I like these videos. I have no interest in becoming a paramedic (EMTs don't exist in Ontario). I honestly just find it fascinating and I love watching Sam. He's just super nice and makes these videos interesting.
@@OutlawCaliber13 Nope, we have 3 levels of paramedic instead, well actually 4 levels. Primary Care Paramedic, Intermediate Care Paramedic, Advanced Care Paramedic, and Critical Care Paramedic.
@@blakey666The US has EMT Basic, intermediate, and Paramedic. My understanding is that the levels are similar in Canada, just labeled differently. I coming from the US. The main course in this area provides EMT-Advanced that runs two years, though fixing to run up to three years. I'll have to check it out deeper.
@@OutlawCaliber13 Well yeah actually that's right. EMT 1 and 2 are similar to PCP and ICP. ACP is the same as Paramedic in the US. And CCP work in Critical Care Land Ambulances and HEMS. Ontario dropped the EMT label many years ago. Although from what I understand as well, PCPs and ICPs have a little bigger scope of training than EMTs.
@@blakey666 Okay, I get what you're saying. I was just like huh, when I first read your comment. Yeah, there's different levels, it just seems they've renamed them. A lot of it is the same. Maybe the course is just the max training though, so I don't know about lesser courses? It's a hard field to get situated in regardless. Lots of applicants, limited jobs....
I go to IO when I've tried to get a vein twice and desperately need a line. Used it several times on awake patients. They received ketamine afterwards as a "sorry I stabbed your bones"
Ketamine dosn't give much retrograde anesthesia tho, right? Snowing with Versed obviously would... But I thought Ketamine really only worked antograde.
Good recap! I remember the sternal IO days, while it did work, I had many issues/failures with it. Glad we have more products for quick access on the market.
I experience my first cardiac arrest with the new department I am working for and used the IO for the first time successfully! Thanks for the great content, keep it up 👍🏻
@@rhoonah5849 we did gain rosc but once we had them transfer to the ED Staff, he started to deteriorate and worked him again for a few minutes and the doc called him shortly after.
I actually made an adapter to fit IO needles to my dewalt drill. It legit works faster and easier. Only thing is that you gotta make sure not to hit it full speed. The RPMs will send the need straight through the bone. Just gotta take it nice and easy. I use it all the time. No complaints
Very interesting. I am so passionate with learning this kind of stuff. Never m ew about this way of administering meds. I learn something every day. That’s why I love this field!
These guys I was learning from showed me the sternal IO. I don't remember the name of the device, but it looked wicked. Bunch of needles, one big one in the center. Place the bag on the sternal notch, punch to the marks, and push hard. I never got certified, but that looked painful as hell. lol Cool as hell, too, though. I imagine it wouldn't be all that difficult in actual practice. Seen the humeral a couple times, in video. Never seen the tibial ever.
I love the sam io for the fact that it doesn’t have a battery. But the plastic driving mechanism is to flimsy. Make it out of SS and you have a top notch product
I called for an ALS intercept once and after the medic tried SEVEN times to get an IV, he pulled the drill on the wake patient and of course the patient flinched which apparently hosed that route so the medic drilled the OTHER leg. I guess the important part of the story was that the patient got the fluids he needed (his BP was dropping and he was growing pale hence why I called for ALS... I think he had internal bleeding after a recent GI surgery) but jeesh... this poor guy getting stuck 7x and then drilled twice.
Yeah, I try two IVs and then consider how much the patient actually needs access. If they really need it then they get the drill. Unfortunately in your scenario saline is 100% the wrong thing to give a patient bleeding internally, even if it is all you have and even if they are hypotensive
@@PrepMedic Two seems reasonable to me. In this case the patient was getting more hypotensive as time went on. I actually found them on the floor in the bathroom because he stood up, felt dizzy and fell. I have attended a couple of symposiums where the chief ER attending as spoken about using saline (crystalloids) and he echoes your thoughts that is is great for adding volume but does absolutely nothing for carrying oxygen so I would agree that in a case like this it was probably a bad decision. Thanks for the great channel by the way!
