This is the intraosseous infusion skill.
First thing that you want to do is to explain the procedure to our patient.
From there we are going to go ahead and assemble our equipment.
For this skill we'll need IV soultion
an administration set
our IO needles and an insertion device
our sharps container as well as tape, alcohol,
gauze, syringes and kerlix
You'll also need PPE consisting of glove and eye protection.
Now were are going to prepare to spike the bag.
First we want to grab our saline solution
and make sure that we have the proper solution with a good expiration date
We also want to make sure that the solution is clear
and there is no particulate matter.
We are also going to make sure that the tail ports
still have the protective coverings on them.
Next we want to make sure that we have the correct administration set
with the proper drip rating.
We want to remove it from the package
making sure it stays untangled
and make sure both ends still have the protective covers on the ports.
Lastly we want to make sure our flow clamp is close to our drip chamber.
From here we are going to remove the protective cap
from the administration set
as well as the saline bag
while maintaining sterility
we are going to puncture the seal
Turn our bag upright
squeeze our drip chamber filling it halfway
From there we are going to bleed
and purge all air from the line
Once all the air has been purged
we'll close the flow clamp
reattach the administration set to itself
hang our bag
and prepare for using the IO.
Now we are going to prep the rest of our equipment
for the IO puncture.
First we want to prep the tape and securing device.
We want to remove the kerix from its packaging
and tape one side of each end together.
From there were are going to make sure
we have our alcohol swabs
and we are going to make sure that we have the proper PPE.
We are now going to choose the appropriate anatomical site
for the IO puncture which in this instance
will be inferior to the tibial tuberosity.
Right here.
We are going to take our alcohol swab
and clean the site in a circular motion moving outward
using aseptic technique.
Now that we've cleaned the site using aseptic technique
we are going to go ahead and choose the appropriate size of needle
for the IO insertion
We are going to use the pink pediatric needle
We are going to grab our insertion device
remove the needle from the packaging.
and we are going to inspect for burrs
after inspecting for burrs
we are going to stabilize the leg
making sure our hand is not underneath or near the puncture site
We are going to advance the needle at a 90 degree angle
and make our puncture
once the needle has entered the intramedullary canal
you'll feel a pop and notice less resistance.
From there we will remove the insertion device
remove the needle from the catheter
and sharps the needle
After we sharps the needle
We are going to attach the administration set to the line
From there we will attach a saline flush
to the port
and slowly inject while assessing for
infiltration and aspirating to make sure that we have a patent line
From there we will adjust the flow rate appropriately
and stabilize the line
After securing the device
We will assess our patient for therapeutic response
as well as any adverse reactions.