Firstly, I'd like to say that I think you did an EXCELENT job. Those runs always have a bit of "Pucker Factor" but I think you did quite well. While I have not one single problem with your treatment I do have some insight into your situation. I am a medic in the Midwest US. Over the last 5+ years, IO's have been getting huge here. At first they were just for pedi's in arrest. With my current department, we have what's called the EZ-IO (look it up). It is basically a power drill with a needle on it. It's an AMAZING tool. Only used it once myself on an adult in arrest, but I have trained a lot with people who use them constantly and it is quickly becoming the standard. Most protocols I know of use some IO device for any arrest at any age. The consensus is that the 30 seconds time and 95+ succuss rate is better than the 1-3min and 60-70 percent success rate of an IV. While the IO is a bit more 'brutal', the patients that need it are far beyond that point. I have also seen video and heard 1st-hand stories of IO training. EMT's recieved IO's and relate the pain level to that of an IV.(Think about it, there aren't many nerves in the bone) They state most pain come from the pressure used to bolus the saline. My current protocol allows for a bolus of 100mg Lidocaine (Xilocaine) for that reason. In the end, I would say that in your situation I most likely would have started the IO. BUT, I certinly have NO problem with a "Diesel Bolus" either. I applaude your recognition of the severity of the child and it is certinly a testement to you, that you are agonizing this much over a run. And THAT is what makes a good medic! Stay safe out there! Chris Turner