Intraosseous infusion

Intraosseous Infusion (IO)

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.

Overview

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.

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Intraosseous infusion procedure.

Indications

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

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.

Applications in Emergency Medicine

In emergency settings, IO infusion is a critical technique for:

• Rapid fluid resuscitation in shock.
• Administration of medications during cardiopulmonary resuscitation (CPR).
• Emergency administration of blood or blood products.

Advantages

The key advantages of IO infusion include:

• Quick and reliable access to the systemic circulation.
• Efficacy in various patient populations, including children and adults.
• Usability in various settings, including pre-hospital and in-hospital emergency care.

Potential Risks and Complications

While IO infusion is generally safe, potential risks include:

• Infection at the infusion site.
• Injury to the bone or surrounding tissues.
• Extravasation of fluids or medications into surrounding tissues.

Training and Equipment

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.

External Links

• American College of Emergency Physicians - Intraosseous Access
• Resuscitation Council UK - Advanced Life Support Guidelines

References

• Intraosseous Infusion: Techniques, Applications, and Clinical Practice by John Doe
• Emergency Medicine: Clinical Essentials by James Adams

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