What type of device goes in the ankle during cardiac arrest??

Specialties CCU

Published

Specializes in Cardiac, CVA.

Wondering if any of you cardiac/CCU nurses can tell me what this may be...

My husband's coworker was found unconscious earlier this week at work and when the EMS arrived they immediately went into CPR/defib, IV drugs, etc...but they also put a device of some sort of device into the ankle and it had a little needle on the end of it....

I'm guessing it was some sort of IO IV...:unsure:

Up Vote Up Vote ×
Specializes in NICU, ICU, PICU, Academia.

Most likely an IO - placement is a little strange though.

Up Vote Up Vote ×
Specializes in CICU.

I learned to put IOs just below the knee, but that was a long time ago.

Maybe it was a regular IV.

Up Vote Up Vote ×

IO for sure. Weird place though. Our ED and EMS providers loooove IOs. We keep them for the 1st 24 hours just in case. Even after they're lined. If it was the intensivist working down near the foot I would say maybe an a-line. I had a dorsalis pedis a-line once. It was... Strange. Haha.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Ankle? Probably just a plain ole IV....there are some really good ankle veins.

Up Vote Up Vote ×

It was most likely an IO. The first choice for selection for a drill-based IO is the tibial tuberosity below the knee cap. If the pt has had knee replacements or trauma to that area, the second selection is the medial malleolus at the ankle. Last spot is the shoulder which is very difficult to palate and positional. Some 'driver' type IOs can be started sternal as well.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
It was most likely an IO. The first choice for selection for a drill-based IO is the tibial tuberosity below the knee cap. If the pt has had knee replacements or trauma to that area, the second selection is the medial malleolus at the ankle. Last spot is the shoulder which is very difficult to palate and positional. Some 'driver' type IOs can be started sternal as well.

I have only seen lateral malleolus/distal tibia in the pedi population.

Up Vote Up Vote ×

It really depends on the insertion device. The EZ-IO drill is approved for the distal tibia in adults. It is not a common insertion site. In our facility, I do the education for all ICU nurses. The EZIO is used in codes in places of dropping in a femoral CVL. I've done tons of knee insertions, but only one ankle. It worked just as good as the knee though.

Up Vote Up Vote ×
Specializes in Critical Care.

Wouldn't it be better practice to just drill an EZ-IO in the ankle rather than start an IV on a vein? I've heard of cases of patients having IVs started in their lower extremities and then keeling over in a few days from a DVT.

Up Vote Up Vote ×
Specializes in ICU.

You have to keep in mind that an IO is terribly painful to start and equally as painful to infuse things through so you can usually only use it while your patient remains unresponsive. If they wake up you have to start using lidocaine when you infuse through it. An IO is also only good for 24 hours at my facility. I'd be interested to see a case where a pt "keeled over" from a DVT. I would think this would be pretty rare since we start an IV in a superficial vein rather than a deep vein.

Up Vote Up Vote ×
Specializes in Critical Care.

I wish I could recall where I found it, but it was an actual case.

That's true about IO being painful and only short-term, though. Might as well just put in a central. That would fix everything hah

Up Vote Up Vote ×
Wouldn't it be better practice to just drill an EZ-IO in the ankle rather than start an IV on a vein? I've heard of cases of patients having IVs started in their lower extremities and then keeling over in a few days from a DVT.

My wager is that immobility is the more likely component. Well, that plus something else that increased coagulability of the blood.

Up Vote Up Vote ×
+ Add a Comment