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Entrance Exam Prep > IO > Flashcards

IO Flashcards

1
Q

Which of the statements concerning placement of the EZ-IO Vascular Access System are correct?

a) Avoid excessive pressure on driver during insertion
b) Apply the EZ-Stablizer Dressing after removal of the stylet
c) The EZ-Connect Extension Set should be primed
d) Monitor the extremity/site frequently for signs of complications
e) All of the above

A

e) All of the above

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2
Q

For patients that respond to pain, consider using 2% lidocaine (preservative and epinephrine free)
IO prior to initial flush.

a) True
b) False

A

a) True

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3
Q

Pain management for patients who are alert or responsive to pain may include regular periodic
assessment for pain response AND PRN infusions of lidocaine following medical protocols.

a) True
b) False

A

a) True

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4
Q

The EZ-IO Vascular Access System may be considered for use in the following situations/patients:

a) Anytime vascular access is difficult
b) When there is an urgent, emergent or medically necessary need for vascular access
c) As a bridge to a central venous catheter or PICC placement
d) All of the above

A

d) All of the above

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5
Q

Several studies and articles suggest the humerus may be a superior site for flow rates, drug delivery and management of infusion pain.

a) True
b) False

A

a) True

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6
Q

Which of the following is NOT a contraindication for use:

a) Infection at the insertion site
b) Recent fracture of the target bone
c) Previous IO in target bone within 48 hours
d) Presence of prosthesis or hardware at site
e) Anticoagulant use by patient

A

e) Anticoagulant use by patient

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7
Q

You have inserted the needle set into the soft tissue and have not reached the bone, and cannot see a black line on the needle remaining outside the patient’s skin.

You should: stop and choose a longer needle length OR consider selecting a different IO site.

a) True
b) False

A

a) True

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8
Q

In the event of an emergency, product failure, or need for immediate assistance; clinicians should call the emergency phone number listed on the wristband or removal poster.

a) True
b) False

A

a) True

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9
Q

Optimal flow rates can be obtained using gravity drip rates.

a) True
b) False

A

b) False

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10
Q

A rapid syringe bolus (flush) of the EZ-IO Catheter will facilitate optimal flow.

a) True
b) False

A

a) True

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11
Q

Studies have shown that infusions via the proximal humerus IO site generally have a faster flow rate compared to tibial insertion sites.

a) True
b) False

A

a) True

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12
Q

Insertion of EZ-IO Vascular Access is a sterile procedure requiring sterile gloves, mask and gown.

a) True
b) False

A

b) False

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13
Q

The 45 mm needle set is recommended for proximal humerus insertion on patients weighing greater than 40 kg.

a) True
b) False

A

a) True

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14
Q

Pain management for patients who are alert/responsive to pain may include (select all that apply):

a) Regular assessment for pain response
b) One time only administration of 2% lidocaine
c) 2% lidocaine per MD order/hospital protocol
d) Pain should not be an issue, there is no perceivable pain

A

a) Regular assessment for pain response
c) 2% lidocaine per MD order/hospital protocol

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15
Q

Care and maintenance of the insertion site (with catheter in place) includes (select all that apply):

a) Securing with an EZ-Stablizer Dressing
b) Periodic, regular assessment of the site
c) Soaking the driver in antimicrobial solutions between use
d) Identifying how long the needle should remain in place

A

a) Securing with an EZ-Stablizer Dressing
b) Periodic, regular assessment of the site
d) Identifying how long the needle should remain in place

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16
Q

If you are unable to aspirate blood when confirming placement, you should attempt to flush the
IO while assessing for evidence of extravasation.

a) True
b) False

A

a) True

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17
Q

The EZ-Connect Extension Set primes with approximately:

a) 1.0 mL
b) 0.5 mL
c) 0.25 mL
d) None of the above

A

a) 1.0 mL

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18
Q
  1. Labs cannot be drawn using an IO site.

a) True
b) False

A

b) False

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19
Q

The 25 mm needle set can ONLY be used in adult patients.

a) True
b) False

A

b) False

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20
Q

To remove the catheter, attach a luer-lock syringe to the hub and rotate the syringe and catheter clockwise while pulling straight out.

a) True
b) False

A

a) True

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21
Q

The EZ-IO is indicated for immediate vascular access in an emergency.

