骨髓腔内注射装置操作完整讲解程序研讨.ppt

* The patient should be in a supine position. Expose shoulder and adduct humerus (place the patient’s arm against the patient’s body) resting the elbow on the stretcher or ground. A Palpate and identify the mid-shaft humerus and continue palpating toward the proximal aspect or proximal humerus. As you near the shoulder you will note a protrusion. This protrusion s the greater tubercle insertion site. A With the opposite hand you may consider “pinching” the anterior and inferior aspects of the proximal humerus while confirming the identification of the greater tubercle. This will ensure that you have identified the midline of the humerus itself. * Once the site has been identified and confirmed, clean the location according to local protocol. * Let’s now look at pediatric IO site selection and skin preparation. (6 Slides) * The Broselow? tape may help as a decision making tool for the EZ-IO? (provided that the pediatric patient is not obese). * Important: The tibial tuberosity is often difficult or impossible to palpate on very young patients! For this reason - the EZ-IO? PD 3-12 kg trainer does not have a palpable tibial tuberosity! The traditional approach for IO insertions in small patients - where the tibial tuberosity cannot be palpated - is to identify the insertion site -“TWO FINGER WIDTHS BELOW THE PATELLA and then medial along the flat aspect of the TIBIA”. On the other hand our EZ-IO? PD 13-39 kg trainer DOES have a palpable tibial tuberosity reflecting the natural growth process. The traditional approach to IO insertion in more mature patients - where the tuberosity can be palpated - is “One finger width distal to the tibial tuberosity along the flat aspect of the medial tibia”. * Once the patients reaches maturity (or adult size) the most acceptable site for EZ-IO? insertions is directly medial to the tibial tuberosity. * Important: The tibial tuberosity is often difficult or impossible to palpate on very young patients! For this reason