What are the indications for IO insertion?

Indications. IO access is the recommended technique for circulatory access in cardiac arrest. In decompensated shock IO access should be established if vascular access is not rapidly achieved (if other attempts at venous access fail, or if they will take longer than ninety seconds to carry out.)

There are already multiple methods for confirming IO placement, including return of bone marrow, visualization of blood in the stylet, firm placement of the needle in the bone, and the ability to smoothly deliver a fluid flush.

Similarly, where do you place an IO? Choose a location for IO needle placement. Location options include: Proximal tibia: on the medial (flat) side of the tibia at the level of the tibial tuberosity, 3 cm distal to the inferior border of the patella (1-2 cm in infants/children).

Also to know is, what are the sites for IO insertion in children?

Technical principles. The preferable puncture sites in children for intraosseous access are the proximal tibia (the site may be located by placing a finger 1 cm below the tibial tuberosity and then sliding the finger 1 cm medially), the distal tibia (2 cm above the medial malleolus), and the distal femur.

What Cannot be given intraosseous?

While all resuscitation drugs can be given by the IO route, administration of ceftriaxone, chloramphenicol, phenytoin, tobramycin, and vancomycin may result in lower peak serum concentrations. The most common adverse effect seen with IO use, extravasation, has been reported in 12% of patients.

What size is the blue IO needle?

The 25 mm (blue hub) and 15 mm (pink hub) needles may be inserted manually.

How bad does an IO hurt?

Insertion of IO needles in conscious patients causes mild-moderate discomfort and is usually no more painful than a large bore IV. Infusion through an IO line may cause severe discomfort for conscious patients and preservative-free lidocaine should be administered.

How long does intraosseous last?

Thus, the use of IO access should be limited to a few hours until IV access is achieved without exceeding 24 hours.

How do you secure an IO needle?

Place the padded mask over the IO needle. The IV tubing can be threaded through the hole at the top of the mask. Secure the mask by wrapping circumferential tape around the extremity and mask as a unit. This mask trick works whether the IO needle is in the tibia, femur, or humerus.

When should Io be attempted before IV?

IO placement may be considered prior to peripheral IV attempts in cases of cardiopulmonary or traumatic arrest, in which it may be obvious that attempts at placing an IV would likely be unsuccessful and or too time consuming, resulting in a delay of life-saving fluids or drugs. 1.

How do you insert an intraosseous needle?

Procedure Identify the appropriate site. Prepare the skin. Insert the needle through the skin, and then with a screwing motion perpendicularly / slightly away from the physeal plate into the bone. Remove the trocar and confirm position by aspirating bone marrow through a 5 ml syringe.

When should IO access be attempted before vascular?

IO access can be performed safely in children of all ages, and it can often be achieved in 30 to 60 seconds. In certain circumstances (eg, severe shock with severe vasoconstriction or cardiac arrest), it may be the initial means of vascular access attempted.

How do you use the EZ IO drill?

Steps to Insert an EZ IO Attach needle set to the driver – allow magnet to connect between hub and driver. Remove safety cap. Stabilise the limb with your non dominant hand. Push needle through the skin until the tip of the needle rests on the bone – do not use the drill to push to needle through the skin.

Can you draw blood from an intraosseous?

Blood drawn from an IO can be used for type and cross, chemistry, blood gas. There is not good correlation with Sodium, Potassium, CO2, and calcium levels.

What is the preferred route for access of drugs when intravenous access is not available?


What is intraosseous route?

Intraosseous infusion. Intraosseous infusion (IO) is the process of injecting directly into the marrow of a bone. This provides a non-collapsible entry point into the systemic venous system. This technique is used to provide fluids and medication when intravenous access is not available or not feasible.

Can nurses do intraosseous?

The Emergency Nurses Association and ACEP both have positions that support the use of intraosseous (IO) vascular access to include insertion by nurses. Yet IO remains an underutilized technique in most emergency departments. Nurses say that doctors are unfamiliar, uncomfortable, and resistant to using IO.

How do you remove an IO needle?

Removal should be performed: within 24 hours of insertion. Removing the EZ-IO catheter involves disconnecting infusions, attaching a 10 ml luer-lock syringe to the catheter hub, then rotate the catheter clockwise-while pulling straight back, disposing of catheter in bio-hazard container, and apply simple dressing.

Is an IO a central line?

Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. In their protocol, IO catheters were the first-line access for patients in cardiac arrest and were to be used if a CVC could not be placed after two attempts or within 5 minutes.