Many Registered Nurses are familiar with Intravenous infusions of normal saline, 5% dextrose, fresh or frozen plasma and other electrolytes. During IV infusion a pliable plastic needle (cannula) is inserted into a vein aseptically by a Registered Nurse or duly trained professional. This cannula facilitates the entry of the fluid into the patients circulation. When a qualified person is unable to find a vein, as may happen with babies, then another route of administration needs to be chosen. The INTRAOSSEOUS route of fluid administration is sometimes used The bone marrow cavity is used for the administration of fluids because it is in continuity with venous circulation. This method is often used for short periods of time because of the higher risks associated (may cause ostemyelitis) with this type of infusion.
This procedure is only indicated when vascular access is needed in life threatening situations in babies, infants and children. It is only indicated when other attempts at venous access have failed.
Anterior aspect of the tibia or femur are the most frequently used sites. Avoided: bones with osteomyelitis, fractures or other skin abrasions which may cause the site to become septic.
Legal consent is needed to perform this procedure. In order for this procedure to proceed smoothly it is necessary to explain the procedure to the patient as full as is humanely possible to obtain his support and cooperation.