Trick of the Trade: Tibial Intraosseous Line Stabilization in an Agitated Patient

Jul 20, 16
Trick of the Trade: Tibial Intraosseous Line Stabilization in an Agitated Patient

Intraosseous needle - image from Dr. Rob CooneyWith the advent of commercial intraosseous (IO) needles for vascular access, administering IV medications for patients in extremis has been made much easier. Securing the IO needle to the patient’s tibia, femur, or humerus, however, is a different story. After successful patient resuscitation, these needles often tenuously secured through creative uses of sterile gauze, trimmed paper cups, bag valve masks, and/or just tape. Stabilization of tibial IO lines can be difficult in a sedated, intubated patient. This can be even more difficult in an agitated, moving patient.

Trick of the Trade

Use a modified knee immobilizer to secure tibial intraosseous lines

Tibial IO Immobilizer How-to

Tibial lines are at risk of trauma and displacement from contact with bed side-rails and the patient’s other leg. This risk is particularly high in the agitated patient and is not sufficiently resolved with traditional ankle restraints.

In order to sufficiently protect a tibial IO, place a knee immobilizer to limit the patient’s movements. Cut a fenestration to allow unobstructed access to the IO. The IO can be further stabilized by packing gauze on either side and covering the leg in a sheet.

Sketch image credit

Author information

Eric Shappell, MD

Medical Education Fellow
Department of Emergency Medicine
University of Chicago

The post Trick of the Trade: Tibial Intraosseous Line Stabilization in an Agitated Patient appeared first on ALiEM.

Leave a Comment

Like articles like this one?

Join our Email List and get the latest TCCC/TECC/TEMS news bulletins, articles, product releases, and more!

Free Delivery

On all orders over $99 within CONUS and to APO/FPO

Easy Returns

We're here to help! Satisfaction Guaranteed

Knowledgeable Staff

Ready to assist you at a moment's notice

Safe& Secure Checkout

World’s most advanced and secure website encryption.