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Adult Intraosseous Infusion
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Protocol number: GEN-001 INTRODUCTION:
The technique of intraosseous
infusion (IO) was first described over 70 years ago. It has been
used extensively since that time for the administration of
fluids, medications
TRAINING:
The EZ-IOTM infusion
system requires specific training prior to patient use.
INDICATIONS:
Adult patients (Greater than 12
years of age or > 40 Kg)
ONLINE*1. Intravenous fluids or medications needed and
a peripheral IV cannot be established with 2 attempts or within 90
seconds AND exhibit 1 or more of the following:
a. An
altered mental status (GCS of 8 or less)
b.
Respiratory compromise (Such as patients with a SaO2 90%
after appropriate oxygen therapy or a respiratory rate < 10 or >
30 / min)
c.
Hemodynamic instability (As noted by a decreased BP, decreased skin
perfusion, or weak or absent radial pulses).
*Must receive
Online Medical Direction approval prior to introduction of
IO.
STANDING2. EZ-IOTM may be considered PRIOR
to peripheral IV attempts in the following situations:
a. Cardiac
arrest (medical or traumatic) or near arrest
b. Profound
hypovolemia (Shock) with altered mental status
c. Urgent
need for IV but venous access is not readily available
CONTRAINDICATIONS:
CONSIDERATIONS:
Flow
rates:
Due to
anatomy of the IO space flow rates may be slower than those achieved
with IV catheters.
·
Rapidly flush (bolus) 10 ml saline with a
syringe through the EZ-IO
·
Use a pressure bag or pump for continuous
infusions
Pain:
Insertion
of the EZ-IOTM in conscious patients causes mild to moderate
discomfort and is usually no more painful than a large bore
IV.
Infusion
through the EZ-IO may cause severe discomfort for conscious
patients.
·
Prior to IO flush (bolus) on an alert
patient, SLOWLY administer 20 to 40 mg (1-2mL) 2% Lidocaine
(Preservative Free) through the EZ-IOTM.
PRECAUTIONS:
EQUIPMENT:
Adult IO Kit including:
PROCEDURE:
If the patient is conscious,
advise them of the EMERGENT NEED for this procedure and obtain informed
consent.
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