How do you use an intraosseous needle?

Procedure

1. Identify the appropriate site.
2. Prepare the skin.
3. Insert the needle through the skin, and then with a screwing motion perpendicularly / slightly away from the physeal plate into the bone.
4. Remove the trocar and confirm position by aspirating bone marrow through a 5 mL syringe.

How much do I flush in an IO?

Flush the IO catheter with 0.9% normal saline, (5-10mls for Adults and 2-5mls for Paediatrics). Flushing will help clear the marrow and fibrin from the medullary space, allowing for effective infusion rates. For Adults: Use either a syringe bolus or pressure bag capable of generating 300mmHg pressure.

How long can an IO needle stay in?

Often, definitive IV access is easier to obtain once a bolus of fluids and medications has been administered via the IO needle. IO needles may be left in place in the marrow for up to 72-96 hours; presumably, the longer the needle remains in place, the greater the risk of infection and dislodgment.

How much fluid can you push through an IO?

The IO access allows rapid fluid administration to provide the required volume resuscitation in patients in shock. The IO flow rate may reach up to 150 mL/min in either the tibial or humeral route when the pressure bag is inflated up to 300 mm Hg [36].

Can you draw blood from EZ IO?

All medications that can be given via central line can also be given via IO line. Blood can be drawn and sent for lab analysis just as with IV access. Although an IO line only has one lumen, there are multiple possible insertion sites, and multiple IO lines can be placed in the same patient simultaneously.

How do you tell if an IO needle is inserted correctly?

Use a twisting motion with gentle but firm pressure. until there is a sudden release of resistance as the needle enters the marrow space. If the needle is placed correctly, it should stand easily without support.

Can you bolus through an IO?

Fluid does not flow as rapidly through an IO catheter as through an IV line; therefore, adult patients should be given crystalloid boluses with a pressure infuser device.

What Cannot be given io?

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.

Can blood be given 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 much fluid can go into an IO?

The maximum rate of administration through the IO needle was reportedly equivalent to a 21 G peripheral cannula [23]. The flow rates of an intravenous cannula are typically in the range of 200 (16 G peripheral cannula) to 20 ml/min (24 G peripheral cannula) [30].

Can I draw blood from a io?

At this time, only ABO blood grouping is possible on intraosseous (IO) blood specimens. Why this is important: IO blood sampling is a procedure for obtaining blood from the bone marrow. An IO line is established to provide fluid and medication when intravenous access is not available or feasible.

What I Cannot give Io?

The IO access can be used to draw blood samples. In hemodynamically stable patients, just after the IO needle is placed sodium, magnesium, calcium, lactate, glucose, blood gases (pH and PCO2), and hemoglobin values are similar between IO and IV accesses.

Can nurses start io?

2. 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.