Into the bone

Last week in our pediatric lecture class, the instructor showed us the equipment used for intraosseous access. Everyone knows about intravenous (IV) access, but IO is so much cooler. Rather than using a vein to infuse fluids, a bone is used instead. It seems bizarre to jab a needle into a femur or sternum, but bone is highly vascularized and fluids infused by that route rapidly enter the bloodstream. Also, bone doesn’t collapse or roll like veins can, and studies show that there is no increased risk of infection. Right now, IO access is used in critical cases where immediate fluid resuscitation is required.



I’ve seen a child come into the ICU by helicopter transport with an IO line that was started by the flight nurse. It works pretty much like an IV. The needle with attached catheter is inserted and the metal guide known as a stylus is removed. The tubing is hooked up and it’s ready to go.