IV and IO access Flashcards
where is the needle placed in IO cases
in the bone marrow which is highly vascular, quickly and easily absorbed
indication for IO cases
need for emergency vascular cases when cases cannot otherwise be easily obtained
contraindications of IO acsess
infection at the site
fracture of the bone of insertion
prosthetic joint or limb at chosen site
cautions
- very small infants, avoid over insertion by stopping when you hear a ‘pop’
- conscious patient
-pervious IO in the same limbs within last 24 hours
how to locate the proximal tibia in adults
-3cm (2 finger widths) down from the base of the patella (kneecap)
- one finger breath inwards( towards midline), 1cm medially from the tibial tuberosity, finding the flat aspect of the tibia
- ( where the top right of my skar is )
how to locate proximal tibia for a paediatric
1 cm down from patella
1 cm inwards (towards midline
how should an IO be drilled in for adults
apply steady pressure advancing the needle 1-2 cm until the needle reaches the skin or until you feel a pop or give
how to drill in an IO for peads
apply pressure until there is a pop or give
what colour IO needle for pads
pink
what colour IO for proximal tibia
blue
what colour for the proximal humerus
yellow
when is lxignicoane indicated for IO cases
Intraosseous injection for significant bone pain associated with intraosseous administration
e.g. patient not arresting/responsive to pain
what do you need to do before drilling
push the needle down until you hit bine without drilling( do not cut downwards pressure, just let it sink in) , ensuring you can still see the 5mm line
steps of getting an IO
- locate and mark insertion site
- push down without drilling until meet bone
- ensure can still see the black Cather line
- drill advancing until needle reaches skin or you feel it give or pop
what must be done after the IO is in place
- remove the needle from the IO
- sharps away
- place dressing over the Hib
- aspirate for bone marrow with a 5 ml syringe
- flush firmly with 5ml saline
- lignocaine if indcated
name some complications of IO cases
pain, fracture, dislodgement of acsess, infection, compartment syndrome, air emboli
how to find humeral head for IO cases
- bend pts arm over body (as if it were in a sling) 90 degrees
- with palm, feel for big round lump, that is the general area to aim for
- place one of your hands vertically, parallel to your collarbone and the other on the midline of the delt
- palpate with your thumbs up the arm until your feel the humeral head, it will feel like a gold ball on a tee
5.the spot where the “ball” meets the “tee” is the surgical neck. - The insertion site is 1–2cm above the surgical neck, on the most prominent aspect of the greater tubercle.
what is the line primed with for a conscious/ pt that can feel pain
prime line with lignocaine not saline
