Intraosseous access in ED

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Dharmesh Shukla

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Dec 28, 2011, 4:52:10 PM12/28/11

to ABEM (Old Group), ABEM, Peter McGuire

In the last week, I had to use the IO route twice in our ED. Those who were with me in those shifts including the unfortunate shift of 29th morning have seen how quick it is.

The IO route has frequently been forgotten in our ED, with "needs contrast CT but no big canula" being a frequent problem.

We have EZ-IO brand intraosseous device. All drugs that are given IV can be given by IO route, including - Code medications, RSI drugs, Fibrinolytics and IV CT contrast. AND IT IS LESS PAINFUL THAN IV CANULA.

Do use the proximal humerus route - it is minimally painful, and do flush with 10 ml saline fast if you do not aspirate blood.

Almost guaranteed wide bore access in 10 seconds flat, with minimal pain and much less complications than CVCs.

Take a look at the following webpage: http://lifeinthefastlane.com/2011/03/seizing-and-no-access/.

Just one problem: the IO needles are not sometimes replaced, and you might find that you have the drill only and no adult needle when you need it. So if you are the person who just used that last needle - like me on 29th - talk to the Head Nurse Office so that they can replace it.