The patient is pale and dizzy following a gunshot wound to the groin. Minimal bleeding is noted at the site. Vital signs are notable for a heart rate of 125 bpm and a blood pressure of 73/39 mm Hg. Two unsuccessful attempts have been made to establish an IV site. He loses consciousness. Which action does the nurse take next?

Prepare to establish an intraosseous (IO) site. The patient is symptomatic for hemorrhage, likely from an internal injury to the femoral artery. The most immediate concern is to rapidly obtain IV access to administer blood products as quickly as possible. Establishing access using an intraosseous site (IO) will be the quickest way of obtaining IV access. Attempting to establish an IV site again will be slower than using an IO, especially after two failed attempts. Inserting a central line will take longer to place than an IO will. Using ultrasound guided IV placement may be appropriate when it is difficult to establish IV access, but will take longer than an IO will, and is not best for this emergent situation.

The patient is pale and dizzy following a gunshot wound to the gr...

Category: Physiological Adaptation
Difficulty: 4

Topics: Cardiovascular Hematology/Oncology Routes of Administration Delegation, Prioritization and Leadership Fluid and Electrolytes Health Care Quality Medication and Blood Products Nursing Interventions

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