User:Mr. Ibrahem/Intraosseous infusion

Intraosseous infusion (IO) is an injection through a specialized needle into the marrow of a bone. It is used to give fluids and medication when intravenous access is not easily or rapidly available. It is generally faster than intravenous access, with evidence that it can be placed in under 20 seconds. Blood tests may also be run from an IO sample.

Preparation involve sterilizing the area and potentially using local anesthesia. When using the drill, the first step is to push the needle through the skin perpendicular to the bone until bone is contacted. At this point the drill is activated with some downwards pressure. In adults the proximal tibia and humeral head are most commonly used, while in babies the distal femur and proximal tibia are most commonly used. The site for the proximal tibia is a finger width below the tibial tuberosity and a bit to the inside.

Signs of success include a stable needle, ability to aspirate bone marrow, and the ability to flush normal saline (NS). To reduce injection pain, place 20 mg of 2% lidocaine in an adult before flushing with 10 ml if NS. The needle is then stabilized. Any medication that can be given intravenously (IV) can be given IO, including contrast agents. The device can be used for up to 24 hours. The procedure was developed in the 1920s to 1940s.