@@PrepMedic Greetings frome Europe! Why's saline 100% wrong? I mean: yes you should permissive hypotension at a patient with uncontrolled bleeding And "blood is better than water". But on the most ambulance there's no blood and sometimes the blood pressure is so low that you've got to do something for a better blood pressure. For some paramedic levels saline or other cristalloid solution is the only thing. (And of course a fast transport. Without a fast transport al other things are useless)
We still do hand crank IO's. CCT and the helicopter are the only ones who have the EZIO. But we can sure spend the hundreds of thousands of dollars for the Zoll AutoPulse and the time to train us and the county AND city FD on how to use them and then have them permanently removed from the field two months later...
To my knowledge you can push any medication and treat an IO like any regular IV in regards to medications. The bones are super vascular. If I'm wrong and anyone can correct me that'd be great.
*Most* IV medications can be given the IO route. All of your ACLS medications can, no problem. The ones that can't are oddballs like chemotherapy drugs and TPN (which we're not concerned about prehospitally).
I had an IO,when I got out of the helicopter I still had the needle protruding from my tibia, but once in shock trauma they removed it, put a bandaid on it and got better access.
All ports in rough weather. Never withhold D50 or glucagon from a diabetic because you cannot get a line. Just drill and let wound care deal with any issues later.
@@PrepMedic On a side note, you should talk about and discuss why EMS provider's salaries are not very high and your opinions on it. This is a big point of discussion in Michigan. (Medicare/Medicaid billing, schooling, stigma as patient transporters)
IO is one of the most painful iv’s when u was in Iraq a kid had a wound through his upper neck and was knocked out on arrival as soon as we started the IO he woke up and started grabbing at the needle my opinion IO should be last resort
when i was a kid, i got a flu shot with one of those old school gun flu shots, ive always been skinny, and they hit the bone with it, and it hurt soo much, i can only imagine how much going into the bone hurts ( and im surprised it goes in soo easy)....... now im wondering if it was actually one of these! hahaha.
I like these videos. I have no interest in becoming a paramedic (EMTs don't exist in Ontario). I honestly just find it fascinating and I love watching Sam. He's just super nice and makes these videos interesting.
EMTs don't exist in Ontario? I'm aiming at training there, right now.
@@OutlawCaliber13 Nope, we have 3 levels of paramedic instead, well actually 4 levels. Primary Care Paramedic, Intermediate Care Paramedic, Advanced Care Paramedic, and Critical Care Paramedic.
@@blakey666The US has EMT Basic, intermediate, and Paramedic. My understanding is that the levels are similar in Canada, just labeled differently. I coming from the US. The main course in this area provides EMT-Advanced that runs two years, though fixing to run up to three years. I'll have to check it out deeper.
@@OutlawCaliber13 Well yeah actually that's right. EMT 1 and 2 are similar to PCP and ICP. ACP is the same as Paramedic in the US. And CCP work in Critical Care Land Ambulances and HEMS. Ontario dropped the EMT label many years ago. Although from what I understand as well, PCPs and ICPs have a little bigger scope of training than EMTs.
@@blakey666 Okay, I get what you're saying. I was just like huh, when I first read your comment. Yeah, there's different levels, it just seems they've renamed them. A lot of it is the same. Maybe the course is just the max training though, so I don't know about lesser courses? It's a hard field to get situated in regardless. Lots of applicants, limited jobs....
I go to IO when I've tried to get a vein twice and desperately need a line. Used it several times on awake patients. They received ketamine afterwards as a "sorry I stabbed your bones"
After…oof
After bro come on man! That must hurt them so much dang!
Lmao
Sorry, have some drugs
Ketamine dosn't give much retrograde anesthesia tho, right? Snowing with Versed obviously would... But I thought Ketamine really only worked antograde.
Thanks for the knowledge, I'm gonna go try it now.
"Hey little bro, come here a second!"
lol
Why hurt family that’s what probies at the firehouse are for 😅😅😅
I'm a retired X Ray tech. Retired at the beginning of 2022 with 32 years of service. This was a great video and you are an excellent instructor!!
Good recap! I remember the sternal IO days, while it did work, I had many issues/failures with it. Glad we have more products for quick access on the market.
I experience my first cardiac arrest with the new department I am working for and used the IO for the first time successfully! Thanks for the great content, keep it up 👍🏻
That's awesome! Did the patient make it?
@@rhoonah5849 we did gain rosc but once we had them transfer to the ED Staff, he started to deteriorate and worked him again for a few minutes and the doc called him shortly after.
i really like the "how to" videos! please make more. can you show how a 12 lead is done? like on a Zoll or similar monitor?
