What is an Intraosseous Access and When Do You Need One

By  //  May 4, 2022

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When patients lose fluids from their bodies, their blood pressure drops dangerously low, causing other medical issues to arise like heart failure. The fact that there’s not enough oxygenated blood flowing through their bodies may affect their brain’s thinking ability, and in the long term, the kidneys and other organs could also suffer.

It would be critical to supplement the pressure loss by adding more fluids to the body. There are a few different ways to provide this support to patients, one of which is intraosseous access:

Intraosseous Access

Intraosseous access was introduced in 1922 by Dr Cecil Drinker. After two decades of experimentation and trials, it became popular in World War 2 because of soldiers experiencing hemorrhagic shock. It only became a standard emergency procedure in the 1980s and only for children, Presently, it’s recommended in advanced cardiac and pediatric life support treatment protocols.

It entails the insertion of a needle into the bone marrow as a means of injecting blood products, fluids, or medication. Administration is done in rapid succession to save the person’s life.

The procedure can be excruciating for patients. Still, the device or cannula has an attachment used to infuse the area with a numbing agent like lidocaine before the fluids start pumping into the bone marrow cavity. Applying local anesthesia to the skin would relieve the person undergoing the procedure. For more information on the cannula or driver and its use, read through helpful resources online.

For adult patients, the procedure would be done just below the knee joint on the tibia, the front long bone of the shin. The doctor or medic will clean the area with an alcohol swab, insert the needle, and check its placement before connecting the fluids. If the positioning is less than optimal, there may be complications for the patient.

Some of the common complications noted by medical staff are when the fluid leaks from the bone marrow cavity and infiltrates the surrounding bone, tissue, and skin. There may be pieces of bone that fracture in cases when medics or doctors place the cannula hastily and without much preciseness.

Any medical procedure would carry some risk, and with intraosseous access, the benefits outweigh the lesser serious complications.

When You Need One

You can define medical emergencies as life-threatening situations wherein patients may lose their lives if they don’t receive immediate treatment intravenously or through any similar method. Some conditions for intraosseous access may include:

■ Irregular heart rhythm brought on by blood or fluid loss. The heart loses blood pressure provided by the blood, and fluids and cannot cope by handling the output needed to supply the ailing body.

■ Severe bleeding from wounds and injuries

■ Systemic infections may cause the body to go into shock. These severe infections cause a similar reaction to blood loss and could have devastating effects on the body.

■ Patients with breathing-related problems, like respiratory failure, may need more fluid pressure so that the lungs can supply the required oxygen to the body.

■ When a patient is severely dehydrated, like soldiers that have been in the field without provisions for an extended time, they’d need a rush of fluids to stabilize their condition.

■ A complication of diabetes called diabetic ketoacidosis may cause patients to fall into a coma. Rapid administration of fluids and medications to counter the reaction is needed to prevent serious consequences.

■ Burn victims will benefit from an intraosseous access point if regular intravenous access isn’t possible due to the degraded skin from their wounds.

The procedure is relatively standard in a medical facility for younger trauma victims like babies and children, but it has excellent results on the battlefield. Soldiers on the frontlines could sustain severe bodily harm in explosions, shootings, or other injuries. There’s no time to safely escort the injured soldier from the fighting zone, and, sometimes, treatment would have to be administered in the field to save them.

Any hospital or trauma center would have the necessary equipment and knowledge to use intraosseous access. Even ambulances can be equipped with bone drills to use for this purpose.

In Conclusion

There’s always a good reason for inventing life-saving techniques. One such technique is the intraosseous access used on many patients.

When the administration of blood products and other fluids isn’t possible through intravenous access, central venous catherization, or venous cutdown, this is the method that you could need during cardiac or pediatric life support treatment situations such as when bleeding from wounds and injuries, experiencing hemorrhagic shock, or respiratory failure.