Cleaning & Disinfecting Wipe clean with moistened cloth -
removing large contaminantsSpray with anti-microbial solution -
follow manufacturer instructionsMomentarily depress trigger several
times during cleaningRemove battery cap (if necessary) - and clean
seal Clean around drive shaft with cotton applicator - check drive
shaft tip to ensure nothing has attached to the magnetic tipWipe
dryInspect driver and return to case
DO NOT SUBMERGE DRIVER AT ANY TIME
*Once the EZ-IO is in position and treatment has begun it is
important to secure the tubing and, to a lesser degree, the
catheter. This can be accomplished with a commercially available
securing systems or tape. You may also consider a lightly rapped
rolled gauze or similar bandage in situations where adhesives will
not stick. (Be extremely careful that you do not create excessive
circumferential pressure on the leg!)
Remember to place the EZ-IO identification bracelet on the
patients wrist! This will alert future members of the health care
team to the presence of an EZ-IO.
If your insertion attempt failed for any reason place the EZ-IO
bracelet on the patient, report the complication and document
accordingly. Your report, documentation and bracelet placement may
prevent a repeated IO attempt on the same leg (A repeated
insertion, without knowledge of the previous IO attempt, might
cause extravasation and subsequent injury to the patient).
Training Manual Revision B Page 23*The EZ-IO catheter should be
removed within 24 hours!Removal of the EZ-IO catheter is simple.
You may either grasp the hub directly or attach a sterile syringe.
(The syringe will serve as larger handle for the catheter hub and
is preferred) Support the patients leg while rotating the catheter
(clockwise if you are using a syringe) and gently pulling the
catheter out (Recall that the exterior portion of the catheter is
smooth or not threaded). Be careful with the sharp catheter once
removed from the patient! Once the catheter has been removed
immediately place it in an FDA approved bio hazard container.
* Removal of the extension or fluid administration set, without
proper protection of the EZ-IO hub (in the form of a sterile cap,
port or syringe), could cause bleeding or infection. Refer to
slides 34, 36 and 37.
* Maintaining a 90 degree angle while rotating the catheter will
insure proper removal without complications.
* Be certain that you DO NOT ROCK the catheter while removing.
Rocking or bending the catheter with a syringe may cause the
catheter to separate from the hub!
If hub-catheter separation occurs use an appropriate hemostat to
grasp and gently remove the catheter in the same manner as
suggested above (rotating while gently pulling).
Training Manual Revision B Page 25*Once the catheter has been
removed dress the site according to protocol.
Clinical experience has shown that a very small amount of
bleeding may occur after removal. This bleeding can be stopped by
either applying gentle pressure on the insertion site for several
minutes or by applying a small pressure dressing directly over the
site.
Dressing the site often consists of a small amount of
anti-bacterial ointment and a suitable dressing. Be certain to
monitor the site for signs of bleeding or infection.
Training Manual Revision B Page 25*Extravasation: (leakage) The
EZ-IO reduces this possibility because of the precise rotational
method used to insert the needle set the EZ-IO catheter has a very
snug fit once placed in the bone. Dislodgment: The EZ-IO infusion
system is designed to be low profile this limits accidental
movement, additionally the actual method of insertion also enhances
the catheter fit against the bone this, including the flat aspect
of the flange, limits motion or accidental dislodgment. Compartment
Syndrome: Because the EZ-IO insertion method decreases the
possibility of extravasation, the likelihood of swelling to the
point of compartment syndrome (excessive constricting pressure in
the soft tissue - leading to a decrease in circulation and possible
loss of extremity) is significantly diminished. As with any
vascular access device one MUST always maintain a watchful eye for
complications. Fracture: The EZ-IO infusion system is unique in
that the insertion method requires limited pressure on the bone.
The driver itself utilizes an orthopedically proven safe technique
to power through the bone without the use of excessive force in any
direction. As Dr. Larry Miller puts it A kinder, gentler way. Pain:
IO placement and its use can cause discomfort. You could consider a
local anesthetic for conscious patients (caution allergies)
however, clinical experience has demonstrated that EZ-IO insertion
is no more painful than a standard IV catheter placement. One
important facet about the EZ-IO infusion system is its speed of
insertion (average insertion is approximately 3 seconds). Less time
inserting translates to less pain. We have noted in clinical
studies that there is considerable pain for conscious patients
associated with the infusion of fluid. 20 50 mg of 2% (Preservative
free) Lidocaine IO has proven helpful in reducing or eliminating
the patients discomfort. Additional findings suggest that the
initial administration of Lidocaine or fluid for conscious patients
should be given slowly.Reduced Flow Rate: At times you may
experience flow rates significantly lower than expected, The first
consideration should be the possibility of inadequate initial
flushing. Consider a second 10 ml Syringe Flush or Bolus. You may
additionally try gently backing out the catheter approximately 1mm.
Lastly, the establishment of a second EZ-IO catheter on the
opposite leg should also be considered as a viable
option.Infection: Extensive experience with thousands of children
and adults demonstrates a low incidence of infection (0.6%). These
infections are usually not serious and can be treated with device
removal and antibiotics. Once the EZ-IO has been placed (and the
patient stabilized) it is recommended that prophylactic antibiotic
therapy be initiated. The EZ-IO should be removed within 24
hours
Training Manual Revision B Page 26*Now lets finish up with the
care and maintenance of the EZ-IO driver.
Training Manual Revision B Page 27 & 28*Following the
instructions listed here will help prevent equipment failure.
Training Manual Revision B Page 27
