emDOCs Podcast Episode 28 - May 11, 2021 - By Brit Long
“Key Points
- When a patient is in extremis and PIVs are not easily obtainable, don’t hesitate to place an IO
- Utilize a pressure bag with any form of intravascular access to increase flow rates
- Blood aspirated from an IO can be used for laboratory analysis, although not all values will be accurate
- If using the landmark-approach, use adjunctive techniques to increase rates of success
- Consider the external jugular vein before jumping to ultrasound-guided PIV
- When placing an ultrasound guided IV, vessels that are more superficial and wider in diameter will lead to increased successful placement
- Longer catheters with the majority of the catheter in the vessel lead to increased lifespan of ultrasound-guided IVs
- If ultrasound-guided peripheral IV placement isn’t successful, consider an “easy-IJ” before placing a CVC
- Midline catheter placement is an emerging alternative to both ultrasound-guided IVs and CVCs”