What is Intraosseous Infusion?
Intraosseous infusion is a medical procedure in which fluids and medications are directly administered into the bone marrow. This technique is typically used in emergency situations where intravenous access is difficult or impossible. The bone marrow's vascular network allows for rapid absorption into the systemic circulation, making it a viable alternative to traditional intravenous routes. When is Intraosseous Infusion Used?
Intraosseous infusion is primarily used in
emergency medicine scenarios, such as cardiac arrest, trauma, and shock, where
intravenous (IV) access is challenging. It is often employed in pediatric patients, whose smaller veins can complicate IV access. Additionally, it can be used in adult patients with collapsed veins due to severe dehydration, obesity, or vascular disease.
Sites for Intraosseous Infusion
The most common sites for intraosseous access include the
proximal tibia,
distal femur, and
proximal humerus. These locations are chosen due to their accessibility and minimal risk of damaging surrounding structures. The sternum may also be used, particularly in adults.
Procedure and Equipment
The procedure involves the use of a specialized needle, which is inserted into the bone cortex to reach the marrow. Equipment typically includes an
intraosseous needle, drill or manual driver, and a pressure bag for fluid administration. Sterile technique is crucial to prevent infection.
Advantages of Intraosseous Infusion
Rapid access to the circulatory system, facilitating the quick delivery of medications and fluids.
Can be established in under a minute by trained healthcare professionals.
Useful in patients where
IV access is difficult or impossible.
Reduces the time to treatment in critical situations.
Potential Complications
While intraosseous infusion is generally safe, there are potential complications, including
osteomyelitis (bone infection), compartment syndrome, and damage to growth plates in pediatric patients. Extravasation of fluids into surrounding tissues can also occur if the needle is improperly placed.
Nursing Responsibilities
Nurses play a critical role in the management of intraosseous infusions. They are responsible for assessing the patient, assisting with the procedure, and monitoring for complications. Nurses must ensure that the insertion site is kept clean and dry and that the infusion is flowing correctly. Regular assessment of the site for signs of infection or extravasation is essential. Training and Competency
Proper training is essential for healthcare professionals to perform intraosseous infusion safely and effectively. Many institutions provide
training and competency assessments for nurses and other emergency personnel. Simulation-based training can enhance skill acquisition and confidence in performing the procedure.
Conclusion
Intraosseous infusion is a critical technique in emergency medicine, offering a reliable alternative when
IV access is not feasible. With proper training and vigilance in monitoring, nurses can effectively utilize this method to improve patient outcomes in urgent care settings.
