Distal Femur IO Access
(Pediatrics Only)
FF/P Cynthia Kovacich ALS Continuing Education CoordinatorFall, 2025
Indications
We use the distal femur IO site in very specific situations:
1. In cardiac arrest, for pediatric patients OR
2. When vascular access isn’t available, after two unsuccessful peripheral IV attempts, in any patient with a life-threatening illness or injury requiring medications or fluids
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Contraindications
Infection or cellulitis at the insertion site
A conscious patient with stable vital signs
When vascular access is readily available
A known bone disorder
Suspected or known fractures in the targeted extremity
Prior joint replacement in the targeted extremity
A previous IO attempt in the same bone within 48 hours
Unable to identify landmarks
Remember: only two attempts are allowed. If more are needed, consult before proceeding.
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Why Choose the Distal Femur?
- 95% success rate for both the proximal humerus and distal femur
- Reduced risk of dislodgement
- About 10% in the femur, compared to 15–16% in the humerus or tibia
- Excellent flow rates
- Around 100–105 cc per minute, which is comparable to other sites
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Needle Sizing
EZ-IO® needle sets come in three sizes:- 15 mm needle for patients weighing 3–39 kilograms.
- 25 mm needle for patients 3 kilograms and up.
- 45 mm needle for patients 40 kilograms and above.
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Distal Femur IO Access Demonstration
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Conclusion
Remember, this site is for pediatric patients only, and it requires careful attention to detail.
By practicing good site selection, positioning, and technique, you’ll increase your chances of success and reduce complications.
Thank you for your commitment to keeping our patients safe.
Exit presentation
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Distal Femur IO Access
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Transcript
Distal Femur IO Access
(Pediatrics Only)
FF/P Cynthia Kovacich ALS Continuing Education CoordinatorFall, 2025
Indications
We use the distal femur IO site in very specific situations: 1. In cardiac arrest, for pediatric patients OR 2. When vascular access isn’t available, after two unsuccessful peripheral IV attempts, in any patient with a life-threatening illness or injury requiring medications or fluids
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Contraindications
Infection or cellulitis at the insertion site
A conscious patient with stable vital signs
When vascular access is readily available
A known bone disorder
Suspected or known fractures in the targeted extremity
Prior joint replacement in the targeted extremity
A previous IO attempt in the same bone within 48 hours
Unable to identify landmarks
Remember: only two attempts are allowed. If more are needed, consult before proceeding.
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Why Choose the Distal Femur?
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Needle Sizing
EZ-IO® needle sets come in three sizes:- 15 mm needle for patients weighing 3–39 kilograms.
- 25 mm needle for patients 3 kilograms and up.
- 45 mm needle for patients 40 kilograms and above.
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Distal Femur IO Access Demonstration
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025
Conclusion
Remember, this site is for pediatric patients only, and it requires careful attention to detail. By practicing good site selection, positioning, and technique, you’ll increase your chances of success and reduce complications. Thank you for your commitment to keeping our patients safe.
Exit presentation
Howard County Department of Fire and Rescue Services | Bureau of Education and Training | 2025