- Consensus is that all drugs required for emergency situations can be given via the intraosseous routes:
- Includes any drugs given peripherally or centrally
- The only exception is bretylium (anti-arrhythmic)
- Achieves pharmacokinetics comparable with central venous access
- Intraosseous dosages are typically identical to IV dosages.
- Fluid must be infused under pressure via the IO route:
- An IV pressure bag is usually required to generate optimal flows
- Different rates can be achieved according to the insertion site:
- Flow rates are dependent on performing a syringe flush prior us
- The sternal site provides the fastest flow but is not routinely recommended
- Estimates from a study with fluid infused at 300mg pressure suggest flows of:
Site
Flow Rate
Humerus
5L/hour
(~80ml/min)
(~80ml/min)
Tibia
1L/hour
(~15ml/min)
(~15ml/min)