[The intraosseal route. When the veins have disappeared]

The aim of this study was to demonstrate the usefulness of the intraosseal route in providing emergency vascular access, especially in children, when vascular access through peripheral or central routes is difficult or impossible. A literature review revealed that the intraosseal route provides rapid, easy and effective access to the vascular system, especially in children under the age of 6 years. This route is indicated when, in emergencies, peripheral or central cannulation is too slow and the child's life is at risk. The most appropriate sites of insertion are the proximal or distal segments of the tibia and the distal segment of the femur. The administration of fluids, electrolytes and drugs through the intraosseal route is similar to that through the venous route. Complications are rare, the most serious being compartmental syndrome. In addition to providing an alternative route for the infusion of drugs and other substances into the bloodstream, the intraosseal route also provides access to the vascular system when samples for laboratory investigations are required. In conclusion, the intraosseal route provides rapid, safe and easy access to the vascular system. Complications are infrequent and there are few contraindications.