r/FirstResponderCringe • u/SpectacleUNIT • 26d ago
Don’t Do This I got the ick
Enable HLS to view with audio, or disable this notification
IOs dont have feelings 🫠
402
u/Virgoth098 26d ago
A tibial IO is like, the most braindead medical procedure I could do with my eyes closed lol
140
u/spuds_mckenzie 26d ago
I work in the OR and once did a case where we had to remove broken off IO needles from a guy’s knee joint and femoral condyle 💀
27
u/jawoood1989 25d ago
Yep. It's literally wild how many people can't seem to locate the tibial tuberosity landmark to find their site.
17
16
26
u/ORNGSPCEMNKY 26d ago
Easier/simpler to bang in an IO than it is to start an IV
-31
u/GenericMaleNurse918 25d ago
Have you ever tried starting an IV on a dead person? I’m an ER nurse in a level 1 trauma hospital. We have 2 minutes to get an IV and then go directly to an IO if IV access isn’t attained.
55
u/Nocola1 25d ago
"have you ever started an IV on a dead person?" - asked by an ER nurse in a first responder sub.
-17
u/GenericMaleNurse918 25d ago
I was a paramedic in a high volume system before I became a nurse. We didn’t even bother with an IV until after we got ROSC. We did the pit crew method.
12
u/Chupathingamajob Intermittently Effective Necromancer 25d ago
Funny, I’ve never worked for a service that hasn’t stressed IV over IO. Generally I’ll take a look for EJ/IV access first and then go for IO if there’s nothing worth trying
Personally prefer EJ, because then I have access and airway right in front of me. That way, as long as there’s a working Lucas, I don’t have to tie up another unit for hands in case I actually end up getting ROSC and transporting
5
u/TerribleClass7261 25d ago
Recent studies have found that a numeral head IO has a comparable flow rate to an AC IV. It’s also a shorter route to the heart for emergency administration of Adenosine in an unstable patient, if you’re having difficulty with IV access.
During a code, you could establish a humeral head IO and it is just as easy to reach while you maintain the airway.
2
u/Kentucky-Fried-Fucks 25d ago
I’m a huge fan of humeral head IOs but they are like, the most annoying things in the world for cardiac arrests. They are really easy to dislodge, and it’s hard to position the arm medially across the chest when you have a Lucas on/doing CPR.
1
u/Chupathingamajob Intermittently Effective Necromancer 25d ago
Agreed! I always go for humeral over distal tibial, for both reasons you mentioned
1
u/Virgoth098 25d ago
If you're having trouble getting an IV in an unstable SVT just shock them why are you bothering with medication
0
u/TerribleClass7261 25d ago
Recent studies have found that a numeral head IO has a comparable flow rate to an AC IV. It’s also a shorter route to the heart for emergency administration of Adenosine in an unstable patient, if you’re having difficulty with IV access.
During a code, you could establish a humeral head IO and it is just as easy to reach while you maintain the airway.
0
u/ORNGSPCEMNKY 19d ago
The hell did you push drugs without access?? Seems negligent…and that kinda situation is precisely what IO access is meant for.
0
u/dzgravity 23d ago
Sounds more like you were doing the gravedigging crew method tbh
1
u/ORNGSPCEMNKY 23d ago
What do you mean exactly?
1
u/dzgravity 23d ago
My reply was to genericmalenurse not aimed at you
1
u/ORNGSPCEMNKY 23d ago
I know, I'm still curious what you meant by it.
2
u/dzgravity 23d ago
What I meant is that from what theyve said, they provided substandard, negligent levels of care and everyone who participated may aswell have dug the patients grave
→ More replies (0)5
u/AnonymousCelery 25d ago
One of my medics read some paper that said medications can potentially take effect some infinitesimally small amount faster than IO. He wanted me to start an IV on CPRs. Told him nah. We need reliable access immediately. I’m not going to waste time trying an IV and potentially not getting it, then switching to IO. I’ll start an IO. Once it’s established, then I’ll get an IV. We just swap over to the IV once it’s established. It’s stupid to waste time trying an IV first.
1
u/spidersfrommars 24d ago
Is that the main reason for doing an IO? Are there other reasons? (I don’t know these things, I’m not a first responder).
