Intraosseous Medical directive

Question 1

Intraosseous Indications

Answer 1

Actual or potential need for intravenous medications OR fluid Therapy
AND
Intravenous access is unobtainable
AND
Cardiac Arrest or Pre-arrest state

Question 2

Intraosseous Conditions

Answer 2

Anyone

Question 3

Intraosseous Contraindications

Answer 3

Fracture or crush injuries proximal to access site
Suspected or known replacement / prosthesis proximal to access site

Question 4

You must attempt an IV prior to Intraosseous access?

Answer 4

False
IV must considered, although you dont need to attempt and fail an IV
Document on ACR supporting rationale to bypass IV

Question 5

CPER approved Sites?

Answer 5

Proximal Tibia
Proximal Humerus (adults only)

Question 6

How do you landmark proximal tibia site?

Answer 6

1. Rotate leg externally
2. Find medial and lateral condyles of tibia
3. Find tibial crest and tibial tuberosity
4. Insertion site 1 - 2 fingers below and medial of tibial tuberosity

Question 7

How do you landmark proximal Humerus site?

Answer 7

1. Internally rotate shoulder
2. Find Greater tuberosity by sliding fingers up surgical neck of humerus
3. Insert needle at 45 degree angle

Question 8

What are 3 common IO needle Sizes and Colours?

Answer 8

1. Pink - 15mm
2. Blue - 25mm
3. Yellow - 45mm

1. Paed 2. most common 3. Excessive adipose

Question 9

After inserting IO needle into skin what marker MUST be present prior to drilling?

Answer 9

5mm marker at top of needle