This presentation is only for Pediatric specific IO site location and placement For complete IO insertion education please refer to the website wwwvidacarecom 2 T 509 Insertion sites 3 Proximal ID: 581025
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EZ-IO in the Pediatric PatientSlide2
This presentation is only for Pediatric specific IO site location and placement. For complete IO insertion education, please refer to the website
www.vidacare.com
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Insertion sites
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Proximal
Humerus
Proximal
Humerus
Proximal Tibia
Proximal Tibia
Distal Tibia
Distal Tibia
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Proximal tibia
2 fingerbreadths below base of patella and 1 fingerbreadth medial
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Proximal tibia
Pinch the sides of the tibia bone between your fingers and isolate the proximal tibia
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Ability to locate accurate site on proximal tibia
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If
Tibial
Tuberosity
cannot be palpated
then find base of patella
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Ability to locate accurate site on distal tibia
Place one finger directly over the medial
malleolus
Move 2 fingerbreadths proximal
Palpate anterior and posterior tibia borders to confirm the flat center aspect of the bone
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Proximal humerus
Should only be used in patients whose landmarks can clearly be identified
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surgical neck
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Elbow
should remain
adducted &
posteriorly located
Place the hand over the umbilicus for humeral positioning and safety
Ability to locate accurate site on proximal
humerus
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Ability to locate accurate site on proximal humerus
Use the thumb to palpate up the humerus until a notch/groove is felt
Insertion site is approximately 1 cm above the site. At the most prominent point
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Pediatric EZ-IO insertion sites
Proximal Tibia
Distal Tibia
Proximal Humerus
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STEP-by-step procedure
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Chose appropriate insertion site
Identify the site by palpation
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Primary Consider tissue depth PRIOR to bone insertion
Chose appropriate needle - 15, 25 or 45 mm
Special situations
Excessive soft tissue
Excessive muscle tissue
Edema
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Prime EZ-Connect with Saline
Consider Lidocaine* if awake
Clean insertion site with antiseptic
Place needle on driverRemove needle safety cap
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Press needle set through skin until tip touches bone
At least 5 mm of the cathether must be visible
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Squeeze Driver trigger
Apply
gentle
, steady pressure
Immediately release trigger when sudden ”give” or ”pop” is felt -
indicates entry into the
medullary
cavity
STOP WHEN YOU FEEL THE POP
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Remove Driver and stylet
Use of stabilizer is strongly recommended for pediatrics
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Attach primed
EZ-Connect
Flush with normal saline
NO FLUSH. NO FLOW.
For patients responsive to pain,consider administering 2% lidocaine prior to flush
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Confirm placement with at least 3 of 4 methods
Stability of catheter
Ability to aspirate
Physiological or pharmacologic changesAdequate flow rate
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Apply EZ-IO wristband
Do not leave catheter inserted for more
than 24
hours
NOTE!Monitor insertion site frequently for extravasation
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