Intraosseous Line Insertion




Indications



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  • • Emergent temporary vascular access during cardiopulmonary resuscitation or during the treatment of uncompensated shock when unable to insert an intravenous line.


    • Volume resuscitation.


    • Administration of blood and blood products.


    • Administration of fluids and electrolytes.


    • Administration of medications.


    • Infusion of inotropes and pressors.


    • Sampling of blood and bone marrow.





Contraindications



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Absolute





  • • Do not insert in a recently fractured bone.


    • Do not insert through an infected site.


    • Osteogenesis imperfecta.


    • Osteopetrosis.





Relative





  • • Osteoporosis or osteopenia.


    • Cystic bones.





Equipment



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• Caution: All equipment must be latex free.






  • • Intraosseous needle (18 or 20 gauge) or bone marrow aspiration needle.


    • Povidone, chlorhexidine, and alcohol wipes.


    • Gauze.


    • Tape.


    • Extension tubing.


    • T-connector.


    • Syringe.


    • Gloves.





Risks



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• Each of the risks listed is < 1%.






  • • Infection.


    • Injury to growth plate.


    • Bone fracture.


    • Hematoma.


    • Extravasation.


    • Compartment syndrome.


    • Severe vasoconstriction if vasoactive substances extravasate.



Jan 4, 2019 | Posted by in PEDIATRICS | Comments Off on Intraosseous Line Insertion

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