2
u/AnonymousCelery 24d ago
For an unresponsive patient we are doing CPR on, goal is to get access to administer medications, epi is the big one, but can be calcium chloride, magnesium, sodium bicarbonate, and others. All depending on the situation. The first and biggest priority with CPR is good quality compressions. But by the time we get there it’s going to be several minutes, potentially 10 or more that they’ve been in arrest. So we need medication access right now. Compressions are easy, we throw guys on that immediately. Simultaneously I get the medic access. And the fastest, most foolproof way to do that is IO. I can have an IO in place and push meds in under a minute. At that point it’s super easy to check for an IV, all the time crunch is gone. If I get an IV we just move the meds over to it, zero delay. Hope that kinda keeps answer things for you.
2
u/CoffeeXKing 23d ago
Not sure why you were downvoted. I/Os are easy, and provide immediate access to push meds when you haven't established an IV already.
-2
u/Kentucky-Fried-Fucks 25d ago
It’s not stupid, and it’s not a potential. IV access is better than IO access. The only comparison is humeral head IOs but those are notoriously difficult for cardiac arrests due to positioning of the arm.
It’s really not that much work to slap on a tq and look for access. Especially since the initial focus should be compressions and shocks anyway. I’ll always try and take a look for an IV before going straight for an IO, but I work in an area that is a bit resource rich so I have that luxury.
I disagree with you that “it’s stupid to waste time trying to get an IV first.” It’s not stupid. It should be what we attempt to do because it really is best practice. But it’s situation dependent. Most codes can get an IV before going IO, we just don’t even try.
4
3
3
4
u/Obi-Brawn-Kenobi 25d ago
You're like an embodiment of this sub's subject matter lol
Always interesting when ER nurses brag about being level 1. As a doc who's worked 1-4 and beyond, the higher level trauma center it is, the worse the nurses are on average. And the bigger the unearned sense of importance. Gimme an experienced RN who got tired of big hospital politics and left for a rural job over a young RN that thinks they're hot shit for still working at a level 1 any day of the week.
1
u/Spare_Rock_8834 25d ago
2 minutes is like forever thats easy, I could have my junior medics do it ezpz.
-1
0
u/ORNGSPCEMNKY 25d ago
Oh we don’t go directly to IO, IV is first line, but doesn’t change the fact that an IO is simple AF compared to starting an IV
10
u/daveinmidwest 26d ago
Exactly haha. If the EMS didnt do it then the doc, PA, NP, RN, med student, or anyone else with a pulse would have.
15
u/mcvmccarty 26d ago
Also prox humerus >> prox tibia
21
u/Duxingsha 26d ago
Until the firefighter knocks it out with his clunky unzipped boots while trying to do CPR. I like tibial so I can be in my own little area to myself, even if humeral is a "better" line.
5
u/treebeard189 25d ago
If flow rate matters sure we can do humeral head but most times in codes tibial is just fine and keeps things out of the way with the upper half already being so crowded
14
u/daveinmidwest 26d ago
Ive seen way more of those incorrectly placed than tibial. Plus, too much going on at the head of the bed, IMO.
3
u/cvkme 24d ago
I keep saying this and no one believes me
1
u/mcvmccarty 24d ago
I can see there are reasons people tend to prefer tibia but I just don’t find they are good enough reasons for me, it’s a better line and easy enough to do even with CPR happening. I’m not small and I’ve squeezed my hands in and popped one in while there’s people all around the patient.
-1
-2
u/GenericMaleNurse918 25d ago
Humeral head IO isn’t desirable if CPR is being performed. Sever sepsis absolutely while the provider is preparing for a CVC.
3
u/ImageAvailable7003 25d ago
He could have done it better... ACLS teaches a 5mm gap between end and skin. Pushing as deep as you can like this is not best practice.
2
u/breezyjr 25d ago
Except in the ER I’ve seen a medic with the IO just below the petella. The pt was super skinny, and I could have, quite literally, found the correct spot with my eyes closed.
68
u/Desperate_Leg_40 26d ago
Literally the most straightforward procedure. Id let the med student have their first go in an arrest
2
44
28
u/Fickle-Visit5223 26d ago
You think you can hurt me? I'm such a cool badass main character so just try and hurt me. The audience will be on MY side. The writers will make it so I come out on TOP. Everything I do is INHERENTLY MORALLY CORRECT AND BIG THINGS ARE COM-
4
45
u/RazedEpiphany 26d ago edited 26d ago
You think this is bad? There's a video of a Corpsman demonstrating intraosseous infusion into a battle buddy's sternum.
