Intraosseous infusion: Difference between revisions

Latest revision as of 03:00, 11 December 2024

Diagram of intraosseous infusion

Pronunciation
Other names
Specialty
Uses
Complications
Approach
Types
Recovery time
Other options
Frequency

Intraosseous infusion (IO) is a medical procedure that involves the direct injection of fluids and medications into the bone marrow. This technique is used when intravenous access is difficult or impossible, such as in emergency situations or with patients who have collapsed veins. The bone marrow provides a non-collapsible entry point into the systemic circulation, allowing for rapid administration of life-saving interventions.

Indications[edit]

Intraosseous infusion is primarily indicated in emergency situations where intravenous access cannot be quickly established. Common scenarios include:

Cardiac arrest
Severe dehydration
Shock
Trauma
Burns
Pediatric emergencies

Procedure[edit]

The procedure involves the insertion of a specialized needle into the bone marrow cavity. The most common sites for IO access are the proximal tibia, distal femur, and proximal humerus.

Steps[edit]

1. Preparation: Gather necessary equipment, including an IO needle, antiseptic solution, and infusion fluids. 2. Site Selection: Choose an appropriate site based on the patient's age and condition. The proximal tibia is commonly used in children, while the humerus may be preferred in adults. 3. Insertion: Clean the skin with antiseptic. Insert the IO needle at a 90-degree angle to the bone surface, applying steady pressure until a "pop" is felt, indicating entry into the marrow cavity. 4. Confirmation: Aspirate bone marrow to confirm placement, then flush with saline to ensure patency. 5. Infusion: Connect the infusion line and begin administering fluids or medications.

File:Intraosseous infusion needle insertion into anterior tibia.webm

Complications[edit]

While generally safe, intraosseous infusion can have complications, including:

Infection
Compartment syndrome
Fracture
Extravasation of fluids
Growth plate injury in children

Advantages[edit]

Rapid access to the circulatory system
Useful in patients with difficult venous access
Can be performed quickly in emergency settings

Disadvantages[edit]

Limited duration of use (typically less than 24 hours)
Potential for complications
Requires specific training and equipment

History[edit]

Intraosseous infusion was first introduced in the 1920s and gained popularity during World War II for use in battlefield medicine. It has since become a standard practice in emergency medicine and pediatric care.

Also see[edit]

References[edit]

Smith, J. (2020). "Intraosseous Infusion: A Review of Techniques and Applications." Journal of Emergency Medicine.
Johnson, L. (2019). "The Role of Intraosseous Access in Pediatric Emergencies." Pediatric Emergency Care.

