Extending intraosseous access

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Intravenous literature: Phillips, L., Proehl, J., Brown, L., Miller, J., Campbell, T. and Youngberg, B. (2010) Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings: A Consensus Paper. Journal of Infusion Nursing. 33(6), p346-351.

Extract – Purpose:

In recognition of the value of intraosseous (IO) vascular access in patient resuscitation and stabilization, leading national and international organizations have published position papers that have served to change the standard of care for emergency vascular access. Among them are the American Heart Association (AHA), addressing vascular access in cardiac arrest patients,1 the International Committee on Resuscitation,2 the European Resuscitation Council,3 the Infusion Nurses Society,4 the National Association of Emergency Medical Services Physicians5 with the Emergency Nurses Association and the American Association of Critical-Care Nurses endorsing the Infusion Nurses Society position paper.6,7 These professional societies recognized that IO access may provide significant time savings that could benefit patients in emergent situations by decreasing the time required to achieve access and the time required to administer necessary fluids and medications. The AHA concluded that intravenous (IV) and IO administration have equal, predictable drug delivery and pharmacologic effects. Both AHA and European Resuscitation Council guidelines state that IO access should be the first alternative to failed IV access.1,2Given the well-established use of IO in the emergency setting, the Consortium chose to go beyond its use in resuscitative settings to explore the evidence supporting IO use wherever vascular access is medically necessary or difficult to achieve in all settings. This includes, but is not limited to, patients in the intensive care unit, on high acuity/progressive care floors, on the general medical floor, in preprocedure surgical settings where lack of vascular access can delay surgery, and in chronic care and long-term care settings.

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