IO access

[littlemedic06]

Hi everyone,

I am a pretty new Paramedic working in a larger city in Connecticut and have a question was hoping someone could answer. Where is the best location for IO access in adults and children? I have the general area but for some reason still have an issue with land marks. I have asked other medics i work with and they simply stat youll just know by the feel. Well that doesnt help a new guy who has only dirlled manikins in lab before being released as a medic. If anyone could help me with this and have any tricks for getting access it would be greatly appreciated!

[Arctickat]

Have you checked Youtube? The Tibia is my preferred site.

https://www.google.ca/search?q=youtube+intraosseous&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-GB:official&client=firefox-a

[Curiosity]

A few inches bellow the knee on the tibia. Feel it, there's a flat surface slightly medial. That's my access point, and the only site we are allowed to access in my service.

If our patients have bilateral femur fx, then we're screwed.

[nypamedic43]

The tibial tuberosity is my preferred site but we can also access the humerous if need be.

[DwayneEMTP]

There's really no tricks for access in my opinion. It's often easier to start an I/O than a peripheral IV.

But before you move forward, get good with the landmarks. There is only one reason that I can imagine that you're having trouble with the landmarks, and that's because you haven't bothered to learn them. There are truly very few landmarks more easily identified than those on the Tibia.

Please believe that I mean this with respect...move away from the "New medic turned loose on his own" mentality. You've decided to accept this gig, you've decided that you want to be the guy that people call when they need help. All of the "I'm only new" in the world isn't going to help them when they intelligence, competence and confidence instead. Step up Brother...

Welcome to the City! I hope that you'll stick around for a bit...

[DFIB]

I have never actually placed an IO. It is still outside my current protocols but had convinced myself that tibial access was for pediatric patients below the age of two and adult access is in the sternum.

So tell me how far in the ditch that idea is.

[DwayneEMTP]

Pretty far off in the ditch as there's only one of the I/Os that's meant for the sternum, I think?

I've placed more than a dozen I think, and all in the tibia...very easy to do. I've used, I don't remember the names and don't have enough speed to search for them, the electric drill (FAST?) and the hand one..yeah, can't remember...

But, either way in the tibia, adult or child, it's really easy. But your landmarks are pretty important in the child so that you stay distal to the growth plates...

[DFIB]

Pretty far off in the ditch as there's only one of the I/Os that's meant for the sternum, I think?

I've placed more than a dozen I think, and all in the tibia...very easy to do. I've used, I don't remember the names and don't have enough speed to search for them, the electric drill (FAST?) and the hand one..yeah, can't remember...

But, either way in the tibia, adult or child, it's really easy. But your landmarks are pretty important in the child so that you stay distal to the growth plates...

Thanks, I will get to that module one of these days.

[Vorenus]

I have never actually placed an IO. It is still outside my current protocols but had convinced myself that tibial access was for pediatric patients below the age of two and adult access is in the sternum.

So tell me how far in the ditch that idea is.

Far as I know, the only one`s still using sternal access are military medics in the field (apart from the obvious, that you`d need different IO needles for sternal access).

[Arctickat]

Our health region has decided upon the Bone Injection Gun...unfortunately. All it means is that now I have to pay to actually get quality equipment instead of getting it for free from the region.