Page 49 - PJ MED OPS Handbook 8th Ed

EZ-IO Procedure: Tibia

1. Determine that no contraindications are present:
a. Tibial Fracture
b. Previous orthopedic procedure on tibia, previous IO attempt on tibia
c. Infection over insertion site
2. Find insertion site 1 finger breadth medial to tibial tuberosity. This is the flat plateau on the
medial side of the tibia below the knee.
3. Clean insertion site with alcohol or Betadine
4. Anesthetize skin at insertion site
5. Begin insertion:
a. Hold tibia with one hand
b. Position needle set at 90° to insertion site
c. Push needle through skin until contacting bone
d. Apply firm and consistent pressure to manual EZ-IO needle
e. Continue twisting manual EZ-IO needle until “pop” is felt or needle flange touches skin
6. Remove driver from needle set
7. Remove stylet from catheter
8. Confirm catheter tip position:
a. Catheter should be firmly seated at 90° angle
b. Consider aspiration of small amount of marrow to confirm placement
c. Easy flow of flush solution
9. Attach EZ-Connect or standard luer lock to primed IV fluid administration set
10. Flush catheter with 10mL of NS and ensure free flow of fluid
11. Initiate fluid infusion and monitor for signs of extravasation or infiltration
12. Apply EZ-IO wristband and stabilizer dressing
13. Secure tubing and catheter

Drawing courtesy of Vidacare Corp. San Antionio, Texas.

Chapter 6. Surgical and Medical Procedures n 47