  • True
  • False
A
  • True
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22
Q

Rapid syringe bolus or flush after EZ-IO insertion is optional.
* True
* False

A
  • False
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23
Q

What type of clinical scenarios is IO vascular access used? (check all that apply)
* Anaphylaxis
* Dehydration
* Sepsis
* Stroke
* Burns

A
  • Anaphylaxis
  • Dehydration
  • Sepsis
  • Stroke
  • Burns
24
Q

The EZ-IO identification wristband contains the following: (check all that apply)
* Remove in 24 hours
* Time and date of insertion
* Patient name
* Toll free emergency support telephone number

A
  • Remove in 24 hours
  • Time and date of insertion
  • Toll free emergency support telephone number
25
Q

Which of the following is NOT a contraindication for use?
* Recent fracture of the target bone
* Presence of prosthesis or hardware at site
* Infection of the insertion site
* Previous IO in target bone within 48 hours
* Anticoagulant use by patient

A
  • Anticoagulant use by patient
26
Q

The EZ-IO® Vascular Access System may be considered for use in the following situations/patients: (check all that apply)

  • When there is an urgent, emergent or medically necessary need for vascular access
  • A 48 hour infusion of life saving medication
  • Anytime vascular access is difficult
  • As a bridge to a central venous catheter or PICC placement
A
  • When there is an urgent, emergent or medically necessary need for vascular access
  • Anytime vascular access is difficult
  • As a bridge to a central venous catheter or PICC placement
27
Q

How many black lines are on the blue EZ-IO needle sets?
* 2
* 3
* 1
* 4

A

2

28
Q

What is the typical fluid volume that a clinician can infuse under pressure when placing and IO in an adult proximal tibia?
* .5 L/hr
* 1 L/hr
* 5 L/hr
* 6.3 L/hr

A

1 L/hr

29
Q

The 5 mm mark on the EZ-IO catheter: (Check all that apply)
* Has no significance to the insertion process
* Must be verified upon catheter removal
* Appears only on the EZ-IO catheter itself
* Provides a visual marker (when the needle tip is touching the bone) indicating enough catheter length is present to safely enter the medullary space

A
  • Appears only on the EZ-IO catheter itself
  • Provides a visual marker (when the needle tip is touching the bone) indicating enough catheter length is present to safely enter the medullary space
30
Q

Removal of the EZ-IO: check all that apply

  • Can be facilitated by attaching a sterile luer lock syringe to the catheter hub
  • Should be accomplished within 24 hours
  • Requires clockwise rotation and gentle pulling (maintaining the syringe at a 90 degree angle to the bone)
  • Can be accomplished by reattaching the driver and gently pulling perpendicular to the bone when engaging the driver
A
  • Can be facilitated by attaching a sterile luer lock syringe to the catheter hub
  • Should be accomplished within 24 hours
  • Requires clockwise rotation and gentle pulling (maintaining the syringe at a 90 degree angle to the bone)
31
Q

The expiration of the EZ-IO needle set is:
* 2 years
* 4 years
* There is no expiration date
* 7 years

A
  • 4 years
32
Q

Which of the following is an anatomical landmark to help landmark for the proper insertion site in the adult proximal tibia? Check all that apply

  • Tibial Tuberosity
  • Patella
  • Greater Tubercle
  • Flat surface of the tibia approximately 2 cm medial to the tibial tuberosity
A
  • Tibial Tuberosity
  • Patella
  • Flat surface of the tibia approximately 2 cm medial to the tibial tuberosity
33
Q

The ________ is the insertion site for the proximal humerus
* Medial Malleolus
* Tibial Tuberosity
* Humeral Head
* Greater Tubercle

A
  • Greater Tubercle
34
Q

What is the length of the EZ-IO yellow needles?
* 15 mm
* 45 mm
* 25 mm
* 35 mm

A
  • 45 mm
35
Q

The EZ-IO complies with OSHA and JACHO standards for bloodborne pathogens and needlesticks.
* True
* False

A
  • True
36
Q

Typical pain control for IO infusions in an alert patient should include: (Check all the apply)

  • Patient restraints
  • General sedation with Fentanyl & Versed
  • Adults: 40 mg of 2% (preservative and epinephrine free) Lidocaine - IO - prior to initial bolus or infusion.
  • Pediatrics: 0.5 mg/kg of 2 % (preservative and epinephrine free) Lidocaine – IO – prior to initial bolus or infusion.
A
  • Adults: 40 mg of 2% (preservative and epinephrine free) Lidocaine - IO - prior to initial bolus or infusion.
  • Pediatrics: 0.5 mg/kg of 2 % (preservative and epinephrine free) Lidocaine – IO – prior to initial bolus or infusion.
37
Q

