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Intraosseous infusions: a usable technique.

K V Iserson, E Criss

    The American Journal of Emergency Medicine
    |November 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    This study evaluated intraosseous needle insertion techniques for pediatric patients. The Kormed/Jamshidi bone marrow needle and a site near the medial malleolus proved easiest for safe and rapid vascular access.

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    Area of Science:

    • Emergency Medicine
    • Pediatric Critical Care
    • Vascular Access

    Background:

    • Intraosseous infusions were historically used in pediatrics but require optimized insertion techniques.
    • Existing reports confirm safety and accessibility but lack detail on needle insertion challenges.
    • Various needles have been proposed, necessitating comparative evaluation for ease of use.

    Purpose of the Study:

    • To assess the ease of insertion of different needles for intraosseous infusion.
    • To identify an optimal anatomical site for intraosseous needle placement.
    • To validate the chosen technique in clinical settings.

    Main Methods:

    • Comparative testing of spinal needles, IV needles, and bone marrow needles on a pediatric cadaver leg.
    • Evaluation of needle insertion difficulty and obstruction by bone or tissue.

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  • Assessment of anatomical sites for stability and penetrability.
  • Clinical application in pediatric and adult patients.

    • Main Results:

    • The 13-gauge Kormed/Jamshidi disposable bone marrow/aspiration needle demonstrated the easiest insertion.
    • This needle did not plug with bone or tissue during insertion.
    • An area proximal to the medial malleolus was identified as a stable, accessible site.
    • The technique was successfully used in 10 pediatric and 5 adult patients.

    Conclusions:

    • Intraosseous needle placement using the Kormed/Jamshidi needle and the medial malleolus site is safe and rapid.
    • This method provides reliable vascular access, even in severely dehydrated pediatric patients.
    • Optimized techniques enhance the utility of intraosseous infusions.