Standards Procedure (Skill)
Clinical Indications: Level: EMT-P only
Ř Inability to obtain peripheral access in a patient greater than 12 years of age that requires access in an emergent manner.
Procedure:
a. Assemble standard intravenous access equipment as well as IO needle. If a commercial kit is being used, follow the procedure recommended by the manufacturer.
b. Access for trauma, infection, decreased pulses, and decreased sensor motor function (if possible) in the lower extremity where the line is to be placed. If any of these are present, choose another site or method for access.
c. Rotate the chosen leg externally to expose the medial tibia.
d. Locate the medial malleolus. (Is this not in the ankle?) Move one to two finger-widths anteriorly and locate the flat area of the tibia just medial to the tibial crest (okay I don’t know where this is.)
e. Prep the site with Betadine. If time allows, drape the site.
f. Holding the IO needle perpendicular to the site, insert the needle with a twisting motion until you feel decreased resistance or feel a “pop”. Stop advancing the needle.
g. Remove the trochar.
h. Begin infusion of IV fluids. The fluids should flow easily. Once ease of flow has been established, the line may be used just as any other IV line.
i. Stabilize the IO catheter.
j. Dispose of the IO trochar in an appropriate approve container.
k. Record the procedure, time, any complications, and patient response in the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.