Review of sonographic confirmation of intraosseous line placement

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“Correct placement of the IO needle can be confirmed in several ways including the needle standing firmly upright, aspiration of bone marrow, and the infusion of fluid without visible or palpable soft tissue swelling” Saul et al (2014).

Reference:

Saul, T., Siadecki, S.D., Berkowitz, R., Rose, G. and Matilsky, G. (2014) The accuracy of sonographic confirmation of intraosseous line placement vs physical examination and syringe aspiration. The American Journal of Emergency Medicine. December 26th. .

Abstract:

Intraosseous infusion (IO) is a critical resuscitation procedure, providing rapid and reliable vascular access in patients with difficult intravenous access or in time-critical situations. Correct placement of the IO needle can be confirmed in several ways including the needle standing firmly upright, aspiration of bone marrow, and the infusion of fluid without visible or palpable soft tissue swelling. In addition to the importance of ensuring intravascular delivery, there are complications of fluid extravasation from malpositioning, including compartment syndrome [1,2] and tissue necrosis [3,4].

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