IV Access
The preferred standard catheter size (gauge) used by 68Ws to initiate a combat-ready peripheral IV.
An 18-gauge catheter (or needle).
The primary bone in the lower leg used as an anatomical site for pediatric and adult IO insertion.
The tibia (proximal or distal).
This non-opioid, fast-acting pain medication is delivered via the intranasal or oral transmucosal route for moderate-to-severe pain.
Fentanyl (Fentanyl Oral Transmucosal/OTFC) or Ketamine.
This is the primary physiological benefit of administering TXA to a casualty with hemorrhagic shock.
It stops the breakdown of blood clots (anti-fibrinolytic).
This local complication occurs when IV fluids or medications escape from the vein into the surrounding tissue.
Infiltration (or extravasation).
This elastic band must be applied 2 to 4 inches above your intended venipuncture site to engorge the vein
A tourniquet.
This bone, located in the upper arm, is a highly effective adult site for IO insertion, offering rapid infusion directly to the central circulation.
The humerus (proximal humerus).
The standard intravenous dose of Ketamine (in mg) administered via slow IV push for severe pain.
20 mg.
The standard initial dose (in grams) of TXA given to a casualty on the battlefield.
1 gram (or 2 grams under updated guidelines).
This occurs when air is introduced into the venous system, potentially traveling to the heart or lungs.
An air embolism.
The recommended insertion angle (in degrees) when first piercing the skin to gain venous access.
10 to 30 degrees.
This hand-held, battery-powered driver is the standard device used by the Army to insert an IO needle
The EZ-IO driver.
This class of broad-spectrum antibiotic is carried in the Tactical Combat Casualty Care (TCCC) Combat Wound Medication Pack (CWMP).
Moxifloxacin (or Ertapenem for IV/IM).
Under TCCC guidelines, TXA must be administered within this maximum timeframe (in hours) from the point of injury to be effective.
Three (3) hours.
This is the medical term for the inflammation of a vein wall, often caused by prolonged catheter placement.
Phlebitis.
This specific, clear fluid backflow indicates to the medic that the needle has successfully entered the lumen of the vein.
Flashback (or blood flash).
Because fluid flowing into the bone marrow can cause severe pain, this local anesthetic is slowly infused prior to flushing the IO line in conscious patients.
Lidocaine.
This fast-acting medication is the drug of choice for treating anaphylaxis on the battlefield.
Epinephrine (Adrenaline).
TXA should be administered via slow IV/IO infusion over this minimum timeframe (in minutes) to prevent severe hypotension.
10 minutes.
The crucial step of injecting 5–10 mL of normal saline to ensure the IV line is patent and cleared of clots.
Flushing the line.
When a peripheral vein cannot be accessed in a hypovolemic patient, this is the maximum number of peripheral IV attempts a medic should make before moving to alternative access.
Two (2) attempts.
The contraindication that prevents a medic from placing an IO in a specific target limb.
A fracture in that target bone (or severe trauma/infection at the site).
To reverse the life-threatening respiratory depression caused by opioids, a medic must administer this antagonist.
Naloxone (Narcan).
This is the volume of fluid (typically Normal Saline or Lactated Ringer's) that 1 gram of TXA is mixed into before administration.
100 mL.
This systemic complication occurs when a medic infuses fluids too rapidly, leading to respiratory distress, crackles in the lungs, and edema.
Fluid overload (or circulatory overload).