Contraindications to IO insertion include
fracture at or proximal to the insertion site
, cellulitis or other infection overlying the insertion site, prior attempt at the insertion site, or bone disease such as osteogenesis imperfecta or osteopetrosis.
When would you insert an intraosseous infusion?
Intraosseous infusion (IO) is used in pediatric populations during anesthesia when other intravenous access, central venous catherization or venous cutdown, are difficult to use or cannot be used.
When individuals are severely ill and are in need of “rapid, efficient, and safe delivery of drugs”
, IO is used.
Can nurses insert intraosseous?
RN’s, physicians or EMT-P’s may insert an
IO device after they have completed instruction with clinical supervision
. An order must be received to by a physician for a RN or EMT-P to insert an IO. 3. … RN must place the IV fluid bag on either a pressure bag or use an IV pump for infusion.
Where do you insert intraosseous?
The needle is inserted on
the medial surface of the tibia at the junction of the medial malleolus and the shaft of the tibia, posterior to the greater saphenous vein
. The proximal humerus is an alternate site. It has the potential advantage, during shock or cardiac arrest , of being closer to the central circulation.
Who can place IO?
Trained physicians
who have completed the required Intraosseous
How painful is intraosseous?
7 Extreme Pain: Although IO
insertion looks painful
, when inserted with a drill device, it is reported to be no more painful than an insertion of an 18g IV cathlon. There have been reports of increased pain with high-pressure infusions in conscious patients related to stimulation of pressure sensors within the bone.
What drugs can be given intraosseous?
While all resuscitation drugs can be given by the IO route, administration of
ceftriaxone, chloramphenicol, phenytoin, tobramycin, and vancomycin
may result in lower peak serum concentrations. The most common adverse effect seen with IO use, extravasation, has been reported in 12% of patients.
How do you confirm intraosseous needle placement?
A properly placed IO line must be through the cortex of the bone and situated within the marrow cavity. Standard methods for confirmation of IO placement include aspiration of bone marrow,
firm placement of the IO needle into the bone, and no evidence of extravasation
.
Can you transfuse blood through an IO?
Any intravenous fluid, blood products or routine resuscitation drugs can be administered through
the IO route. Complications for short term use are relatively rare compared to the advantages for a child who needs rapid administration of blood or fluid.
How long can an intraosseous needle remain in situ?
The intraosseous needle may remain in situ for
72 to 96 hours
, but it is best removed within 6 to 12 hours, as soon as an alternative site of intravascular access has been established. The intraosseous route provides fast and reliable vascular access in emergency medical situations.
How big is an intraosseous needle?
EZ-IO Set Components: Needle:
15 gauge
.
What can be infused through an IO?
The IO infusion allows for
blood sampling and administration of virtually all types of fluids and medications including vasopressors
Why does flushing an IO hurt?
This can be attributed to several factors.
IO infusion through the tibia is typically more painful
, and the pain is more difficult to manage than when infusing through the humerus for conscious patients. In addition, an inherent pulse pressure must be overcome before any positive flow can be achieved.
What are disadvantages of intraosseous route?
Known rare complications of IO access include
extravasation, soft-tissue necrosis, bone fractures or injury to growth plates
, infiltration of medications, infection, subcutaneous abscess, osteomyelitis, and embolic complications (fat emboli). Extravasation of fluid is the most common complication.
Does IO access hurt?
7 Extreme Pain: Although IO insertion looks painful, when inserted with a drill device,
it is reported to be no more painful than an insertion of an 18g IV cathlon
. There have been reports of increased pain with high-pressure infusions in conscious patients related to stimulation of pressure sensors within the bone.
Is IO faster than IV?
An IO is a quick way to get vascular access in a code,
faster than an IV
and with greater first-attempt success.