I actually made an adapter to fit IO needles to my dewalt drill. It legit works faster and easier. Only thing is that you gotta make sure not to hit it full speed. The RPMs will send the need straight through the bone. Just gotta take it nice and easy. I use it all the time. No complaints
Why don't you just obtain the bone gun that goes with the EZ IO needles? Smaller, quick and easy.
And less effective.
@@PrepMedic the small EZ IO drill gun has always worked perfectly fine, smooth and fast every time I’ve used it.
@@tardre3145 Was talking about the bone gun
Heh? .. You use it all the time? Are you drilling yourself? You don't use this on real medical calls, do you? LOL
Very interesting. I am so passionate with learning this kind of stuff. Never m ew about this way of administering meds. I learn something every day. That’s why I love this field!
Humeral is by far a better place. I'll Tibial to start for CA, work my way back to an IV or Humeral IO post ROSC..
Great video. Never seen it in a clinical setting, but it can life saving in the right situations
Greetings from Taiwan, can you do videos on how to properly put on PPE as well, much appreciated!
*”A surprise to be sure, but a welcome one.”*
No matter how often I place/hear IO's, I never get used to that sound!
Awesome, always wanted to learn more about this method of access. Thanks prepmedic! Have an awesome week
These guys I was learning from showed me the sternal IO. I don't remember the name of the device, but it looked wicked. Bunch of needles, one big one in the center. Place the bag on the sternal notch, punch to the marks, and push hard. I never got certified, but that looked painful as hell. lol Cool as hell, too, though. I imagine it wouldn't be all that difficult in actual practice. Seen the humeral a couple times, in video. Never seen the tibial ever.
@Beloved Son That might be it. It was black, with a white rim near the needles. Sternal IO is the only thing I remember.
That one might be called the FastOne.
@@AimForTheBushes908 Yeah, that looks pretty close to it.
@@OutlawCaliber13 crazy looking device. Wouldn't want to be on the receiving end of any of these devices. Stay safe.
@@AimForTheBushes908 Seen a video of a guy volunteering to get one, non operational setting. He looked very much in pain. lol
I love the sam io for the fact that it doesn’t have a battery. But the plastic driving mechanism is to flimsy. Make it out of SS and you have a top notch product
So I have heard that but at the end of the day o have yet to see any instances of the driver actually breaking.
After I took the EZ-IO cadavers lab, I only place my IO in the Humerus. Far superior placement
I remember the sternal IO days all too much and how fucked that was. The Deltas on my team would prefer tibial insertions, almost impossible to miss
If Im correct, you squeezed the driver 13 times?
cant wait to try this on the homies at the next sleepover
I called for an ALS intercept once and after the medic tried SEVEN times to get an IV, he pulled the drill on the wake patient and of course the patient flinched which apparently hosed that route so the medic drilled the OTHER leg. I guess the important part of the story was that the patient got the fluids he needed (his BP was dropping and he was growing pale hence why I called for ALS... I think he had internal bleeding after a recent GI surgery) but jeesh... this poor guy getting stuck 7x and then drilled twice.
Yeah, I try two IVs and then consider how much the patient actually needs access. If they really need it then they get the drill. Unfortunately in your scenario saline is 100% the wrong thing to give a patient bleeding internally, even if it is all you have and even if they are hypotensive
@@PrepMedic Two seems reasonable to me. In this case the patient was getting more hypotensive as time went on. I actually found them on the floor in the bathroom because he stood up, felt dizzy and fell. I have attended a couple of symposiums where the chief ER attending as spoken about using saline (crystalloids) and he echoes your thoughts that is is great for adding volume but does absolutely nothing for carrying oxygen so I would agree that in a case like this it was probably a bad decision.
Thanks for the great channel by the way!
@@PrepMedic
Greetings frome Europe!
Why's saline 100% wrong?
I mean: yes you should permissive hypotension at a patient with uncontrolled bleeding
And "blood is better than water".
But on the most ambulance there's no blood and sometimes the blood pressure is so low that you've got to do something for a better blood pressure.
For some paramedic levels saline or other cristalloid solution is the only thing.
(And of course a fast transport. Without a fast transport al other things are useless)
Hey I was wondering if you can do a video about wilderness EMT? If you haven’t already
We still do hand crank IO's. CCT and the helicopter are the only ones who have the EZIO. But we can sure spend the hundreds of thousands of dollars for the Zoll AutoPulse and the time to train us and the county AND city FD on how to use them and then have them permanently removed from the field two months later...
