Intraosseous IO Limitations and Practical Tips

How can we use IO to our advantage in the crashing patient? What are the limitations of IO? Which drugs are safe to use through an IO? How should we choose needle size? How should we best prevent dislodgement? Dr. Anand Swaminathan answers these and other practice illuminating questions on this EM Quick Hits video... Visit emergencymedicinecases.com for more high quality free open access podcasts, written summaries, videos, quiz vault and blogs. -------------------------------------------------------------- 📺 About This Video Intraosseous (IO) access limitations and tips Limitations of IO access include: Placing an IO in a bone with a proximal fracture, a previous IO placement attempt or any circulatory compromise proximal to the site is contraindicated. Blood work drawn from an IO are genrally not accurate, so once the patient has been resuscitated with the IO, intravenous blood draws are recommended. Dislodgement is common; it is best to use the stabilizer that comes with the IO kit; if the kit does not have a stabilizer, stack lots of gauze on both sides of the IO needle and tape it down. IOs are only suitable for term infants more than 3kg weight; avoid IOs in premies. Best site for IO? While proximal humerus site portents faster infusion rates than proximal tibia site, the main limitation of the proximal humerus site is that the arm must be held in internal rotation to avoid dislodgement of the IO. Proximal tibia may be easier to landmark than proximal humerus. Other sites include distal tibia, distal femur and sternum but are uncommonly employed in EDs Needle size? It is better to overestimate than to underestimate the needle size based on distance from skin to bone. Please donate to EM Cases to help ensure continued high quality free open access EM education. https://emergencymedicinecases.com/do... Find the EM Cases podcast, the most listened to Emergency Medicine podcast in the world, wherever you listen to your podcasts. https://podcasts.apple.com/ca/podcast... ⚡️ 𝐂𝐎𝐍𝐍𝐄𝐂𝐓 𝐖𝐈𝐓𝐇 𝐔𝐒: Instagram:   / emergencymedicinecases   Twitter: https://x.com/EMCases Facebook:   / emcases   BlueSky: https://bsky.app/profile/emcases.bsky... Disclaimer: The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose, treat, or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of Emergency Medicine Cases of the Schwarz-Reisman Emergency Medicine Institute. #EmergencyMedicine #IO #venousaccess #crashingpatient #resuscitation SUBSCRIBE NOW* ------------------------------------------------------------------------------------------------------