Drilling into Bone: A Nurse’s Guide to Intraosseous Vascular Access

By Sylvia Foley, AJN senior editor

An example of a pediatric manual intraosseous needle insertion. Used by permission. An example of a manual pediatric intraosseous needle insertion. Reprinted with permission from King C, et al. Textbook of Pediatric Emergency Procedures. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2007.

In this month’s CE Emergency feature, “Intraosseous Vascular Access for Alert Patients,” authors Stacy Hunsaker and Darren Hillis  describe this scenario: a three-year-old girl arrives in the ED after three days of fever, vomiting, and diarrhea. She needs fluids urgently, but efforts to establish IV access have been unsuccessful. Now she’s on the verge of decompensated shock. The team is about to try an alternative route—intraosseous (IO) vascular access—but there are concerns: “Could such access be attempted on a patient who wasn’t unconscious? Would the parents understand why a hole was going to be drilled into the bone of their child’s leg?” The team must decide whether and how to proceed.

If this child were your patient, would you know what to do? If you aren’t sure, you are not alone. In this article, Hunsaker and Hillis provide some answers. Here’s a short summary. […]

2017-07-27T14:49:36-04:00October 31st, 2013|Nursing|4 Comments
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The Dance of Empathy

By Peggy McDaniel, BSN, RN. An infusion practice manager currently based overseas, Peggy has written for this blog a number of times in the past.

by Augustin Ruiz, via Flickr

Although it’s only late October, this time of year finds me pondering holidays past, which were often spent working at a hospital. As a younger nurse, I worked in a neuro-trauma-rehab unit at a large children’s hospital. We had a strong primary nursing model and often cared for the same patients throughout their stay, which could last days, weeks, or months. Memories of patients from that unit and others occasionally come back to mind at this time of year, often spurred by holidays.

One of my first assignments was a beautiful youngster who had suffered a brain injury. It was a difficult case and the family spent many hours on our unit, helping me provide basic care and praying for a recovery. But after more than three months, the child’s strong and previously healthy body stopped fighting and the child passed away, with family at the bedside.

Years later, after being away from this facility, I returned for a short stint as a per diem on the float team. I dropped in to work when and where needed, days or nights. Many of the same people I’d loved working with were still there, and […]

2016-11-21T13:11:40-05:00October 25th, 2011|nursing perspective|4 Comments
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Drunk on Water, Drug Shortages, Understanding Health Care News, Plus Nursing Blog Posts of Note

The water myth: A physician, writing in the British Medical Journal (abstract only), has looked at the evidence for drinking eight glasses of water a day and says the oft-recommended practice is “debunked nonsense,” a myth the bottled water companies have been only too happy to exploit and that many respected health care organizations and experts continue to support. Maybe common sense reasoning is also partly to blame—after all, the idea seems to make sense. And all that water certainly conjures images of purification, which is inevitably appealing in a world of pervasive toxins, chemicals, food additives, and the like, and in a time when fewer people in any given Western country practice the same or similar religious sacraments or rituals, practices that may—among other functions—have once served a similar “purifying” psychologic purpose.

Drug shortages: The Wall Street Journal Health Blog has reported on two surveys that suggest that “unprecedented” drug shortages are being experienced by most hospitals. The reasons are multiple: shortage rumors that prompt hoarding, FDA actions that halt production, lack of a crucial ingredient, poor inventory management, and others:

All treatment categories were affected, hospitals said, with 80% or more respondents experiencing shortages of surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrition, pain or infectious disease drugs. And 66% of hospitals reported shortages of cancer drugs. Some 47% […]

2016-11-21T13:12:26-05:00July 15th, 2011|healthcare social media, Nursing|5 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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