Oh, icky! Yuck! WEIRD feeling!! - page 2
I put in my first intraosseous this morning. Man, that felt weird! I've taken PALS many times but in the beginning that was a doc-only job. Luckily I had the medic standing next to me talking me... Read More
Jan 2, '07Quote from SharonH, RN:yeahthat: LOL, I can really relate to that sig line these days!Off topic: LOVE your siggy line!!!!Last edit by bullcityrn on Jan 2, '07
Jan 2, '07Good job. I've only read about it. In ACLS we don't practice on chickens, at least not in the classes I've been in. The codes I've been in have all been adults and we've always had or been able to get access.
Jan 2, '07I, too, am sorry bout the outcome, TazziRN.
This is very under-utilized. Not sure if it would have made a difference in this case, but should employ IO ASAP - after two or three attempts at venous access or 90 seconds, whichever comes first.
Article from eMedicine for those interested in this procedure:
eMedicine - Intraosseous Access : Article by Pegeen Eslami, MD
When I teach PALS, I teach insertion with these two particular IO:
... Illinois sternal iliac IO
I personally use the first one for it fits better in my hand (small hands). The other one is too large and clumsy for me.
Everyone develops their own technique of insertion.
Jan 2, '07EMS made two IO attempts and 1-2 periph attempts without success (baby was cold). I made 2 periph attempts and got flash but couldn't thread, so tried the IO.
Jan 2, '07No, one. Their IO's have short needles and the baby was chunky. Ours has a longer needle and I was able to get it in. The medic said they're not allowed to try anywhere else except the tibial plateau.
Jan 2, '07We use the IO route in vet med too especially in birds and very small puppies and kittens. The first time I did one it gave me the heeby jeebies LOL.
Jan 2, '07Quote from TazziRNIs that where you got yours? I wasn't aware that there were other sites you could use... (Sad about the outcome...)The medic said they're not allowed to try anywhere else except the tibial plateau.
Jan 2, '07Quote from AliRae'Is that where you got yours? I wasn't aware that there were other sites you could use... (Sad about the outcome...)
Tibial plateau, sternum, iliac crest (can also use this for bone marrow asp), distal humerus......those are the places I can think of right off.
Jan 2, '07I've done this once ... it got access but the outcome still wasn't good.
I'm with you TazziRN ... did not relish doing it at all ...
Jan 2, '07Our life flight nurses showed us a new tool that they use. It's a little one handed, battery drill that just bores into the tibial plateau and the bit slides out. We practices on the dummy leg and it wasn't too bad. I still wouldn't want to do it though. blech! Accessing a port finally stopped giving me the heebie-jeebies.
Jan 3, '07Here's a website for the EZ IO gun, used for tibial and humeral insertion.
Intraosseous Vascular Access for Rapid Injection and Infusion: Vidacare EZ-IO
And the FAST-1 is also popular for adult sternal IO's.
Pyng Medical Corporation - Product Guide