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IO access


littlemedic06

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Our health region has decided upon the Bone Injection Gun...unfortunately. All it means is that now I have to pay to actually get quality equipment instead of getting it for free from the region.

Same here: we have the BIG plus Cook needles.

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That's the gun that you push down really hard on until you hear the "snap" and it's supposed to be in place?

I didn't like that, though I only used it once, and it was easy, though failed. I used it when one of the docs asked me to start one..I can't remember why now..I had a borderline bariatric patient without the bariatric needle. I mashed the hell out of it, but maybe my guess on what they considered bariatric was off..

I'm sure it works fine, I just didn't like the whole, "push and pray" thing...Do you know what I mean? Not choosing when to stop, but hoping that it was placed right based on something else that I don't understand..

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The fast one is a medieval looking device that is forced into the sternum. Very brutal looking , but effective. The Pt had better be unconcious. if not they will be when they see you coming at them with it.

The B.I.G. is the gun that effectively shoots the needle into the bone .

EZ IO is the drill which in my personal opinion & experience is the easiest to use and be sure that you will get it correctly placed. different size and length needles.

Our protocols allow the tibia or humorous for placement.

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We use the EZ IO, and I love it! Done it half a dozen times or so now... Looking forward to us going to that first-line for cardiac arrests. I practiced with the BIG and the manual IO's... prefer the EZ. I've only ever placed them in the tibia, but I know some people have done them in the humerus as well.

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Being a medic student and never having done a 'real' IO except on chicken bones, we were taught for children use the anterior tibia. If that location was compromised then try the following distal femur, distal tibia, or anterior superior iliac spine(older children). On adult start with the anterior tibia and if unable to access then, if you have the correct tools, go to the sternum or humerus.

Has anyone ever done an illiac spine?

I don't know all the protocols for the services in my area but one service is allowed two attempts for peripheral IV and if both fail go straight to IO. What are y'all's protocols for using an IO?

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  • 2 weeks later...

I have used the EZ-IO twice in so far in my internship and I enjoyed it as a mainline form of IV access. Site was the tibial plateau both times. Not 100% on whether or not humeral access is permitted but even if I had the option I'm pretty sure I'd still prefer the tibia as my site since it is larger and the plateau serves as a stable base for access.

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