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Copy of Intraosseous (IO) needle insertion

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by

Sondae Stevens

on 12 January 2013

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Transcript of Copy of Intraosseous (IO) needle insertion

Intraosseous (IO) Needle Insertion The goal of this class is to discuss general indications, contraindications, and complications of intraosseous access and infusion, focusing on the proper steps of insertion. Objectives: By the end of the class the student will be able to:
1.State the indications of IO needle insertion.
2.List the contraindications of IO needle insertion.
3.Identify the complications of IO needle insertion.
4.Demonstrate the proper steps of IO needle insertion. Pathophysiology The bone marrow is a rich network of vessels that drain into a central venous canal. Therefore, the bone marrow functions as a no collapsible venous access route when peripheral veins may have collapsed because of hypovolemic shock and vasoconstriction. This access is very important in patients in shock or cardiac arrest, when blood is shunted to the core due to compensatory peripheral vasoconstriction. The IO route allows fluids and medications to enter the central circulation within seconds. The risks and complications of (IO) insertion are few, and the benefits far outweigh the risks in a child without intravenous (IV) access who needs rapid administration of medication or fluid.

Extravasation of fluid is the most common complication. It typically occurs when a needle is misplaced

Compartment syndrome. The needle must enter through the cortex and into the marrow cavity without passing through the cortex on the other side. If the needle is passed through the opposite cortex, infused fluid enters the calf rather than the venous system. Risks and Complications Other possible complications include local hematoma, pain, fracture and growth plate injuries Infection (osteomyelities) are relatively rare complications and occur most commonly if aseptic technique is not followed during insertion. Alternative Insertion Sites Alternative sites for intraosseous insertion include the distal tibia, distal femur, sternum, and humerus. Alternative sites are used in special situations, such as fractures of the tibia. Contraindications of IO needle insertion The only absolute contraindication is fracture of the tibia or long bones.

Relative contraindications to IO insertion include the following:
Cellulitis the risk of introducing bacteria into the bone or bloodstream.
Inferior vena caval injury.
Previous attempt on the same leg bone.
Osteogenesis imperfecta because of a high risk of fractures.
Osteopetrosis. Procedure
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