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D50 through IO
Have any of you ever had to try and push D50 through an IO???? I had to try it yesterday and I have to say, by the reaction of the patient it doesn't seem as painless as the IO rep says its supposed to be!
Replies to This Discussion
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Permalink Reply by Michael Henry on -
I am not a medic YET but the general consenus is the drilling action is painless with a topical anesthetic the pain comes upon infusion due to pressure receptors within the bone. I believe the protocol in my area calls for a dose of lido prior to infusion
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Permalink Reply by Nathan on -
yup I used lido... then tried the d50. that seemed pretty painful so I gave a little morphine. Tried the d50 again, still no joy.. Im thinking that d50 us probably the most painful to push through an IO. Just curious to other peoples experiences trying to push it through an IO.
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Permalink Reply by Joe P. on -
Thinking off the top of my head with only a basic understanding of IO, would it have worked better if you diluted the D50 down so that it was less viscous?
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Permalink Reply by Nathan on
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thats what Im thinking. its what im doing next time. Hospital ended up starting a central line!
Joe P. said:Thinking off the top of my head with only a basic understanding of IO, would it have worked better if you diluted the D50 down so that it was less viscous?
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Permalink Reply by dr-exmedic on -
Joe P. said:
And a little less hyperosmolar, save the bone marrow from early necrotic death....Thinking off the top of my head with only a basic understanding of IO, would it have worked better if you diluted the D50 down so that it was less viscous?
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Permalink Reply by Bob Sullivan on -
I've only done it in an arrest. Any reason not to try glucagon first?
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Permalink Reply by blair4630 on -
Joe P. said:Thinking off the top of my head with only a basic understanding of IO, would it have worked better if you diluted the D50 down so that it was less viscous?
I would also imagine that would help, as it seems all the pain generated with IO infusions is pressure.
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Permalink Reply by blair4630 on
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Bob Sullivan said:I've only done it in an arrest. Any reason not to try glucagon first?
Well I can tell you that not all services carry Glucogan. I would imagine a service that carries I.O. drills probably has a pretty nice drug kit, but you never know.
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Permalink Reply by Nathan on
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Dr ex, Its my understanding that any drug that can be given IV can safely be given IO. I pondered the cell necrosis issue for a few seconds but again, Im told its safe so.... Do you have any info to the contrary?
Bob, I needed access it was a trauma patient.
We do carry glucagon and I was about to give it when we arrived at the hospital. But again, the reason it wasnt my first fallback choice was because I wanted access. The trauma exam was unremarkable but the mechanism was high. He continued straight off an exit ramp and hit a wall head on.
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Permalink Reply by dr-exmedic on
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Nathan said:
No, I think it's more of a theoretical concern--after all, the area you're going into is very, very vascular, but it's not quite the same "protected" area as a vein. And it should really be a problem only in kids, since (now that I think about it) as you age, the appendicular skeleton tends to have its hematopoetic cells replaced by fat.Dr ex, Its my understanding that any drug that can be given IV can safely be given IO. I pondered the cell necrosis issue for a few seconds but again, Im told its safe so.... Do you have any info to the contrary?
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Permalink Reply by Brian Oftedal on -
I have only given Dextrose through an IO, on a cardiac arrest patient. We carry Glucagon in our drug boxes, so that would be the route that I would take. I personally wouldn't want to chance causing a necrotic limb. (Just my 2 cents).
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