Love these videos!
Thanks for sharing.
Good job explaining 😊
Great video as always.
Excellent video
When going through the bone, could this possibly fracture the bone?
I've done it a lot and haven't experienced one doing so and have not heard of one doing so
How was this discovered? , Was it accidentally through the embalming process?
So this spear is supposed to penetrate the bone itself, not just the skin and muscle, right? What kind of medication are injected through it?
To my knowledge you can push any medication and treat an IO like any regular IV in regards to medications. The bones are super vascular. If I'm wrong and anyone can correct me that'd be great.
@@_Dolofonia You are correct. All medications given by i.v can be given i.o
He explained it at the beginning.
*Most* IV medications can be given the IO route. All of your ACLS medications can, no problem. The ones that can't are oddballs like chemotherapy drugs and TPN (which we're not concerned about prehospitally).
Very interesting, many thanks.
Love this, thank you
So SAM is using the SAM IO needle????? Sounds suspicious.....🧐
Great video
Excellent
ive not watched in a while but I dig that beard its sick
Love from India
Sam, is it a good habit to put bandaid over site upon extraction to avoid 2nd insertion?
I had an IO,when I got out of the helicopter I still had the needle protruding from my tibia, but once in shock trauma they removed it, put a bandaid on it and got better access.
Favorite place never used...... iliac crest.
Watched a firefighter turn green when we did this… it was awesome lol
It's like you knew I was talking about this to my fiancee yesterday 🤔
@@2901nc Haha, I've been driving her crazy with every detail of my newly acquired knowledge for the past week 😅 Can't help being hyped!
Dang, and I thought the time the nurse was digging in my wrist trying to start an IV in the dog leg was painful... pretty sure I'd just let me die.
not even gonna cap that thing looks like something straight out of a a movie torture scene
All ports in rough weather. Never withhold D50 or glucagon from a diabetic because you cannot get a line. Just drill and let wound care deal with any issues later.
I mean, I’ll just give glucagon and wait before I drill. Also D50, ew 😂. (Just teasing)
@@PrepMedic 😂.
My Michigan EMS company doesn't not carry glucagon unfortunately, too expensive for us. I had forgotten that IM is good route.
@@PrepMedic On a side note, you should talk about and discuss why EMS provider's salaries are not very high and your opinions on it. This is a big point of discussion in Michigan. (Medicare/Medicaid billing, schooling, stigma as patient transporters)
@@RKLIFE17 I have a video on salary already. ruclips.net/video/CF2jp4iwe28/видео.html
Does IO need local anaesthetic?
It’s usually flushed with lidocaine
Is this good way to administer Heroin to adict who is suffering withdraw? I asking för friend.
Drilling a needle into the bone of your leg isn't Humorous at all...=D
@@hoistline hehehe.
What? Woah woah woah. Did I miss the memo? HE HAS HAIR???? AND IT LOOKS GREAT??
I know Sam is a professional, but I was still a bit nervous with him waving that IO around during the video haha
Bruh
Lol same😂😂😂
Please do a reddit ama
Lol we still use the Fast 1 in the military 😂
IO is one of the most painful iv’s when u was in Iraq a kid had a wound through his upper neck and was knocked out on arrival as soon as we started the IO he woke up and started grabbing at the needle my opinion IO should be last resort
Get some.
when i was a kid, i got a flu shot with one of those old school gun flu shots, ive always been skinny, and they hit the bone with it, and it hurt soo much, i can only imagine how much going into the bone hurts ( and im surprised it goes in soo easy)....... now im wondering if it was actually one of these! hahaha.
Man...that was intensive high-speed. I didn't know that there were alternate ways to administer an I.V..
👊
No homo, keep the beard...
#AEMT
Hi prep medic
How any jobs does this man have
My shins felt very not nice as soon as I realised what this process was.
Ouch
Yikes it hurts so bad
Usually the insertion doesn't hurt at all. It is the initial flushing of the catheter that hurts. The lidocaine helps, but still hurts
8:13...did I hear a phone notification?
Lol yeah, just work email
40kg or older LOL LOL
😳
Bro Said 40 Kilos or older🌚
No gloves. Lol
Get some.
Hi prep medic