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IV / IO PROTOCOL

Universal Patient Care Guideline

Assess need for IV
Sternal IO Device by order of Emergent or potentially emergent medical
precedence: or trauma condition
1. FAST-1 TM
2. EZ T.A.L.O.N. TM Peripheral IV x 2 If patient is deemed a “hard
3. *EZ-IO TM Catheter >18ga
If unable to obtain peripheral IV stick”, IO should be conducted
Locations for EZ-IO TM and EZ access after two attempts or >90 first.
T.A.L.O.N. TM by order of secs proceed to IO.
precedence.
Intraosseous Device for If IV/IO access unsuccessful
1. Bilateral Proximal Humerus Life/limb-threatening event if unable attempt EJ IV Cannulation
2. Bilateral Proximal Tibia to obtain peripheral IV access
3. Bilateral Distal Tibia
See VASCULAR ACCESS Ensure open and functioning
Fluid bolus per specific protocol
(INTRAOSEOUS) for additional At a minimum, maintain a slow “to-
information keep-open” (TKO) drip

Pearls:
• GAIN VASCULAR ACCESS where available based upon patient
• Any pre-hospital fluids or medications approved for IV use may be given through an
intraosseous line – including blood products.
• All trauma patients or potentially ill patients should have AT LEAST TWO functioning
IV / IO lines whenever possible.
• Upper extremity IV sites are preferable to lower extremity IV sites.
• Following IV attempt failure and IO attempt failure, external jugular lines can be
attempted for life-threatening events with no peripheral access.
• Utilize EZ-IO™, FAST-1™, EZ T.A.L.O.N. TM or unit Medical Director approved IO
device.
o Sternal or humeral head sites are preferred over all other sites.
 (Tibia is preferred for pediatrics).
o Correct needle size is critical for the EZ-IO; use of universal/adjustable
depth needle or:
 Yellow - 45mm for humerus and *heavy sternal
 Blue - 25mm for adult *sternum/tib
 Pink - 15mm for children and *sternal/tib
o Pressure infusion bag is recommended for IO starting at 300mmHg
*NOTE: Use of EZ-IO in sternal is off label emergency procedure only see
VASCULAR ACCESS (INTRAOSEOUS)

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