2015 Trumbull Memorial Hospital Demo

Intraosseous EZ-IO

Intraosseous EZ-IO

Clinical Indications:

 EZ-IO Blue Needle: >3kg (>7 lbs)  EZ-IO Pink Needle: 3-39kg (7-86 lbs)  EZ-IO Yellow Needle: >40 kg (>88lbs); excessive tissue over site; proximal humerus  Clinically unstable patient and emergent need for intravenous access; and peripheral IV access cannot be obtained in this critical patient within 2 IV attempts or 90 seconds  May be considered prior to IV access in cardiac arrest, severe clinical instability, or profound hypovolemia with alteration of mental status Contraindications:  Fracture of the bone selected for IO infusion, or IO within 24 hours (consider alternate site)  Excessive tissue at insertion site with the absence of anatomical landmarks (consider alternate site)  Previous significant orthopedic procedures (consider alternate site)  Infection at the selected site (consider alternate site)

Steps

Performed? Yes No

1. Select a site (Proximal Humerus preferred)

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2. Prep the skin with an antiseptic solution

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3. Prepare the EZ-IO driver and appropriate needle set

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4. Stabilize the site and insert appropriate needle set

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5. Remove EZ-IO driver from needle set while stabilizing catheter hub

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6. Remove stylet from catheter, place stylet in shuttle or approved sharps container

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7. Confirm placement, place commercial stabilizing device if available.

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8. Connect primed EZ-Connect

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9. Adults – slowly administer 20-40mg of Lidocaine 2% (preservative free) for pain relief Pediatrics – slowly administer 0.5mg/kg (< 20mg) Lidocaine 2% (preservative free) Do not exceed 40mg of Lidocaine 2% (preservative free) for pain relief in adults

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10. Attach pressure bag or infusion pump for continuous infusions (unless humeral IO)

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11. Begin infusion, dress site, secure tubing, and monitor site for patency or complications

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12. Due to the anatomy of the IO space you will note flow rates slower than those achieved with IV catheters unless the proximal humerus is used

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A similar procedure may be followed with manual insertion of the Jamshidi or Illinois IO needles in children, or the Bone Injection Gun or the NIO if an EZ-IO is not available.

133

EMR

EMT

AEMT

Paramedic

Extended