Intraosseous needle insertion is
a procedure for obtaining access to the circulation in an emergency
, including in some cases of cardiac arrest. This route can be used to administer recommended dosage of drugs and fluids and to collect blood for pathology.
How do you use an intraosseous needle?
- Identify the appropriate site. …
- Prepare the skin.
- Insert the needle through the skin, and then with a screwing motion perpendicularly / slightly away from the physeal plate into the bone. …
- Remove the trocar and confirm position by aspirating bone marrow through a 5 mL syringe.
Where do you put an IO?
The first step in the placement of an IO needle is site selection. The location options include
the proximal tibia on the medial flat side at the level of the tibial tuberosity
. In adults, this spot is about three cm distal to the inferior border of the patella. Another site is the distal tibia.
How do you know when an intraosseous needle is placed?
A properly placed IO line must be through the cortex of the bone and situated within the marrow cavity. Standard methods for confirmation of IO placement include aspiration of bone marrow,
firm placement of the IO needle into the bone
, and no evidence of extravasation.
Does an IO needle hurt?
7 Extreme Pain: Although IO insertion looks painful, when inserted with a drill device,
it is reported to be no more painful than an insertion of
an 18g IV cathlon. There have been reports of increased pain with high-pressure infusions in conscious patients related to stimulation of pressure sensors within the bone.
When do you use intraosseous infusion?
Intraosseous infusion (IO) is used in
pediatric populations during anesthesia when other intravenous access
, central venous catherization or venous cutdown, are difficult to use or cannot be used. When individuals are severely ill and are in need of “rapid, efficient, and safe delivery of drugs”, IO is used.
What drugs can you give intraosseous?
While all resuscitation drugs can be given by the IO route, administration of
ceftriaxone, chloramphenicol, phenytoin, tobramycin, and vancomycin
may result in lower peak serum concentrations. The most common adverse effect seen with IO use, extravasation, has been reported in 12% of patients.
Can nurses insert intraosseous?
The Emergency Nurses Association and ACEP both have positions that support the use of intraosseous (IO) vascular access to include insertion by nurses.
What Cannot be given intraosseous?
Contraindications to IO insertion include
fracture at or proximal to the insertion site
, cellulitis or other infection overlying the insertion site, prior attempt at the insertion site, or bone disease such as osteogenesis imperfecta or osteopetrosis.
What size is an IO needle?
IO needle set:
45mm
(humerus insertion or excessive tissue), 25mm (> 40kg)
What confirms that an intraosseous needle is correctly inserted into the marrow cavity?
Use a twisting motion with gentle but firm pressure.
until there is a sudden release of resistance as the needle enters
the marrow space. If the needle is placed correctly, it should stand easily without support.
Can you draw blood from intraosseous?
Blood drawn from an IO
can be used for type and cross, chemistry, blood gas
. There is not good correlation with Sodium, Potassium, CO
2
, and calcium levels.
Who can insert intraosseous?
It is the position of the Infusion Nurses Society that
a qualified RN
, who is proficient in infusion therapy and who has been appropriately trained for the procedure, may insert, maintain, and remove intraosseous access devices.
How long can an IO needle stay in?
The intraosseous needle may remain in situ for
72 to 96 hours
, but it is best removed within 6 to 12 hours, as soon as an alternative site of intravascular access has been established. The intraosseous route provides fast and reliable vascular access in emergency medical situations.
Why do paramedics drill into leg?
The bone drill can be
used to quickly insert an intraosseous needle directly into the bone to dispense fluids, medications or sugar
. … Previously, paramedics used a small, handheld plug to literally ram the needle into the patient’s leg bone near the knee. “If you’re just doing it by hand, it’s tougher,” said Dr.
How fast can you run fluids through an intraosseous cannula?
The maximum rate of administration through the IO needle was reportedly equivalent to a 21 G peripheral cannula [23]. The flow rates of an intravenous cannula are typically in the range of 200 (16 G peripheral cannula)
to 20 ml/min
(24 G peripheral cannula) [30].
