Intraosseos infusion
Intraosseous infusion (IO) is the process of injecting medication, fluids, or blood products directly into the bone marrow;[1] this provides a non-collapsible entry point into the systemic venous system.[2] The needle is injected through the bone's hard cortex and into the soft marrow interior. The intraosseous infusion technique is used to provide fluids and medication when intravenous access is not available or not feasible. Intraosseous infusions allow for the administered medications and fluids to go directly into the vascular system.[3] The IO route of fluid and medication administration is an alternative to the preferred intravascular route when the latter cannot be established promptly in emergent situations. Intraosseous infusions are used when people have compromised intravenous access and need immediate delivery of life-saving fluids and medications.[3]
This route of fluid and medication administration is an alternate one to the preferred IV route when the latter can't be established in a timely manner especially during cardiac arrest.[4]
Clinical practice guidelines
In 2005, the American Heart Association first included intraosseous infusion as an option for delivery of resuscitation drugs, "If IV access cannot be established, intraosseous (IO) delivery of resuscitation drugs will achieve adequate plasma concentrations".[5]
Effectiveness
This American Heart Association guideline cited two randomized controlled trials, one of 60 children[6] and one of electively cannulated hematology/oncology patients.[7] In addition, uncontrolled studies have been performed[8][9], one of which reported 72% to 87% rates of successful insertion.[8]
Attribution
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References
- ↑ (2010) "Intraosseous access". The Journal of Emergency Medicine 39 (4): 468–475. DOI:10.1016/j.jemermed.2009.04.054. ISSN 0736-4679. PMID 19545966. Research Blogging.
- ↑ (2010) "Intraosseous infusions: a review for the anesthesiologist with a focus on pediatric use". Anesthesia & Analgesia 110 (2): 391–401. DOI:10.1213/ane.0b013e3181c03c7f. PMID 19897801. Research Blogging.
- ↑ 3.0 3.1 Day, Michael W. (2011). "Intraosseous Devices for Intravascular Access in Adult Trauma Patients". Critical Care Nurse 31 (2): 76–89. DOI:10.4037/ccn2011615. PMID 21459867. Research Blogging.
- ↑ Vreede E, Bulatovic A, Rosseel P, Lassalle X. Intraosseous Infusion. Retrieved on 2007-08-23.
- ↑ American Heart Association, (2005). "Part 4: Advanced Life Support". Circulation 112 (22 (supplement): III-25 – III-54. DOI:10.1161/CIRCULATIONAHA.105.166472. PMID 16301345. Research Blogging.
- ↑ Banerjee S, Singhi SC, Singh S, Singh M (1994). "The intraosseous route is a suitable alternative to intravenous route for fluid resuscitation in severely dehydrated children". Indian pediatrics 31 (12): 1511-20. PMID 7875811. [e]
- ↑ Brickman KR, Krupp K, Rega P, Alexander J, Guinness M (1992). "Typing and screening of blood from intraosseous access". Annals of emergency medicine 21 (4): 414-7. DOI:10.1016/S0196-0644(05)82661-7. PMID 1554180. Research Blogging.
- ↑ 8.0 8.1 Frascone RJ, Jensen JP, Kaye K, Salzman JG (2007). "Consecutive field trials using two different intraosseous devices". Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors 11 (2): 164-71. DOI:10.1080/10903120701205851. PMID 17454802. Research Blogging.
- ↑ Davidoff J, Fowler R, Gordon D, et al (2005). "Clinical evaluation of a novel intraosseous device for adults: prospective, 250-patient, multi-center trial". JEMS : a journal of emergency medical services 30 (10): suppl 20-23. PMID 16382512. [e]