Inserting my first Intraosseous needle (layman’s terms: needle in the bone)
I missed on my first try. Definitely not a boost for my confidence. It was about 1 year ago, and it felt like everyone else in my department had started one except for me. At one of my job’s all of the nurses are certified to insert them, the problem is that we don’t get a lot of opportunities to insert them (which is a good thing because we only use them in dire situations.)
My patient had an incredibly low hemoglobin level (their blood levels were dangerously low) and suddenly he went from talking to being unconscious. We had an IV access but it had infiltrated (it was no longer functioning.) We needed to get another access quickly in order to give the patient emergency medications. After a minute and a half of multiple nurses unsuccessfully attempting to establish another intravenous access we knew we had to get intraosseous access.
If we break down the word intraosseous (IO for short) it means: “intra”-within, “osseous”-consisting of or turned into bone. Put that together and it means: within the bone! Ouch! (actually it’s not supposed to hurt that much if Lidocaine is used to numb the area.) There are a few things that makes inserting an IO difficult: you must be very accurate in position placement in order to be successful, it requires a fair amount of strength, and it is an unsettling feeling to penetrate someone’s bone.
During my first attempt, I thought I had properly located the landmark where it needed to be inserted and I grabbed our “easy IO drill” and I went for it. I missed the correct location, and I felt terrible! There was a huge amount of pressure on me to get this right the first time. So what do you do if you miss? Try again! This patient still needed some type of access to give emergency meds. The second time, the physician helped me find the proper location, I used the drill and I got it! We were able to give medications and all was well with the world.
Is there a moral to this story? I suppose that there will always be a first for everything and it will be the most difficult! The only way to ensure you do it better the next time is with practice and confidence. The best way I learn is, unfortunately, through my mistakes. I was terrified at the time, but now I feel much more confident obtaining IO access in an emergency situation 😉
Questions for you: Have you ever had a bad “first-time” experience for something at work? Every had to obtain an IO?