[Intraosseous sampling can be valuable in emergency situations]

Area of Science:

• Emergency Medicine
• Clinical Pathology
• Biomedical Engineering

Context:

• Intraosseous (IO) access is critical for fluid and drug delivery when traditional vascular access is challenging.
• IO needles facilitate rapid administration but raise concerns about sample integrity due to bone marrow particulate matter.
• Analysis of IO aspirates requires careful consideration of potential contaminants and their impact on diagnostic accuracy.

Purpose:

• To evaluate the feasibility and safety of analyzing intraosseous aspirates for clinical diagnostics.
• To address concerns regarding bone marrow particles potentially damaging analytical equipment.
• To provide recommendations for optimizing the analysis of intraosseous samples.

Summary:

• Intraosseous (IO) needles provide vital access for emergency treatments.
• Bone marrow particles in IO aspirates may pose a risk to analysis equipment and affect results.
• Point-of-care (POC) testing is recommended for IO aspirates, especially for blood gas analysis.
• Centrifugation effectively removes particulate matter, yielding plasma suitable for analyzing creatinine, morphine, and troponin.
• Potential for falsely elevated results due to leukocytes and platelets, and the risk of hemolysis, must be considered.

Impact:

• Enables reliable point-of-care diagnostics directly from intraosseous access sites.
• Reduces the risk of damage to sensitive laboratory equipment from bone marrow aspirates.
• Improves patient management by allowing timely analysis of critical biomarkers in emergency settings.
• Highlights the importance of sample preparation techniques like centrifugation for accurate IO aspirate analysis.