Ep 104 - The IV vs IO Trials

About this episode

Dr Jarvis discusses recent RCTs comparing IV and IO access in out of hospital cardiac arrest in light of the new AHA guidelines.

Right on the heels of the release of the 2025 AHA guidelines, including one on preferentially using IVs over IOs, comes two RCTs in the same edition of NEJM that compare intial attempts with IVs to IOs in out of hospital cardiac arrest. Dr Jarvis discusses these two papers while answer a listeners question, and tries to put this, and early epinephrine, into context. And he might throw in some commentary about the AHA's recommendations on mCPR and Heads Up CPR. Citations: 1. Couper K, Ji C, Deakin CD, et al. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2025;392(4):336-348. doi:10.1056/NEJMoa2407780 2. Vallentin MF, Granfeldt A, Klitgaard TL, et al. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. N Engl J Med. 2025;392(4):349-360. doi:10.1056/NEJMoa2407616

People in this episode

Host: Dr Jarvis

Topics covered

• IV vs IO
• cardiac arrest
• AHA guidelines
• RCTs
• epinephrine
• mCPR
• Heads Up CPR

Keywords

• IV
• IO
• cardiac arrest
• AHA guidelines
• epinephrine
• RCT
• mCPR
• Heads Up CPR

Mentioned in this episode

Organizations: AHA

Books & works: N Engl J Med, A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest, Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest

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