IO catheters - Adult

[Bwick]

We are starting to see more IO catheters with some of our trauma patients. I've been looking for some info and there isn't a ton out there - especially nursing info. If you use some of the newer devices, what kind of dressing do you use? Also, when removing - how long do you apply pressure?

Thanks for your help

Sue

[ready4crna?]

Sue- I hope this helps some-

As far as dressing-It depends on the accessed site and product used. Jamshidi needles (typically iserted into the lower extremities) are meant to be temporary and as such, I would use gauze and tape mainly for the purpose of stabilizing the needle itself. The sternal accesses I would use a transparent dressing as this would adhere better. Either way, someone should be attempting central venous access asap.

With removal- depending on the pt's coags, prolonged pressure should not be necessary, like around 5 minutes in a non coagulopathic pt. Compare it to bone marrow aspiration and how long you would hold pressure.

As always, you are going to be able to fluid resus your adult trauma better with large bore venous access than I/O. As a former paramedic though, the I/O can truly save your patient when you do not have the time to mess around with multiple attempts peripherally.

Too point you to good literature, you might try pediatric references. The adult I/O has been around forever, but gaining popularity IMO due to recent battlefield advances (the sternal devices for example).

[Bwick]

Thanks for your input! Any and all is apreciated!

Sue