Page 50 - PJ MED OPS Handbook 8th Ed

EZ-IO Procedure: Humeral Head (HH)

1. Place the patient’s hand on the umbilicus, this brings the HH forward.
2. Use the pads of your second through fourth fingers to feel the spherical HH.
3. Place the IO needle directly anterior/in from the front (not lateral) over the HH.
4. Follow the same procedures as step 5 on page 47.

NOTE: Due to the mobile nature and design of the humeral joint, arm movement and con-
traction of the deltoid muscle (e.g., simple abduction, rotation, or extension of the arm) can
dislodge the IO catheter. Raising the arm horizontally above the plane of the torso will often
impinge the IO catheter and dislodge or bend the catheter. The arm should also be stabilized
to limit movement.

PJ PEARLS:
Use the HH in most situations so you are:
• Working near the airway and have easy access to both the HH and the airway
• Able to place 2 lines at once IAW the Combat Shock Protocol in less than 60 seconds
• Proficient in the most commonly used technique due to combat patients may have ampu-
tated/mangled lower extremities

48 n Pararescue Medical Operations Handbook / 8th Edition