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Intraosseous Access (I.O.)

Intraosseous Access (I.O.). Procedure. Preparation. Sterile technique Check needle – align bevels of the needle Support leg on firm surface Palpate landmark – flat surface of tibia below and medial to tibial tuberosity. Insertion. Insert needle through skin over flat surface of tibia

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Intraosseous Access (I.O.)

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  1. Intraosseous Access (I.O.) Procedure

  2. Preparation • Sterile technique • Check needle – align bevels of the needle • Support leg on firm surface • Palpate landmark – flat surface of tibia below and medial to tibial tuberosity

  3. Insertion • Insert needle through skin over flat surface of tibia • Use gentle/firm twisting motion • Advance needle through bony cortex of proximal tibia • Direct needle at 90 degree angle to axis of bone • Twist, DO NOT push!!!! • Stop advancing when sudden decrease in resistance is felt

  4. Secure Site • Unscrew cap and remove stylet • Attempt to aspirate bone marrow • If aspiration successful, irrigate needle • If unsuccessful, check position, consider flushing • Stabilize I.O. • Slowly inject 10 cc normal saline solution

  5. Signs of Rejection • Resistance to injection • Increased circumference of the soft tissue of calf • Increased firmness

  6. Why use Intraosseous Access ? • Provides access to a noncollapsible marrow venous plexus • Rapid, safe reliable • Route of administration for: • Crystalloids – Normal saline or Ringer’s Lactate • Colloids – Volume Expanders • Drugs • Blood

  7. Reference Pediatric Advanced Life Support (2007). Handout from class given at Memorial Hospital, York, PA (2009).

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