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Why attempt a UVC line when intraosseous access is often available and the literature has demonstrated its ease of placement and effectiveness even in neonates? This article is not intended to suggest giving up IO vascular access if you currently have it in your toolbox. The intent was to discuss an alternative to IO vascular access when it fails--for example, when a tibia is fractured during an IO attempt or is not an option for other reasons. The Fast-Cath UVC is another tool in the advance EMS clinician's arsenal that can be easily learned and utilized. It is an effective option for vascular access in the distressed newborn when other options have failed or are not available.

Delivering a new life into the world is truly a unique and proud moment, not just for the EMS providers who may do only one in their careers, but also for the parents, who probably did not think their new baby would be born outside the hospital.Due to the infrequency of delivering a baby in the prehospital environment, and even more rarely having to perform a major resuscitation on a newborn, perseverance in reviewing and preparing for delivering the newborn who requires ventilation cannot be overlooked, downplayed or pushed to the back of the training calendar. All EMS providers, services and systems need to allocate time for review and improvement in the knowledge, skills and attitudes required to conduct a major resuscitation of a distressed newborn.

For professions that operate in dynarnic environments, developing and improving team performance is a significant issue. Paramedics often utilize advanced, high-risk, low-frequency clinical procedures such as endotracheal intubation, rapid sequence induction, needle chest decompression and surgical airways. These procedures are performed in a team environment alongside EMTs and first responders. Though these groups (paramedics and EMTs/first responders) operate together on scenes, if they come from different organizations, they may rarely train together. By combining the training they receive, each of these groups can improve their cybernation, or the high degree of preparedness and skill achieved when a team performs its individual and collective tasks not only correctly, but also with the rapid and smooth automaticity that's the hallmark of high-performance teams.