Intraosseous Infusions- anyone using it yet?

Sun0408, ASN, RN · Oct 4, 2011

We use them frequently until a central line can be placed for our trauma pts.. However, as soon as the central line is in, the IO is removed.

GinaCat · Oct 4, 2011

We use them frequently until a central line can be placed for our trauma pts.. However, as soon as the central line is in, the IO is removed.

is that because of infection risk? (i don't know much about it). thanks for answering!

danh3190 · Oct 4, 2011

Paramedics in PA have been able to do IOs for some years now. Maybe about 5 years ago we got IO drills that allow us to put them in adults. Before that we had to put them in by hand and that pretty much limited us to kids with their softer bones.

I've only done one IO, on an adult trauma patient. Very easy to do though it took a little psychological effort to get me to drill into someone's bone. In our protocol we administer some lidocaine first if the person in conscious because as I understand it, although the insertion of the IO isn't very painful, infusion through the IO is supposed to be very painful. As I said, my patient was unconscious so no first hand experience with that.

miss81, BSN, RN · Oct 4, 2011

We use them in an emergent situation for both adults and paeds until we can get another line. I find it works well for a short time, but they tend to leak and are very painful. That's my experience...

emtb2rn, BSN, RN, EMT-B · Oct 4, 2011

I'm also in NJ. Our medics have using IO access for a number of years and we've had a drill in the ER for the past 2 years. Faaaast. Especially when the pt comes in BLS cpr in progress.

NeoPediRN · Oct 4, 2011

We see IOs all the time where i work. If there's a code and the patient doesn't have clear attainable access EMS will throw in an IO. We use them on pedi codes often for rapid access. Everywhere I work has a 24 hour max policy before another form of access must be found. We also use an IO drill where I work now.

murphyle, BSN, RN · Oct 4, 2011

We have the EZ-IO setup in our department, but I've never seen our people place one (the IOs I've seen have all come from EMS or transferred from other hospitals). Interestingly, our staff nurses and the nurse practitioners over in Peds are all up on it; it's the physicians who won't let us use it. They'll (very!) grudgingly use an EMS IO during a code, but you won't find a single physician who will agree to us placing one. I'm not sure why. Lack of experience, or previous bad experience with old IO setups, perhaps?

tewdles, RN · Oct 4, 2011

I learned how to do this in the mid 80's, it is a life saver for pedi trauma patients.

Rangerjoe · Oct 4, 2011

My EMS system has been doing IO's for a long while, but we just got the drill about two years ago. We will usually put them in after the first failed attempt on an IV during a cardiac arrest. I actually put one in last week on an obese 43 y/o female that had a PE. Humeral placement in less then 10 secs. Love the drill compared to manual placement. You just have to be careful on ped's because once the drill bites it has a tendency to pull itself in with little to no pressure being exerted by the technician. There is a video circulating around that shows IV and IO infusions under fluro with contrast. It's impressive.

ZooMommyRN, ADN, RN · Oct 4, 2011

almost all incoming adult codes have on in place by the time they hit our doors, we have EZ-IO equipment but haven't got to use it yet, I'd like to tho, however it seems our IV skills prevent the use lately lol

JulieCVICURN, BSN, RN · Oct 5, 2011

We've been talking about it and I keep hearing it's going to become more of a standard, but it hasn't yet. At least, not in my facility.