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IV and IO Starts in Trauma Situations

Thursday, September 24, 2015

In trauma situations, time is of the essence and can often require the use of fluids and medications to save lives. Trauma patients get these life saving fluids and medications through the use of an IV typically, but when a patient has undergone severe injury, intraosseous (IO) access directly through the bone may be a better option.

This is what Dr. Ron Black, CFVH Hospitalist and OB Provider featured at the Sander County quarterly EMT meeting last week. Black, who is also the EMT Medical Director in Hot Springs and Plains, touched on the difference between IV and IO starts and how to properly insert an IO directly into a bone.

"Anything you can put into an IV, you can put through an IO," says Black who talked about ideal IO insertion sites as well as what to keep in mind when treating pediatric patients.

"When we use IOs in the ER and in trauma situations it is only temporary and is usually removed within 24 hours," explained Black. Typical patients who require IOs are those experiencing cardiac arrest, respiratory compromise, have an altered level of consciousness and those who would be difficult to place an IV into.

In addition to lecture, trainees were able to test their skills to get their IV certification and use an actual IO drill to place an access into chicken legs. "This isn't ideal to practice on," said Black, "because the chicken bones are round and we want to place IOs into flatter bone areas for a more secure access, but they do give the EMTs a chance to test the drill out and see that they don't have to apply much pressure to insert the IO correctly."

The quarterly EMT meetings allow EMT's from around the county to come together so they can conduct peer review as well as continued training.

Ben Lindeman, PA-C, CFVH hospitalist and Thompson Falls EMT Medical Director, was also in attendance. He said, "Having CFVH providers as EMT medical directors helps bring a continuity of care to emergency medicine in the county." Lindeman helped teach the first paramedic course offered in Montana in the late 80's and said, "We have come a long way and it is nice to see a common approach to emergency care among all the EMT service levels in the county."

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