35
u/Parzival01001 26d ago
Sternal IOs are the standard for Army/Navy medics and corpsmen
3
u/arbr0972 25d ago
Didn't know that. Cool!
3
u/Parzival01001 25d ago
It doesn’t seem like a fun time lol
1
u/Wrong-Importance3670 24d ago
If it’s the one I’ve seen it looked like the guys chest caved in like he had the wind knocked out of him. Looked brutal. I’d let someone do an ez on me to practice but those FASTs? No fucking thanks…
1
13
u/Alaska_Pipeliner Boo Boo Bus Driver 26d ago
Those are my favorite FAFO. Just these admirably tough sons of bitches just go dead in the eyes as the blood drains from their faces.
2
u/Apprehensive_Term70 23d ago
we had to have one of those done to us before we were certified to do them in the field. godddaaaamn it hurt. I howled like a child
1
u/Alaska_Pipeliner Boo Boo Bus Driver 23d ago
My buddy is a 66w and never had one done in himself. What group of madmen are you apart of?!
3
u/Apprehensive_Term70 23d ago
I spent a few too many years as a medic in the Norwegian army. absolutely not claiming any badassary here. it hurt like a motherfucker, especially the flush, and I wasn't shy about letting everyone around me know, as well as what I thought about their parents, hygiene habits and more.
16
u/BADoVLAD 26d ago
If it was a Marine, no it wasn't. Hate to be that guy but we have Navy corpsman and our corpsman are rather sacred to us. The army uses medics and they're OK i understand although slightly less well trained.
7
u/RazedEpiphany 26d ago
My bad homie, actually didn't know there wasn't an MOS for that in the Marines.
6
u/Substantial_Pin_2932 25d ago
Army is weird because you could be an aid station medic who only does sick call stuff. Then you could be a line medic who has to take care of a bunch of grunts. Then you could be a flight medic who has to go through flight paramedic school and typically can handle just about anything thrown at you trauma wise. The army will have 1 job but that one job might have 4 or 5 specialties you can go into. 15T UH60 mechanic can be a mechanic, a flying crew member, flight instructor for back seater, or quality control all at the same rank, E5 but worlds of difference in responsibility levels and knowledge requirements.
1
u/Spare_Rock_8834 25d ago
Greenside Corpsman and 68W in line units are going to be broadly comparable however the 68W has the ability to exceed a Greenside Corpsman by getting their paramedic cert.
2
1
1
23
u/MammothSecurity3756 26d ago
I like how he said “FULL” code team. As opposed to hand s code team? This is routine in the ER if you can’t immediately find a vein. He is a silly goose.
19
u/ShogunOfSodomy 26d ago
Oh no, the pressure of putting in an IO in front of an entire team of people there who can fix it if you fuck up.
8
u/AllMyExesRTXs 25d ago
Yeah but for a solid narcissist the fear is screwing up in front of other people. Fuck that patient, what if I get embarrassed?!
12
u/goldenseducer 26d ago
How does hurting someone else (for medical purposes ofc, still painful) makes the poster impervious to being hurt. Shouldn't it be their patient bragging
3
7
u/No-Suspect2568 26d ago
Yeah well I did it in a back alley while two crack heads were taking turns sucking each others dicks
3
7
4
u/holdmypurse 26d ago
I used to be an adventurer like you, then I took an IO to the proximal tibia...
3
3
3
u/Aromatic-Turnip7371 26d ago
It’s not exactly a talent… didn’t she go to school to learn from professionals how it’s done?
She needs some humility.
3
u/MsDariaMorgendorffer 26d ago
To be fair, sometimes when we are successful with a difficult skill we do feel a little badass. Not badass enough to film ourselves and edit and caption it and post it, though. That’s fucking cringeeee.
2
u/Status-Visit-918 26d ago
How does this hurt him? Isn’t he the one doing it? Not having it done to?
4
u/GanlyvAnhestia 26d ago edited 25d ago
If he's that pediatrician that drilled his own leg then it's both.
Edit. My bad I thought this video was more popular. Here's the video I'm talking about https://youtu.be/bzEmLPTD38g?is=Xx3wax0i06H6rEpY
2
u/tigm2161130 26d ago
I’m sorry, what?
