I had to take the 2 day class (UGH UGH UGH) because the 1 day would conflict with vacay (nothings getting in the way of me and Harry Potter land at Universal-especially now that I just saw the last movie!!)
So, I'm sitting there (thankfully one of my old buds was in the class she too had a conflict and had to do the 2 day) and they were talking about IO's.
A woman from the other side raised her hand and says "What is all thsi talk bout IO's what are these"
Okay, I'll give it to her, floor nurse, might not know, new nurse might not know.
The Instructor states intraosseous. She literally looks like she's confused. She goes "Okay, what does that mean?" The instructor asked "what do you do?" She answers with an indignant tone "I'm a registered nurse" The instructor broke it down and said "It's a catheter that inserts through bone, which can be used if IV access can't be established" She than askes "you can give meds and fluids through this?" (again with the confused look) The instructor goes "Yes, if placed properly you can infuse through those just like you would a regular INT"
She than shakes her head side to side still looking confused. The instructor asks what still has her confused and the response was "IF it's in the bone, the fluid would just pop back out the bone is solid all the way through!":eek:
The instructor drew a picture of a bone on the white board. She was still confused and was told to stay after on the next break.
Later on we go to lunch, my buddy and I are in line for the sandwhich line and she's talking to another nurse "I think the ER people make things up, who in their right mind would put a needle in bone? It's ridiculous, ER people think they are Gods":cool:
I was a good girl and just ordered a tuna on wheat with no tomato and kept my mouth shut. Am I missing something? Or would other's be as flabergasted as I was (yes, my spelling stinks tonight 1 word Vicodin)
My understanding is that it does hurt quite a bit. However, the patient is usually unconscious and in a full code situation and pretty close to death if not already considered dead.
In the few codes that I've been involved in, every single patient had come in by ambo with an IO already in place by the EMTs. Most of the time, the IO is placed in the tibia, but in one situation, the tibial IO was placed through the bone and we had to insert another IP in the humerus. Once the nurse had the 'drill' in his hand, it took all of 2 seconds to insert the IO and around 5 seconds to start the line flowing.
In one situation, the doctor ordered a central line AFTER the patient was stabilized, but in the ER, an IO is so much faster.
WOW! I had never heard of this. I watched the video on the EZ IO website. Why does this not hurt like H***?!?!
games and trying to avoid talking about medicine since "we're becoming nurses, not doctors."
WOW! I almost fell off my chair when I read this. Twenty years ago when I went to nursing school, knowing your medications was paramount (anyone remember doing drug cards listing all possible side effects?). I would be very wary of any nursing program that does not advocate nurses being required to know precisely what they are administering. I have read some disturbing posts by new nurses and nursing students however, hands down, this is the most troubling.
Not medications, medicine. We still learn lots and lots of meds in nursing school, and do dozens (hundreds?) of drug cards! But what the commenter meant was that we aren't allowed to do is say something like, "I think my patient has pneumonia," because that's a medical diagnosis. We have to say, "My patient has crackles in his lungs, a 101.0-degree fever, and an elevated WBC count," because those are "nursing observations." We are taught that only the doctor can say "That's pneumonia." It's stupid, but that's how they're teaching us.
I graduate from a BSN program in December, and I can't recall ever discussing IOs in a class setting. The only reason I had ever heard of them is from a friend who watched a code and mentioned it. She had previous knowledge of them from her years of working as an EMT. However, we have received enough A&P to know that a bone is not completely solid.
While I value the education I have received in my BSN program, I agree that there is too much focus on perfecting NANDAs, etc, and not enough hands on experience. They say that ADN prepared RNs have an edge after graduation because they have more hands on training and experiences. They also say BSN prepared RNs catch up in the next couple of years because of the critical thinking we have been taught. Personally, I feel we could use a little more hands on experience versus multiple classes and lectures on nursing theory, as well as a 2 classes dedicated solely to research in nursing. (which I do think has some importance; we just cover it WAY too much)
When going through medic training in the Air Force, we would routinely practice skills on each other. For some insane reason I volunteered for the NGT... never again. But I remember my fellow classmate volunteered for an IO and said that it didn't really hurt until they flushed it.
I work in the ER and we see them semi regularly. They are often on unconcious people but not always. We had a lady from a motorcycle accident yesterday with an amputated leg and she was awake and got one...although compared to the other leg I'm sure it didn't hurt much.
They are very painful when placed. After they are placed that bone is now considered and open fracture. You should remove the IO as soon as you get a new line. They are meant to be temporary. Antibiotics are always given because of the open fracture. They aren't an everyday thing but they are quick and wonderful if you need something fast and don't have a lot of other options.
I don't fault the lady for not knowing what it was upfront but to then not believe it and to bash nurses who use it shows she is very ignorant.
Up until last month I worked in the ER and never seen this done. I'm a new nurse and only learned about IO from reading my clinical skills book. We never discussed it in school. Also, it was discussed for about 30 seconds during my nurse orientation.
Specializes in Complex pedi to LTC/SA & now a manager.
I am impressed in my PN pediatrics class IO lines were discussed, not in depth, but discussed on the potential need for them. We also needed to know what IO meant for Fundamentals.
As a much older nurse than most of you writing posts, I feel I must tell all the readers that IO means "intraosseous infusion". I had to get into the textbooks to find that out. Please don't feel bad for not knowing. Every nurse cannot know EVERYTHING.
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ChuckeRN, BSN, RN
198 Posts
My understanding is that it does hurt quite a bit. However, the patient is usually unconscious and in a full code situation and pretty close to death if not already considered dead.
In the few codes that I've been involved in, every single patient had come in by ambo with an IO already in place by the EMTs. Most of the time, the IO is placed in the tibia, but in one situation, the tibial IO was placed through the bone and we had to insert another IP in the humerus. Once the nurse had the 'drill' in his hand, it took all of 2 seconds to insert the IO and around 5 seconds to start the line flowing.
In one situation, the doctor ordered a central line AFTER the patient was stabilized, but in the ER, an IO is so much faster.