Intraosseous Infusion as a Bridge to Definitive Access

Area of Science:

• Emergency Medicine
• Trauma Care
• Vascular Access

Background:

• Difficult intravenous access is a common challenge in emergency medicine.
• Intraosseous (IO) needle placement provides an alternative route for vascular access.
• IO access is crucial in emergent situations requiring rapid fluid or medication delivery.

Purpose of the Study:

• To evaluate the indications and outcomes of intraosseous (IO) needle placement.
• To analyze the effectiveness of IO access in a Level 1 trauma center.
• To identify complications and mortality associated with IO use.

Main Methods:

• Retrospective study analyzing data from January 2008 to May 2015.
• Included patients with IO needle insertion.
• Collected data on demographics, indications, infusions, interventions, and outcomes.

Main Results:

• 68 patients analyzed; common indications were difficult IV access (69%) and rapid sequence intubation (20.6%).
• Median time to IO access was 3 minutes; 72.1% achieved subsequent IV access.
• IO infusions included crystalloids, ACLS medications, and blood products; 7.4% experienced extravasation.

Conclusions:

• Intraosseous access is a valuable tool for rapid vascular access in emergencies.
• Consider IO access for patients requiring immediate intervention and vascular access.
• While effective, IO use in severe trauma is associated with high mortality.