Intraosseous Administration of Drugs in Infants and Children
Intraosseous Administration of Drugs in Infants and Children
Intraosseous (IO) infusion of fluids via the sternum was first suggested by Drinker and colleagues in 1922. The use of the IO route for administration of fluids, drugs, and blood products became relatively common in the 1930's and 1940's, but eventually fell out of favor with improvements in plastic catheters which allowed for more rapid attainment of intravenous (IV) access. The IO route reemerged in the 1980's as an option for fluid and drug delivery during emergencies. In 1986, the American Heart Association (AHA) approved use of the IO route for administration of fluids and medications during pediatric resuscitation. In their 2005 guidelines on pediatric basic and advanced life support, the AHA and the International Liaison Committee on Resuscitation (ILCOR) reiterated the recommendation for establishing intraosseous (IO) access if vascular access is not rapidly achieved in any infant or child requiring IV drugs or fluids.
The primary advantage of the IO route is the ease with which access may be obtained. It has been shown that trained health care providers can achieve IO access within 1-2 minutes, with a rate of successful insertion of 80% or greater. In addition to the administration of fluids and medications, IO lines may also be used to obtain mixed-venous samples for blood chemistry, blood gas, and type and cross match studies prior to being used for drug administration.
Abstract and Introduction
Abstract
Intraosseous (IO) infusion of fluids via the sternum was first suggested by Drinker and colleagues in 1922. The use of the IO route for administration of fluids, drugs, and blood products became relatively common in the 1930's and 1940's, but eventually fell out of favor with improvements in plastic catheters which allowed for more rapid attainment of intravenous (IV) access. The IO route reemerged in the 1980's as an option for fluid and drug delivery during emergencies. In 1986, the American Heart Association (AHA) approved use of the IO route for administration of fluids and medications during pediatric resuscitation. In their 2005 guidelines on pediatric basic and advanced life support, the AHA and the International Liaison Committee on Resuscitation (ILCOR) reiterated the recommendation for establishing intraosseous (IO) access if vascular access is not rapidly achieved in any infant or child requiring IV drugs or fluids.
Introduction
The primary advantage of the IO route is the ease with which access may be obtained. It has been shown that trained health care providers can achieve IO access within 1-2 minutes, with a rate of successful insertion of 80% or greater. In addition to the administration of fluids and medications, IO lines may also be used to obtain mixed-venous samples for blood chemistry, blood gas, and type and cross match studies prior to being used for drug administration.
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