IO feb 252022 Flashcards
What is the primary purpose of an Intraosseous Injection?
Provides fluid and/or medication access using the medullary sinuses in bone marrow of the long bones
When should an Intraosseous Injection be used?
After x2 failed vascular access attempts or if placement time is greater than 90 seconds
List at least three indications for Intraosseous Injection.
- Cardiac arrest
- Hemodynamic instability
- Respiratory failure
- Status seizures
- Critical burns
- ALOC
What are the contraindications for Intraosseous Injection?
- Recent fx or absent pulses in the selected limb
- Local infection/cellulitis to the selected site for insertion
- Excessive tissue or inability to landmark appropriately
- Recent IO placement at insertion site (48 hours)
- Prosthesis
True or False: Intraosseous Injection is contraindicated in the case of local infection at the insertion site.
True
What complications can arise from Intraosseous Injection?
- Extravasation
- Compartment syndrome
- Pain
- Dislodgment
- Skin necrosis
- Subcutaneous abscess
- Fat embolism
- Tibial fx
- Osteomyelitis/Cellulitis
- Growth plate injury
- Fluid overload/reduced flow
How many approved insertion sites are there for Intraosseous Injection?
Three
Name the approved insertion sites for Intraosseous Injection.
- Proximal humerus
- Proximal tibia
- Distal tibia
What types of Intraosseous insertion devices are available?
- Battery Powered EZ-IO
- Impact driven (bone injection gun)
- Manual IO needles
What is the length and usage of the pink EZ-IO needle?
15 mm, used for patients that weigh 3-39 kg
What is the length and usage of the blue EZ-IO needle?
25 mm, used for patients that weigh equal or greater than 40 kg
What is the length and specific usage of the yellow EZ-IO needle?
45 mm, used for patients with excessive tissue or large bone, specifically in the adult proximal humerus
Fill in the blank: The __________ is a hand-held, lithium battery-powered needle driver approved for use in AHS EMS.
EZ-IO
What should be done to prepare the site for a humeral IO procedure?
Use antiseptic technique
What angle should the needle set be aimed at during the humeral IO procedure?
45-degree angle to the anterior plane and posteromedial
What is the required depth for the needle set in the humeral IO procedure after entering the medullary space?
Approx. 1-2 cm
What technique should be used for proximal tibia insertion during an IO procedure?
Insert IO approx. 2cm medial to the tibial tuberosity or approx. 3cm below the patella
What angle should the needle be aimed at during the proximal tibial insertion?
90-degree angle to the center of the bone
Where should the distal tibia insertion site be located?
Approx. 3cm proximal to the most prominent aspect of the medial malleolus
What indicates successful placement of the IO catheter?
The catheter is firmly seated and does not move; blood or marrow can be aspirated
How should the site be flushed after Intraosseous Injection?
- Adults: 10 mL NS
- Pediatrics: 5 mL NS
What is the pressure setting for an adult procedure using a pressure infuser?
150-300 mmHg
What should be monitored to avoid during fluid administration in pediatric patients?
Fluid overload
What is included in the EZ-IO Kit?
- Hand-held IO drill
- IO needles x2 of each size (15mm/25mm/45mm)
- IO tubing set
- 10 mL syringe
- 20 mL syringe
- Stabilizer
- Pressure Infuser/3 way stop cock
- Antiseptic swabs
