[6-25-2017 Please review the following blog posts on Intraosseous Access along with this post: Use of Ultrasound To Confirm Correct Pediatric Intraosseous Placement, Posted on October 25, 2016; Use of Ultrasound To Confirm Correct Pediatric Intraosseous Placement, Posted on October 25, 2016; Practicing Newborn Vascular Access With Liz, Newborn Pediatric Transport Nurse Of St. Vincent Hospital, Posted on May 15, 2016; Intraosseous Access – A Critical Skill For ACLS, and PALS, Posted on May 12, 2016. And the big key is – after you’ve reviewed all this, practice with your team and with the equipment you will be using in your practice environment. And remember that you can also run mental simulations as well.]
Dr. Mellik’s video shows placement of an intraosseous (IO) needle with the EZ-IO system in both a newborn and in an adult, both of whom required iv access during cardiopulmonary resuscitation.
During the first placement of the IO needle in the neonate it was inserted too far. Dr. Mellik, in the video, summarizes the following Learning Points:
- The trap door effect is absent when the EZ-IO drill is used [you won’t feel the sudden give that you feel when inserting the IO needle manually. And so if you keep drilling until you feel the pop, you won’t feel it and you’ll go too deep.].
- [So] decide the desired depth before drilling.
- Stop sooner. You can go deeper if necessary.
- Newborn bone diameter is very small.