EZ-IO
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This document provides an overview of EZ-IO insertion for pediatric patients. It begins by stating the learning objectives, which are to understand the indications, contraindications, complications and steps for EZ-IO insertion. It then provides information on why IO access is needed when vascular access is difficult, the indications and contraindications for EZ-IO placement, and potential complications. Components of the EZ-IO system and how to select the appropriate needle set based on weight are described. Anatomical landmarks and steps for insertion are outlined, and additional resources like videos are provided for further learning. The objectives of an in-person class are stated to be practicing EZ-IO placement in a task trainer and discussing any
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EZ I/O Presentation at FCA
Presentation by John Peterson at RMH Field Care Audit on 1/18/12. videos are posted on youtube.com/4docmontey
http://youtu.be/ahCxJ5vEcF0
http://youtu.be/Av0IJ-THnIE
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Recommended
EZ I/O Presentation at FCA
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http://youtu.be/ahCxJ5vEcF0
http://youtu.be/Av0IJ-THnIE
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Endotracheal intubation involves placing a flexible plastic tube into the trachea to maintain an open airway or administer drugs. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure. Indications include CNS depression, neuromuscular disease, chest injuries, airway obstruction, and aspiration risk. The procedure requires a laryngoscope, ET tube, suction equipment, and securing the tube once placed to ventilate the lungs. Complications can include injury and intubation in the wrong airway.
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Dr. Aftab came upon the scene of a car accident and found the driver was unable to breathe properly. His efforts to clear the driver's airway were not improving the situation. Dr. Aftab remembered an alternative procedure and rushed back to his car. The document then describes different types of cricothyroidotomy procedures, their anatomy, indications, steps, and complications. It returns to the scenario, where Dr. Aftab faces another emergency case he cannot intubate due to mandibular fracture. Seeing the worsening oxygen saturation, Dr. Aftab decides to use an alternative airway procedure.
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EZ-IO
- 1. EZ-IO Insertion Danny Castro, D.O. Assistant Professor of Pediatrics Baylor College of Medicine Medical Staff Section of Critical Care Medicine Texas Children’s Hospital
- 2. OBJECTIVES By the end of this module, the learner will be able to: – State the indication(s), contraindication(s) and complications associated with EZ-IO placement – Identify the components used in the insertion of an EZ-IO – Distinguish the needle sets according to length and color – Determine the appropriate needle set based on weight and/or “5 mm mark” – Describe, in their own words, the anatomical landmarks used for each pediatric site of insertion – Outline the steps in EZ-IO insertion
- 3. EZ-IO
- 4. So why an IO??? http://images.frompo.com/i/difficult-vascular-access (original source unknown)
- 5. Indications • Difficult vascular access in emergent, urgent or medically necessary cases – Fluid resuscitation – Medication administration, etc. Contraindications • Fracture in target bone • Infection at the area of insertion • Excessive tissue (i.e. severe obesity) and/or absence of adequate anatomical landmarks • IO catheter use in past 48 hrs of the target bone • Previous, significant orthopedic procedure at the site, prosthetic limb or joint
- 6. Complications • Infection • Extravasation which could result in compartment syndrome • Pain – Insertion – Infusion • Fracture of target bone • Catheter breakage
- 7. Components EZ-IO needle sets EZ-Connect EZ-Stabilizer EZ-IO Power Driver NeedleVISE
- 8. Needle Set Selection MODIFIED FROM: http://www.teleflex.com/en/usa/ezioeducation/documents/8082_Rev_A_US_FDA_Intraosseous_Infusion_System_IFU.PDF AND www.hospitalprocedures.org Allneedlesare15gauge
- 9. Needle Set Selection • Just prior to insertion, you push the needle set (attached to driver) through the skin until the needle tip touches bone. • If 5 mm of the needle (i.e. at least one black line) is not visible outside the skin then the needle is likely to short and the next size up should be used.
- 10. MODIFIED FROM: https://www.pinterest.com/pin/469289223642339035/ Call (in no particular order): • Matt Musick • Fernando Stein AND/OR • Paul Checchia Pediatric sites of insertion: • Proximal humerus • Distal femur • Proximal tibia • Distal tibia Aseptic technique (i.e. CHG or povidone-iodine) • Don’t forget to prime (i.e. flush) EZ Connect • Aspirate slightly • FLUSH w/ 10 ml NS (adults) or 2-5 ml (infant/child) • Confirmatory methods: • Stable catheter in bone • Able to aspirate after flush • Adequate flow rate • Secure w/EZ stabilizer once placement is confirmed
- 11. Videos & other resources • Go to this hyperlink: EZ IO videos & additional resources – Prior to class, I recommend viewing the: • “Infant/child Needle Selection and Insertion Technique Animation Video” AND • “Clinical Principles PowerPoint Presentation” • Science and Fundamentals of Intraosseous Vascular Access 2013 2nd Edition (Also found on the above website. An extensive document on EZ IO covering a wealth of information) • EZ-IO Presentation
- 12. There is also an app for that…
- 13. IN-CLASS OBJECTIVES By the end of class, the learner will: – Discuss any content requiring clarification or elaboration – Perform EZ-IO placement in a step-wise manner using a task trainer