Trick of the Trade: Tibial Intraosseous Line Stabilization in an Agitated Patient
With the advent of commercial intraosseous (IO) needles for vascular access, administering IV medications for patients in extremis has been made much easier. Securing the IO needle to the patient’s tibia, femur, or humerus, however, is a different story. After successful patient resuscitation, these needles often tenuously secured through creative uses of sterile gauze, trimmed paper cups, bag valve masks, and/or just tape. Stabilization of tibial IO lines can be difficult in a sedated, intubated patient. This can be even more difficult in an agitated, moving patient.
Delivering a curriculum of core content to interns is both a priority and a challenge. Weekly conference provides time to deliver such a curriculum; however, varied rotation schedules limit consistent conference attendance, and intern-targeted content is inappropriate for upper-level residents. We addressed these challenges by implementing a flipped-classroom intern curriculum using training level-specific breakout sessions and a dedicated resource for asynchronous learning.