| Mr. Ibrahem/Intraosseous infusion | |
|---|---|
 The tibia IO insertion sites are just below the tibial tuberosity and just above the medial malleolus.[1] | |
| Other names | Intraosseous vascular access |
| Specialty | Emergency medicine |
| Complications | Fracture, osteomyelitis[1] |
Intraosseous infusion (IO) is an injection through a specialized needle into the marrow of a bone.[1] It is used to give fluids and medication when intravenous access is not easily or rapidly available.[3] It is generally faster than intravenous access, with evidence that it can be placed in under 20 seconds.[1] Blood tests may also be run from an IO sample.[1]
Preparation involve sterilizing the area and potentially using local anesthesia.[1] When using the drill, the first step is to push the needle through the skin perpendicular to the bone until bone is contacted.[2] At this point the drill is activated with some downwards pressure.[2] In adults the proximal tibia and humeral head are most commonly used, while in babies the distal femur and proximal tibia are most commonly used.[1] The site for the proximal tibia is a finger width below the tibial tuberosity and a bit to the inside.[1]
Signs of success include a stable needle, ability to aspirate bone marrow, and the ability to flush normal saline (NS).[1] To reduce injection pain, place 20 mg of 2% lidocaine in an adult before flushing with 10 ml if NS.[1] The needle is then stabilized.[1] Any medication that can be given intravenously (IV) can be given IO, including contrast agents.[1] The device can be used for up to 24 hours.[1] The procedure was developed in the 1920s to 1940s.[1][3]
References edit
- ^ a b c d e f g h i j k l m n o p q r Dornhofer, P; Kellar, JZ (January 2021). "Intraosseous Vascular Access". PMID 32119260.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Roberts and Hedges' clinical procedures in emergency medicine and acute care (Seventh ed.). Philadelphia, PA: Elsevier Health Sciences. 2019. p. 472. ISBN 9780323547949.
- ^ a b Petitpas, F; Guenezan, J; Vendeuvre, T; Scepi, M; Oriot, D; Mimoz, O (14 April 2016). "Use of intra-osseous access in adults: a systematic review". Critical care (London, England). 20: 102. doi:10.1186/s13054-016-1277-6. PMID 27075364.
{{cite journal}}: CS1 maint: unflagged free DOI (link)