Trauma Skills (IO) Flashcards
When to Use IO out of Trauma
- Paeds and adult shock
- Burns
- Drug overdose
- Hypothermia
- Drowning
- Post partum haemorrhage
When to Use IO in Cardiac Issues
- Arrest
- Arrythmias
- MI
- Congestive heart failure
- Chest pain
When to Use IO in Neurological Issues
- Status epilepticus
- Stroke
- Coma
- Rapid sequence induction
When to use IO in Respiratory Issues
All respiratory emergencies
When to use IO in Systemic Issues
- Sepsis
- Sickle cells crisis
- Dehydration
- DKA
Guidance on When to use IO in Patients and Unconcious Patients
- Had 2 unsuccessful IV attempts or IV cant be established in 90 seconds
Conscious patients that:
- Have a GCS of 8 or less
- Respiratory compromise less than 80 sats after oxygen
- Systolic >90
- Pt in need of immediate medication and/or fluids
- Profound hypovolaemia with altercation of mental status
Contra-indications of IO
- Prosthetic
- Trauma to bone eg fracture
- No anatomical landmarks
- Local infection
- Recent IO (48hrs)
What Drugs can go through IO?
All paramedic drugs
Locating Site (Humeral Head)
- Place the pts hand over their abdomen (or behind in unconscious)
- Place your palm on the pts shoulder anteriorly. The area that feels like a ‘ball’ under your palm is the general target area
- Place hands either side of the ulnar
- Bring your thumbs together, splitting the arm in half
- Palpate up the humerus to the neck of the humerus
- The insertion site is 1 to 2cm above the neck
IO Procedure
- Clean the area with a swab and chose appropriate needle size
- Set up the three way tap
- Aim the needle at a 45 degree angle, perpendicular to the skin
- Push the needle through the skin
- Look for a black 5mm line, if can see go up a size
- Gently drill until you feel it give or till the hub reaches the skin
- Hold the hub in place and pull off the needle and dispose
- Connect to the three way tap
- Aspirate for blood/bone marrow
- Flush 20ml before administering any drugsand securing
What are the Sites?
- Proximal Humerual Head - preferred site, optimal drug uptake, less painful
- Distal Femur (paeds usually)
- Proximal Tibia (Main)
- Distal Tibia
Needle Sizes
Pink - 15mm
Blue - 25mm
Yellow - 45mm (adult humeral head)
Locating Site (Proximal Tibia)
- 2 fingers down from the tibial plateau
- Then two fingers medially
- 1 finger for infants (not on growth plate)
Why do you need to Flush?
Flushing creates space, getting rid of the marrow etc and will really hurt when flushing but means fluids/drugs will hurt less later
