them weekly—sometimes daily. It's been a real game-changer for us."
Manuela M., Clinical Lead Rapid Response Nurse, describes her facility's success with the NIO™, especially in code blue situations.
"Recently, I have used it in three code blues—it was the humeral head. Had no issues with it, [it had] good positioning."
Tanya S., RN, is a member of the Rapid Response and Vascular Access Team. Here, she recounts how her team was able to quickly and safely reestablish central access with the NIO™ after a patient's peripheral IV had been lost in transit.
"I love that you're able to use them on patients of all sizes—that's another huge benefit. Especially in a more obese patient where we would typically have a harder time getting access..."
Tasha, Nurse Educator for Anaheim FD, explains why her department chose to carry the NIO™ over a popular drill-based device.
"... it started off being cost-effective and then after we started using it after the trial, we realized how much easier it was to use..."
Assistant Chief Nicholas M. gives his firsthand account of how the NIO™ successfully established intraosseous access in a cardiac arrest code blue patient faster than our competition.
"Before they were even able to put the needle on the gun, we had the IO in place and established [with the NIO]. Immediately hooked up an IV line to it and we were able to infuse fluids without even having to put pressure on the bag."
Natalie, an Atlanta paramedic, describes her repeated success using the NIO™ to treat bariatric patients.
"I find this great with obese patients... I've found that I have not missed with obese patients."
Tanner, an Atlanta Paramedic, explains why usability and accessibility are some of his favorite features of the NIO™.
"I would swear by it if I could. It is by far the most easily accessible and easily insurable IO access that I've used. You can't miss."
Shane C., Paramedic with Powder River First Responders, recounts an event in which the NIO™ allowed for IO access when traditional IV access wasn't feasible.
“The NIO is one of the slickest tools I have used. IO access was gained in seconds on a patient involved in a motorcycle wreck. IV access would have extended scene time especially as the injuries to the patient precluded using a tourniquet on either arm. The NIO allowed us to get fluids to the patient, where an IV wasn’t even feasible.”
After experiencing issues with a popular drill-based device and manual devices, Paul, a paramedic with Grady Health Systems, decided to review the NIO™ as an intraosseous option.
Paul Beamon is part of the reason Georgia paramedics can perform intraosseous injections. Back in the early 2000s, he approached the board that governed the state’s paramedic practice and asked for the capability, and the successful study that resulted led to IOs being added to Peach State medics’ scope of practice.
The challenge since has been finding the best tool to deliver them. Back then his service used a gun-type device with an automatic spring-loaded needle, but that could jam and cause recoil without the right technique. More recently at Atlanta-based Grady Health System, providers used a popular drill system and manual devices but had problems with cost and loss.
“After reviewing the NIO™ and changes they’d made to it and using it a few times, I was sold,” Beamon says. “I found it very comparable with other devices, but with greater ease of use. The problems I’d experienced with previous devices were not there with this one.”
The NIO is a small, light automatic intraosseous device designed for safe, quick, and easy vascular access without drills, batteries, or extra parts. Coming assembled and ready to use, it provides vascular access in as fast as 10 seconds.
“Literally that day,” Beamon says, “we had people using it and having success and feeling great about it. It actually changed people’s minds from wanting to go back to [an alternative system] to wanting to just keep the NIO.”
That was this summer, and the positive reception has continued through the ensuing quarter.
“I’ve been very pleased with the use of the device—the success rate has been phenomenal,” Beamon says. “It’s just an all-around easy device to use, and I think patients benefit from it.”
November 2018 Issue EMS World Magazine
After multiple failed attempts to gain peripheral IV access, Sam, Emergency Dept. Clinical Leader at UF Health Shands Hospital, turned to the NIO™ to gain rapid intraosseous access.
“We had a come in from EMS that was on and off coding and required numerous interventions and medications. Numerous attempts were made for peripheral access with no success. We had just begun to transition to the NIO™ devices and used this as an opportunity to both teach and obtain access on a critically ill patient.
The NIO worked flawlessly and the pigtail with stopcock allowed us to quickly administer and flush medications with ease.”
"The initial reason for looking into the NIO was price. Since we have put it into service, it has done exactly what we hoped it would do—save us money by being a more cost-effective device without any sacrifice to patient care."
Beginning early in 2019, Woodford County EMS made the decision to change from using the EZ-IO®, which we had for many years, over to the new NIO device that was now on the market. Initially, the main reason for the switch was the price comparison between the two devices. The EZ-IO—which worked flawlessly for us for years—required that crews keep up with multiple, variously sized needles as well as a battery-powered driver. All of these components needed to be stored together, taking up space in the crews’ jump kits.
The price had become an issue since we are a smaller-budget service, so we are always conscious of money and looking for ways to save money without sacrificing patient care.
Seeing the NIO in action for the first time at a cadaver lab was nothing short of impressive. Ease of use, the speed at which the device was deployed, the speed at which fluid flow was shown, and the fact that it was an all-in-one system, complete in one simple package. These factors, along with the cost comparison, were enough for us to decide to make the switch over to the NIO. Being one of a few EMS services in Kentucky to use them, we didn’t have a lot of contacts to reference how it had worked for their service, but after seeing and working with it in the cadaver lab, we felt it was worth the switch.
Within a few weeks of acquiring the NIO and getting the crews trained, we had several deployments. Since then, we have had numerous deployments on both adult and pediatric patients—both went very well. No system is flawless, and we had a few early hiccups—the sales team and manufacturer of the NIO were amazing to work with. Even though we as a service assumed it was operator error, never once did the manufacturer nor our sales rep initially state that. They took the devices that we encountered issues with all the way back to their testing facility to examine them and make sure it was, in fact, operator error and not a problem with their product. They returned their results, and with that, offered to come and provide us updated training on ways to avoid duplicating errors we had made.
Training is 100% the key to success with the NIO device. Our service is made up of experienced providers, all of whom were fluent with the EZ-IO system. Training experienced medics on new devices, as we all know, is never easy. The team from PerSys Medical and Bound Tree—who I had the pleasure of meeting initially at the cadaver lab—came to our service and spent an entire day training, answering questions, helping, and making sure that when they left our place, our team was ready to go into the field and be successful with their product.
After the first few months of usage, PerSys and Bound Tree both returned to our service, listening to the experiences we had had so far, and making sure every medic at our service was comfortable with the usage of the device going forward. Since their follow up training session, our success rate with multiple deployments has been above 95% success on the first attempt.
The initial reason for looking into the NIO was price. Since we have put it into service, it has done exactly what we hoped it would do—save us money by being a more cost-effective device without any sacrifice to patient care. PerSys Medical, along with Bound Tree, has produced, sold, trained, and, most importantly, STOOD BEHIND this device since we began using it in 2019.
Kent Berry, Assistant Director
Woodford County EMS