Comparison Study of Intraosseous, Central Intravenous, and Peripheral Intravenous Infusions of Emergency Drugs

Orlowski, James P.; Porembka, David T.; Gallagher, Jean M; Lockrem, John D.; VanLente, Frederick

doi:10.1001/archpedi.1990.02150250124049

Cited by 71 publications

(55 citation statements)

References 15 publications

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“…185 IO access can be used to obtain blood samples for analysis including for type and cross match and blood gases during CPR, 186 but acid-base analysis is inaccurate after sodium bicarbonate administration via the IO cannula. 187 Use manual pressure or an infusion pump to administer viscous drugs or rapid fluid boluses; 188,189 follow each medication with a saline flush to promote entry into the central circulation.…”

Section: Intraosseous (Io) Accessmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

913

304

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Section: Intraosseous (Io) Accessmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

913

304

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“…Even if intravenous access was established, the small lumen of the catheters inhibited the rapid flow of intravenous fluid, medications, and blood. Multiple reviews, 7,10,11 reports, and studies in the 1980s and early 1990s indicated the effectiveness of intraosseous devices in animal models, [12][13][14] in children and adults in the prehospital setting, 15,16 and in adults in the hospital. 6 On the basis of these studies, in 1985 the American Heart Association 17 endorsed the use of intraosseous devices in children; the current guidelines 18 continue that endorsement.…”

Section: Intraosseous Anatomymentioning

confidence: 99%

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Day

2011

Critical Care Nurse

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Three intraosseous devices have been approved by the Food and Drug Administration for use in adult trauma patients when intravenous access cannot be obtained. Sites of insertion are the sternum (FAST1), proximal tibia and humerus (Big Injection Gun), and proximal and distal tibia and humerus (EZ-IO). Insertion generally requires less than 1 minute, and flow rates up to 125 mL/min can be achieved. The devices are used for emergency resuscitation and should be removed within 24 hours of insertion or as soon as practical after peripheral or central intravenous access has been achieved. Contraindications include fractures or other trauma at the insertion site, prosthetic joints near the site, previous attempts to insert an intra osseous device at the same site, osteoporosis or other bone abnormalities, infections at the proposed site, and inability to identify pertinent insertion landmarks. Primary complications are extravasation of medications and fluids into the soft tissue, fractures caused by the insertion, and osteomyelitis.

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“…23 Pharmacokinetic studies have shown similar physiological effects and serum drug levels when comparing the intraosseous and intravenous routes. 24 Any currently approved medication or blood product that can be infused intravenously can be safely infused via the IO route. An exception to this may be the use of hypertonic saline (HS) for small volume resuscitation in hemorrhagic shock.…”

Section: Considerations Limitations and Contraindicationsmentioning

confidence: 99%