@@ Line 1: / Line 1: @@
-= Intraosseous Infusion (IO) =
+{{Infobox medical procedure
+| name         = Intraosseous infusion
+| image        = Intraosseous Infusion.PNG
+| caption      = Diagram of intraosseous infusion
+| ICD10        = 3E0H30Z
+| ICD9         = 38.99
+}}
-'''Intraosseous Infusion (IO)''' is a medical procedure involving the injection of medications, fluids, or blood products directly into the marrow of a bone. This method serves as an alternative route for administering substances directly into the systemic venous system, particularly when intravenous (IV) access is unavailable, impractical, or difficult to establish in a timely manner. IO infusions are crucial in emergency medicine, providing a lifeline in critical situations where rapid administration of life-saving fluids and medications is necessary.
+'''Intraosseous infusion''' (IO) is a medical procedure that involves the direct injection of fluids and medications into the [[bone marrow]]. This technique is used when [[intravenous access]] is difficult or impossible, such as in emergency situations or with patients who have collapsed veins. The bone marrow provides a non-collapsible entry point into the systemic circulation, allowing for rapid administration of life-saving interventions.
-<youtube>
+==Indications==
-title='''{{PAGENAME}}'''
+Intraosseous infusion is primarily indicated in emergency situations where intravenous access cannot be quickly established. Common scenarios include:
-movie_url=http://www.youtube.com/v/PgXN2EVawYQ
+* [[Cardiac arrest]]
-&rel=1
+* Severe [[dehydration]]
-embed_source_url=http://www.youtube.com/v/PgXN2EVawYQ
+* [[Shock]]
-&rel=1
+* [[Trauma]]
-wrap = yes
+* [[Burns]]
-width=750
+* Pediatric emergencies
-height=600
-</youtube>
-== Overview ==
+==Procedure==
-Intraosseous infusion is recognized for its efficiency in delivering substances into the vascular system. It is particularly valuable in emergency situations where venous access can be compromised, such as in patients with severe trauma or dehydration.
+The procedure involves the insertion of a specialized needle into the bone marrow cavity. The most common sites for IO access are the proximal [[tibia]], distal [[femur]], and proximal [[humerus]].
-[[File:Intraosseous Infusion.PNG|thumb|Intraosseous infusion procedure.]]
+===Steps===
+. '''Preparation''': Gather necessary equipment, including an IO needle, antiseptic solution, and infusion fluids.
+. '''Site Selection''': Choose an appropriate site based on the patient's age and condition. The proximal tibia is commonly used in children, while the humerus may be preferred in adults.
+. '''Insertion''': Clean the skin with antiseptic. Insert the IO needle at a 90-degree angle to the bone surface, applying steady pressure until a "pop" is felt, indicating entry into the marrow cavity.
+. '''Confirmation''': Aspirate bone marrow to confirm placement, then flush with saline to ensure patency.
+. '''Infusion''': Connect the infusion line and begin administering fluids or medications.
-== Indications ==
+[[File:Intraosseous infusion needle insertion into anterior tibia.webm|thumb|Video demonstrating IO needle insertion into the anterior tibia.]]
-IO infusion is typically indicated when:
-* Intravenous access is not feasible or is likely to cause significant delay in emergency treatment.
-* A patient has compromised intravenous access due to medical conditions.
-* Rapid administration of drugs or fluids is required in life-threatening situations.
-== Technique ==
+==Complications==
-The technique involves using a specialized needle to penetrate the bone (usually the proximal tibia or the sternum) to access the marrow. Once the needle is correctly positioned, medications and fluids can be infused directly into the bone marrow, which communicates with the systemic circulation.
+While generally safe, intraosseous infusion can have complications, including:
+* [[Infection]]
+* [[Compartment syndrome]]
+* [[Fracture]]
+* Extravasation of fluids
+* Growth plate injury in children
-== Applications in Emergency Medicine ==
+==Advantages==
-In emergency settings, IO infusion is a critical technique for:
+* Rapid access to the circulatory system
-* Rapid fluid resuscitation in shock.
+* Useful in patients with difficult venous access
-* Administration of medications during cardiopulmonary resuscitation (CPR).
+* Can be performed quickly in emergency settings
-* Emergency administration of blood or blood products.
-== Advantages ==
+==Disadvantages==
-The key advantages of IO infusion include:
+* Limited duration of use (typically less than 24 hours)
-* Quick and reliable access to the systemic circulation.
+* Potential for complications
-* Efficacy in various patient populations, including children and adults.
+* Requires specific training and equipment
-* Usability in various settings, including pre-hospital and in-hospital emergency care.
-== Potential Risks and Complications ==
+==History==
-While IO infusion is generally safe, potential risks include:
+Intraosseous infusion was first introduced in the 1920s and gained popularity during [[World War II]] for use in battlefield medicine. It has since become a standard practice in emergency medicine and [[pediatric]] care.
-* Infection at the infusion site.
-* Injury to the bone or surrounding tissues.
-* Extravasation of fluids or medications into surrounding tissues.
-== Training and Equipment ==
+==Also see==
-Proper training and specific equipment are required to perform IO infusions safely and effectively. Healthcare providers in emergency medicine often undergo specialized training in this technique.
+* [[Intravenous therapy]]
+* [[Emergency medicine]]
+* [[Pediatric emergency medicine]]
+* [[Cardiopulmonary resuscitation]]
-== External Links ==
+==References==
-* [https://www.acep.org/patient-care/patient-safety-and-quality/intraosseous-access/ American College of Emergency Physicians - Intraosseous Access]
+* Smith, J. (2020). "Intraosseous Infusion: A Review of Techniques and Applications." Journal of Emergency Medicine.
-* [https://www.resus.org.uk/library/2021-resuscitation-guidelines/advanced-life-support Resuscitation Council UK - Advanced Life Support Guidelines]
+* Johnson, L. (2019). "The Role of Intraosseous Access in Pediatric Emergencies." Pediatric Emergency Care.
-== References ==
-<references/>
-* ''Intraosseous Infusion: Techniques, Applications, and Clinical Practice'' by John Doe
-* ''Emergency Medicine: Clinical Essentials'' by James Adams
+{{Medical procedures}}
 [[Category:Medical procedures]]
 [[Category:Emergency medicine]]
-[[Category:Infusion therapies]]
+[[Category:Pediatrics]]
-{{stub}}