Trauma skills - IO, Decompress, pressure infusers, decompression, hemorrhage control Flashcards
IO indications
Cardiac arrest, difficult IV in hypovolemia, needs fluid or drugs within 5 minutes, two IV attempts or 90 seconds
Equipment
Gun, needle, IV solutions tubing fluid, stopcock 60cc and 10cc syringe, gauze, extension tubing and tape
Landmarks for proximal tibia
2cm below patella 2 cm medial to tibial tuberosity
Landmarks for distial tibia
3cm proximal to most prominent aspect of medial malleolous. Palpate anterior and posterior borders of tibia to ensure your insertion site is on flat central aspect
Once you’ve drilled
Slowly inject 10mL of NS and attempt to aspirate marrow/blood. Check for increased resistance, extravasation, bleeding, occlusion, dislodgement.
Attach infuser, labels EZ-IO wristband on pt, reasses pt
Complications of IO
Extravasation, compartment syndrome, dislodgement, fracture, failure, pain, ,infection
Contras to IO
Infection, fractures, prosthesis, IO within 24 hours, don’t do two IOs in same extremity, osteogenesis imperfecta, excessive tissue or unable to landmark
Indications for decompression
Poor compliance, decrease/loss of consciousness, hypotension, hyper-resonance, absent breath sounds, respiratory distress, JVD, tracheal deviation
Oxygenation for tension pneumo
Supplemental high flow oxygen to patient and/or ventilation support NRB/BVM
Equipment for decompression
10-14G IV catheter optimum length 5cm 10mL syringe
Iodine/betadine/alcohol swabs
Tape/securing device and heimlich valve with connection tubing or other type of flutter valve
Landmarking
Explain procedure to pt, landmark 2nd or 3rd intercostal space midclavicular or 4th or 5th intercostal midaxillary
Decompression procedure
Swab, take cap off and attach 10mL syringe with 5mL. Stick it in then tape, avoid kinking/bending. Reassess lung sounds, attach heimlich valve. Constant monitoring
Bleeding control procedure
Direct constant pressure, compress as much as possible
Maintain pressure, only move once to identify correct spot if needed
Horizontal or slightly head down positioning.
CAT
Wound packing dressing with hemostatic agent
Bleeding control others
Support airway/oxygenation and ventilation
Fluids
Lactated ringers increase cytokine which contributes to lactic acidosis
NS can cause hyperchloremia
Both can cause neutrophil release