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Tue Mar 20 11:20:06 GMT 2007

With bone marrow on aspiration, but a simple washout with saline will
suffice.
Peter.

-----Messaggio originale-----
Da: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
Per conto di Bjorn, Pret
Inviato: martedì 20 marzo 2007 11.39
A: Trauma &amp; Critical Care mailing list
Oggetto: RE: IO's?...good for?

Occlude it ... with what, exactly?

If you can't draw blood back, your access is iffy at best.  Unless there's
mobile fluid on the far end, I'd be extremely reluctant to use the IO.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Anthony Caruso
Sent: Monday, March 19, 2007 9:40 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: IO's?...good for?

Prêt, I heard from a ER nurse, that its not a good idea to aspirate from the
I.O.  The thought behind it is, that you have more of a chance to occlude
it.  The new thought is to just send a bolus of .9 NS through it, to see if
it infiltrates.  That's just what I had heard.  Any thoughts behind it?

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Pret Bjorn
Sent: Monday, March 19, 2007 8:42 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: IO's?...good for?

I know that the vendors say you can use proximal tibial IO in adults; but I
can't help but think that the cortex is thick enough in grown-ups to make it
a tough shot.  

Were you able to aspirate anything?

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of trauma at emergencyunit.com
Sent: Monday, March 19, 2007 2:57 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: IO's?...good for?

Thirties, I suppose.

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Pret Bjorn
Sent: 19 March 2007 00:47
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: IO's?...good for?

How old was this patient?

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of trauma at emergencyunit.com
Sent: Friday, March 16, 2007 2:56 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: IO's?...good for?

Have used Cook a few times - work but slow to insert. Used BIG once and the
trocar jammed in the cannula (and I have heard multiple reports of others)
and EZIO twice - both times on people stuck under 4x4s and only partially
accessible. The first person was unconscious and I only had access to head
and shoulders so put one in the humeral head. Easy, useful. The second was a
conscious biker with the 4x4 resting on his crash helmet so all I could get
at was knees downward. I drilled a tibia which made him squeak a bit, but
what I was UNABLE to do was put anything through it. You are supposed to put
2 ml of lidocaine through to anaesthetise the medulla but no amount of
lidocaine made any difference (2ml at a time) rendering the IO useless. 

So it's a bit of a mixed result, to be honest.

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Charlene M Morris
Sent: 16 March 2007 15:32
To: Trauma &amp, Critical Care mailing list
Subject: Re: IO's?...good for?

Honeslt, we rarely use IOs. You are at a big city ED with a peds unti, so
many need them more than some.

In ACLS, we all *learn* to use these yet most paramedics and ED docs I know
do not use them often. Keep us posted on your experiences!

C M Morris
Stonewall, NC

On 3/16/07, Joe Nemeth <joe.nemeth at mcgill.ca> wrote:
>
>
> our ED is thinking of purchasing high-end fancy-shmancy IO needles....
>
> opinions/experiences on the necessity of these toys in tertiary care 
> ED please?
>
> joe
> McGill University
> MOntreal
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R: IO's?...good for?