Protocol: Intraosseous Infusion

Original Effective Date: 01/01/2001 | Revised Date: 01/01/2002

ILS | ALS PROTOCOL

INTRODUCTION:

Rapid emergency "vascular access" when other avenues inaccessible or inappropriate secondary to severe nature of disease, injury, or time/ resource demands. May be used for fluid resuscitation and/or delivery of medications. This procedure is for treatment of potentially life threatening conditions.

PROCEDURE:

  1. Patients which Intraosseous (IO) access may be performed:
    1. Infants, Children, & Adolescents (medial tibial plateau).
    2. Unresponsive or significant depressed level of consciousness required.
    3. EMT-Intermediates may only attempt IO access after two unsuccessful peripheral IV attempts. (IO limited to one attempt)
SPECIAL CONSIDERATIONS/NOTES/PRECAUTIONS:

  1. Do not perform IO access on an extremity that appears fractured.
  2. When inserting the IO, use caution to maintain a 90 degree angle between the axis of the needle and surface of the tibia. Should the needle bend, discontinue the procedure and select another needle.
  3. Ideally, aspiration of blood or blood tinged saline should be performed after insertion. This is not required to verify patency of the IO. Reasonable infusion flow without evidence of infiltration at the IO site is ultimately verification of proper placement.

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