>We are planning a procedures lab for training our RN's and RRT's in advance-
>directed pediatric transport. .....Similarly, are chicken legs still
the"best" for simulating IO's?
>Clearly $$, time, and availability are all factors being considered...
>Thank you in advance for your assistance.
>Scott Freedman MD
The chicken leg is the best simulation of an infants tibia for IO
placement, in terms of ease of insertion, thickness of cortex etc. I
strongly believe that a manikin that has *correct lower leg anatomy and
landmarks* is a must. One of the more common errors I see is a failure to
place the needle in the tibia when residents and medics try this in live
children (they hit the anterior or posterior compartment). One possible
explanation is training only with a chicken leg that has no landmarks and
no flat bony surface.
Older children have thicker tibial cortex and are more difficult to insert
the IO needle in (No clear simulation winner for the older child, although
beef ribs have been used).
Michael Tunik, MD
Pediatric Emergency Medicine
Bellevue Hospital Center/NYU School of Medicine
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