TL;DR
IV and IO Access: Vascular access: peripheral IV cannulation and intraosseous needle insertion into bone marrow.
IV and IO Access
Definition
Vascular access: peripheral IV cannulation and intraosseous needle insertion into bone marrow.
Troubleshooting
Troubleshooting iv and io access in the field:
- Waveform capnograph: If measures end-tidal co2 continuously with waveform display fails, verify connections, check battery, try alternate equipment. Available sizes: Mainstream (inline), Sidestream (sampling)
- AED: If automated external defibrillator for vf/pvt fails, verify connections, check battery, try alternate equipment. Available sizes: Adult pads (over 8yo or 25kg), Pediatric pads (under 8yo or 25kg)
- Pulse oximeter: If measures spo2 via infrared absorption through capillary bed fails, verify connections, check battery, try alternate equipment. Available sizes: Finger clip, Earlobe, Pediatric wrap
Patient Communication
Communication about iv and io access in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.
Key Values & Ranges
Key values and ranges relevant to iv and io access in prehospital care:
| Parameter | Adult | Pediatric |
|---|---|---|
| SpO2 | 95-100% | 95-100% |
| blood pressure | 90/60-120/80 mmHg | 70+(2*age) systolic minimum |
| respiratory rate | 12-20 breaths/min | 25-50 (infant), 15-30 (child) |
| temperature | 97.8-99.1 F (36.5-37.3 C) | same range, rectal preferred under 2yo |
Workplace Applications
In daily practice, iv and io access is applied consistently according to facility protocols and current evidence-based guidelines. Competency is maintained through annual skills validation, continuing education, and quality improvement participation.
Exam Focus Areas
On the Nremt Paramedic exam(s), questions about iv and io access typically test:
- Recognition of signs and symptoms requiring immediate intervention
- Assessment findings that differentiate between similar presentations
- Appropriate transport decisions and hospital notification criteria
- Correct medication selection, dosing, and route of administration
Historical Context
The modern EMS system in the United States traces to the 1966 "Accidental Death and Disability" white paper (NAS/NRC). Understanding of iv and io access has advanced significantly with evidence-based protocols. The NREMT, founded in 1970, standardized certification levels. Current ACLS and PALS guidelines are updated every 5 years by the AHA based on the International Liaison Committee on Resuscitation (ILCOR) evidence review.
Why It Matters
IV and IO indications, sites, and troubleshooting tested on Paramedic exam.
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