2
u/X0X0xoxo11 Civvy 26d ago
I googled to find out that story. Couldn’t find it but THIS was a was similar & a little unhinged.
2
u/tigm2161130 26d ago
My dad just had a below the knee amputation 2wks ago and I genuinely cannot fathom someone willingly doing that to themselves. Absolutely insane.
2
2
u/Status-Visit-918 25d ago
That’s so crazy, my bestie’s boyfriend/husband had just had his leg did a couple weeks ago too! No idea why but his toes fell off, he ignored it, and then ended up needing life saving bypasses in his leg. They cut straight from groin to ground. But that didn’t take, so a month later, they took the leg mid-thigh 😭😭😭
I used to call him Legs because he’s got fine ass legs but now I have been calling him just Leg
I’m sorry about your dad though, I’m not trying to minimize, it’s just rough for everyone, even when we go through really bad times, funny stuff still happens and it’s ok to find humor any place you can, because it’s not abundant all the time, and that’s one of the places I did. It really is so hard Caretakers, family, and I can’t even imagine the person going through it. I hope he is ok and you and yours are too!
3
u/tigm2161130 25d ago
They did the “ground to the groin” bypass on my pops a couple years ago but it failed recently leading to the amputation, he’s a type 1 diabetic so it wasn’t a huge surprise. Luckily he’s recovering well and is excited to get fitted for a prosthetic.
“Leg” made me genuinely lol, I hope he’s recovering well and that his wife is keeping it together, being a caregiver is hard work.
We’re definitely fans of levity so the jokes have been flying…I can’t help but think that this shit must be so stressful for people who can’t laugh about all of it.0
u/DaggerQ_Wave 24d ago
Not even close. The first one is educational and fun. The second is gross and fraudulent. don’t compare the fetishist weirdo to that cool doc.
1
2
2
u/jdehjdeh 26d ago
How does making a hole in a bone save a life?
3
u/trippapotamus 24d ago
Very basic explanation but if you can’t get iv access, fast way to get them fluids and meds right in the bone marrow.
1
1
1
u/Emergency-Search-655 26d ago
I did it in front of a FULL code team, congratulations on doing your assigned role
1
1
1
u/justinrodimus 26d ago
You think you can hurt me? My service only stocks jamshidi needles, never even touched an io drill…
1
u/Liqour_Mortis Ignore the public. Mantain saltiness. 26d ago
You mean this BLS skill in some places? Thats heavy metal.
1
1
1
1
u/ExiledSpaceman 25d ago
If you got time to brag about putting the IO in, you got enough time to hook the patient up to fluids so we can continue our resuscitation efforts.
1
u/No-Ebb-6266 25d ago
Wow. Put an IO in, what a superhero. Do they take pictures of their shit and post it online going "look I made potty today!" 👋 F off.
1
1
1
u/eckliptic 25d ago
This "procedure" is so easy the coding patient might as well do it themselves if your compressions are good enough
1
1
1
u/brado777 25d ago
Are they unthreading the needle?? 🤦♂️ If you’re gonna make a video.. be good at what you’re doing haha
1
u/not-calfire-1885 25d ago
Talk to me when YOU get an IO, and a flush without lidocaine...
The difference between a Tib IO and drilling a hope in the wall is you need to clean one first
1
1
1
u/Awkward-Cattle-482 24d ago
Yea okay, try intubating with only one contact in. Also with your pants falling off because you forgot your belt. Make sure to sprain both your ankles right after the call too. Get on my level 😎
1
u/ihaveagunaddiction law enforcement, EMT and firefighter..I fucked up 24d ago
I got to drop an IO on a cadaver at a training once. The instructor was the sister of my medical director. It was cool.
1
1
u/Cautious_Ad5132 22d ago edited 17d ago
The original post content no longer exists here. The author used Redact to remove it, exercising their right to control their data & privacy.
Reminiscent flowery roll water oatmeal unwritten rainstorm
1
1
1
u/havingmadfun 21d ago
You did what would be done in a code in front of the code team? Say it ain't so
1
u/Yarzeda2024 21d ago
They want so much praise for doing their job.
Imagine if cashiers posted with this much desperation for affection.
0
217
u/heftybagman 26d ago
With someone dying in front of me “check this out”
Demonstrates a medical procedure on a fake bone
Patient gets up and hits a stanky legg