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EZ-IO in the Pediatric Patient
• 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
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Insertion sites
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Proximal Humerus Proximal Humerus
Proximal Tibia Proximal Tibia
Distal Tibia Distal TibiaT- 509
Proximal tibia
• 2 fingerbreadths below base of patella and 1 fingerbreadth medial
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Proximal tibia
• Pinch the sides of the tibia bone between your fingers and isolate the proximal tibia
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Ability to locate accurate site on proximal tibia
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If Tibial Tuberosity cannot be palpated
then find base of patella
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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
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Proximal humerus
• Should only be used in patients whose landmarks can clearly be identified
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surgical neck
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Elbow should remain adducted & posteriorly located
Place the hand over the umbilicus for humeral positioning
and safety
Ability to locate accurate site on proximal humerus
9T- 509
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Ability to locate accurate site on proximal humerus
• Use the 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
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Pediatric EZ-IO insertion sites
Proximal Tibia Distal Tibia Proximal Humerus11T- 509
STEP-BY-STEP PROCEDURE
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• Chose appropriate insertion site
• Identify the site by palpation
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• 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
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• Prime EZ-Connect with Saline
• Consider Lidocaine* if awake
• Clean insertion site with antiseptic
• Place needle on driver
• Remove needle safety cap
15T- 509
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• Press needle set through skin until tip touches bone
• At least 5 mm of the cathether must be visible
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• 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
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• Remove Driver and stylet
• Use of stabilizer is strongly recommended for pediatrics
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• Attach primed EZ-Connect
• Flush with normal saline NO FLUSH. NO FLOW.
• For patients responsive to pain,consider administering 2% lidocaine prior to flush
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• Confirm placement with at least 3 of 4 methods– Stability of catheter– Ability to aspirate– Physiological or
pharmacologic changes
– Adequate flow rate
21T- 509
• Apply EZ-IO wristband
• Do not leave catheter inserted for more than 24 hours
• NOTE!Monitor insertion site frequently for extravasation
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