Which of the following is an FDA cleared EZ-IO insertion site for the adult and pediatric patient:
* Proximal Tibia
* Distal Tibia
* Proximal Humerus
* All sites listed are viable

A
  • All sites listed are viable
38
Q

The EZ-Connect® Extension Set primes with approximately:
* 1.0 mL
* 0.25 mL
* No correct answers listed
* 0.5 mL

A
  • 1.0 mL
39
Q

Care and maintenance of the insertion site (with catheter in place) includes: (check all that apply)
* Soaking the driver in antimicrobial solutions between use
* Periodic, regular assessment of the site
* Securing with an EZ-Stablizer® Dressing
* Identifying how long the needle should remain in place

A
  • Periodic, regular assessment of the site
  • Securing with an EZ-Stablizer® Dressing
  • Identifying how long the needle should remain in place
40
Q

When placing an IO. The user wants the tip of the needle to end up in what anatomical structure?
* Cortical Bone
* Axillary Artery
* Axillary Vein
* Cancellous Bone

A

Cancellous Bone

41
Q

EZ-IO PD (15 mm ) Needle Set insertion is MOST appropriate for:
* Ideal patients between 3 – 39 kg
* Obese pediatric patients
* Patients weighing 40 kg and above
* None of the listed answers

A
  • Ideal patients between 3 – 39 kg
42
Q

Gloves are required for EZ-IO placement.
* True
* False

A
  • True
43
Q

Optimal flow rates for the EZ-IO infusions can be obtained with gravity.
* True
* False

A
  • False
44
Q

How quickly will medication reach the heart on an adult when the clinician uses the proximal humerus for the IO insertion site?
* 3 seconds
* 10 seconds
* 20 seconds
* 35 seconds

A
  • 3 seconds
45
Q

Which of the following fluids should NOT be recommended to be given through the EZ-IO?
* Saline
* Vesicant Drugs
* D50
* Adenosine

A
  • Vesicant Drugs
46
Q

Distal Tibia Insertion Instruction (Adult)

A

The insertion site is approximately 3 cm proximal to the most prominent aspect of the medial malleolus. Palpate the anterior and posterior borders of the tibia to assure that your insertion site is on the flat center aspect of the bone.

47
Q

Proximal Tibia Insertion Instruction (Peds)

A

The insertion site is approximately 1 cm medial to the tibial tuberosity, or just below the patella (approximately 1 cm) and slightly medial (approximately 1 cm), along the flat aspect of the tibia

48
Q

Distal Tibia Insertion Instruction (Peds)

A

The insertion site is located approximately 1‐2 cm proximal to the most prominent aspect of the medial malleolus.

49
Q

Distal Femur Insertion Instruction (Peds)

A

The insertion site is approximately 1 cm proximal to the superior border of the patella and approximately 1‐2 cm medial to midline

50
Q

Pain Protocol for EZ-IO

A

1) Confirm lidocaine dose per institutional protocol
2) Prime extension set with lidocaine (approximately 1.0 mL) Adults: Typical initial dose is 40 mg
Infant/Child: Typical initial dose is 0.5 mg/kg, not to exceed 40 mg
3) Slowly infuse lidocaine IO over 120 seconds
4) Allow lidocaine to dwell in the IO space for 60 seconds
5) Flush with normal saline
6) Slowly administer an additional dose of lidocaine IO over 60 seconds. Repeat PRN
Adult: Typical additional dose is 20 mg
Infant/Child: Typical additional dose is half the initial dose)

51
Q

How often does vascular access fail during emergency situations?

A

Up to 40% of the time

52
Q

What products should be used with caution through EZ-IO?

A

Use caution when infusing hypertonic solutions, chemotherapeutic agents, or vesicant drugs. Follow medication administration with a flush.

53
Q

Is EZ-IO a sterile procedure?

A

No

54
Q

According to clinical data how painful is the insertion of the Arrow® EZ-IO® System, and infusion when using the device?

A

EZ-IO® System insertion pain on average rates as a 3 on a 0-10 pain scale with lidocaine use.

EZ-IO® System infusion pain for the proximal humerus is an average 1.8 on a 0-10 pain scale with lidocaine use.

EZ-IO® System infusion pain for the tibia is an average 2.2 on a 0-10 pain scale with lidocaine use.

55
Q
A

Entrance Exam Prep (2 decks)

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