YDR CT Intraosseous Iodinated Contrast Injection Policy
IO lines may be used for power injection of iodinated contrast for CT
1. Flush IO line with 20cc IO saline. If IO line does not flush easily, do not use.
2. If Patient is unconscious, no analgesia is required. If patient is conscious and responsive to pain, IO 2% epinephrine free lidocaine should be administered (nursing/provider responsibility) just prior to contrast as per the protocol below:
ADULT:
- Prime EZ-Connect extension set with lidocaine. Note that the priming volume of the EZ-Connect is approximately 1.0ml
- Slowly infuse lidocaine 40 mg IO over 2 minutes.
- Allow lidocaine to dwell in IO space for 1 minute.
- Flush with 5 to 10 mLs of normal saline.
- Slowly administer and additional 20 mg of lidocaine IO over 1 minute.
Pediatric:
- Usual dose is 0.5mg/kg, not to exceed 40mg.
- Prime EZ-Connect extension set with lidocaine. Note that the priming volume of the EZ-Connect is approximately 1.0ml.
- Slowly infuse lidocaine over 2 minutes.
- Allow lidocaine to dwell in IO space for 1 minute.
- Flush with 2-5 mLs of normal saline.
- Slowly administer subsequent lidocaine (half the initial dose) IO over 1 minute.
3. Hook power injector tubing directly to IO line hub.
4.Inject contrast through IO line. No guidelines exist on rates for injection so use lowest injection rate possible (up to 5cc/sec) for the study and do not exceed 300 psi.
5. Disconnect power injector tubing from the IO line hub and flush the IO line with 20 cc IO saline.
4.Inject contrast through IO line. No guidelines exist on rates for injection so use lowest injection rate possible (up to 5cc/sec) for the study and do not exceed 300 psi.
5. Disconnect power injector tubing from the IO line hub and flush the IO line with 20 cc IO saline.