EZIO in the Pediatric Patient 1 This presentation

EZ-IO in the Pediatric Patient 1

• 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 T- 509 2

Insertion sites Proximal Humerus Proximal Tibia Distal Tibia T- 509 3

Proximal tibia • 2 fingerbreadths below base of patella and 1 fingerbreadth medial T- 509 4

Proximal tibia • Pinch the sides of the tibia bone between your fingers and isolate the proximal tibia T- 509 5

Ability to locate accurate site on proximal tibia If Tibial Tuberosity cannot be palpated T- 509 then find base of patella 6

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 T- 509 7

Proximal humerus • Should only be used in patients whose landmarks can clearly be identified surgical neck T- 509 8

Ability to locate accurate site on proximal humerus Elbow should remain adducted & posteriorly located Place the hand over the umbilicus for humeral positioning and safety T- 509 9

Ability to locate accurate site on proximal humerus • Use 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 T- 509 10

Pediatric EZ-IO insertion sites Proximal Tibia T- 509 Distal Tibia Proximal Humerus 11

STEP-BY-STEP PROCEDURE T- 509 12

• Chose appropriate insertion site • Identify the site by palpation T- 509 13

• 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 T- 509 14

• Prime EZ-Connect with Saline • Consider Lidocaine* if awake • Clean insertion site with antiseptic • Place needle on driver • Remove needle safety cap T- 509 15

• Press needle set through skin until tip touches bone • At least 5 mm of the cathether must be visible T- 509 16

• 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 T- 509 17

• Remove Driver and stylet • Use of stabilizer is strongly recommended for pediatrics T- 509 18

• Attach primed EZ-Connect • Flush with normal saline NO FLUSH. NO FLOW. • For patients responsive to pain, consider administering 2% lidocaine prior to flush T- 509 19

20 T- 509

• Confirm placement with at least 3 of 4 methods – Stability of catheter – Ability to aspirate – Physiological or pharmacologic changes – Adequate flow rate T- 509 21

• Apply EZ-IO wristband • Do not leave catheter inserted for more than 24 hours • NOTE! Monitor insertion site frequently for extravasation T- 509 22