Three intraosseous devices have been approved by the Food and Drug Administration for use in adult trauma patients when intravenous access cannot be obtained. Sites of insertion are the sternum (FAST1), proximal tibia and humerus (Big Injection Gun), and proximal and distal tibia and humerus (EZ-IO). Insertion generally requires less than 1 minute, and flow rates up to 125 mL/min can be achieved. The devices are used for emergency resuscitation and should be removed within 24 hours of insertion or as soon as practical after peripheral or central intravenous access has been achieved. Contraindications include fractures or other trauma at the insertion site, prosthetic joints near the site, previous attempts to insert an intra osseous device at the same site, osteoporosis or other bone abnormalities, infections at the proposed site, and inability to identify pertinent insertion landmarks. Primary complications are extravasation of medications and fluids into the soft tissue, fractures caused by the insertion, and osteomyelitis.
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Trauma| April 01 2011
Intraosseous Devices for Intravascular Access in Adult Trauma Patients
Michael W. Day, RN, MSN, CCRN
Michael W. Day is a trauma nurse coordinator at Providence Sacred Heart Medical Center and Children’s Hospital, Spokane, Washington
Corresponding author: Michael W. Day, rn, msn, ccrn, 12915 E Main Ave, Spokane Valley, WA 99216 (e-mail: firstname.lastname@example.org).
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Crit Care Nurse (2011) 31 (2): 76–90.
Michael W. Day; Intraosseous Devices for Intravascular Access in Adult Trauma Patients. Crit Care Nurse 1 April 2011; 31 (2): 76–90. doi: https://doi.org/10.4037/ccn2011615
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