Why Does That Patient Have An IV In Their SHIN??

When you start doing IV insertions in the real world, you may feel the way many nurses before you have felt: starting IVs can be tricky.

Sometimes you will have a patient with veins you could see from space. Other times, you may have a patient in which you question the existence of veins.

Always remember though: just because you can’t see something doesn’t mean it doesn’t exist. 🙂

The veins are there. However, depending on a number of factors, such as dehydration or certain medical conditions like diabetes, the veins can be difficult to find.

In emergent situations (particularly in the pre-hospital setting) we don’t have the luxury of time on our side as healthcare professionals.

For instance, when paramedics respond to a patient in cardiac arrest, there is no time to “hunt for a vein”. We need intravenous access and we need it NOW.

So what if the paramedic or EMT has difficulty locating a vein?

Enter IO.

IO is short for INTRAOSSEUS and refers in this case to drilling into the bone to obtain IV access directly in the BONE.

A common site for IO placement is the tibia.

The advantage is that IV access can be obtained rapidly in emergency scenarios.

Even though the entry point is bone, the end result is systemic access to the bloodstream. Medications and fluids can be given.

As a nurse, you may encounter a patient with an IO, particularly if they were brought to the hospital under emergent conditions.