If you’re anything like me, you’ve struggled with IVs. After all, it’s an impossible task in most patients, who can be described as McDonald’s Most Loyal customers. They’ve got insulating layers that’d make a walrus jealous. How are we supposed to start an IV on that? If you can’t see a vein, there’s no way of knowing it’s there.
Luckily, technology steps in where proper diets fail. While an IV is literally impossible on these patients, they all have bones; meaning intra-osseous access is not only possible, but necessary. And it’s for that reason that IO access is my go-to for any patient weighing over 200 pounds.
That’s right. 200 pounds or, in medical terms, 78 kilograms. I actually carry an IO drill on my belt that I can draw out and instantly gain access within seconds. Most patients might not be okay with it, but remember: we’re not here to ask for consent. We’re here to save lives.
Now I know the standard argument when it comes to IOs: they’re not fast to act. But that’s entirely dependent on the access site. The traditional mid-tibial access takes minutes for medications to enter the system. But a 45mm insertion to the sternum can get medication to the superior vena cava within seconds. If you haven’t tried it just because it’s not in your protocols, well, it sounds like you’re not keeping up with EMS research. Luckily, you’re reading this bog, written by the best paramedic in Oklahoma (and according to several court documents, the most ‘criminally inventive).
paragoddess.com 
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