Sun31October0735PM 1

Intraosseous (IO) cannulation:

True / False

In adults the proximal humerus is a convenient site of insertion Correct

In the limbs it should be inserted at the fracture site Correct

Is rarely indicated during a paediatric cardiac arrest Correct

May be considered when attempts at obtaining venous access are delayed Correct

Can be inserted in the midline at the level of the tibial tuberosity Correct

Explanation

First used in the 1930's as an alternative method of gaining vascular access, intraosseous (IO) cannulation is currently recommended during life threatening situations when vascular access is required quickly. It can be performed on paediatric and adult patients. Therefore, when attempts at gaining venous access fail or are delayed, intraosseous cannulation should be considered in patients of any age. The main cinical indications in adults include cardiopulmonary resuscitation and fluid resuscitation in patients following trauma.

The main sites of access include the proximal tibia, proximal humerus and distal tibia where thin cortical bone overlies a large medullary cavity.

In paediatric cardiac arrest it is the recommended technique for gaining circulatory access and may be achieved quickly. Many potential anatomical sites for intraosseous cannulation have been described, including the lower and upper limbs and sternum. The correct site on the proximal tibia is 2 to 3 cm below the tibial tuberosity on the antero-medial surface (not midline). IO cannulae should not be inserted into fracture sites, and limbs with proximal fractures should also be avoided.

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Average score: 90.68%

Times answered: 251