Introduction You are attending a patient in A&E admitted with polytrauma. There have been multiple attempts to gain IV access which have been unsuccessful. You suggest inserting an intraosseous needle to deliver drugs and...
In general, indications for both adults and children include: Failure to gain intravenous access in a resuscitation, trauma or peri-arrest setting allowing stabilization and facilitation of definitive, long-term intravenous access Failure to gain access in a...
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...
Risk to the clinician (e.g. lack of patient compliance). Fracture in target bone (compartment syndrome risk) Attempt on target bone within 48 hours Overlying site infection Previous surgery near the insertion site (caution plates or implants) Severe obesity or...
Overall rate of serious complications is of (<1%) Vascular Complications Extravasation (most common)Compartment syndrome (if large extravasation or infiltration goes unnoticed)Embolism (air or fat) Osseous Complications Fracture of the target bone Necrosis of...
