Demonstration of the Procedure for Inserting an Intraosseous Line in a Mannequin

Introduction

Intraosseous (IO) access is a life-saving procedure used in pediatric emergencies when intravenous (IV) access is difficult or impossible to obtain. The technique involves inserting a specialized needle into the bone marrow cavity, providing rapid fluid and medication administration.

Indications for Intraosseous Access in Pediatric Emergencies

• Cardiac arrest
• Severe shock (hypovolemic, septic, or cardiogenic)
• Need for rapid resuscitation
• Failure to obtain IV access within 90 seconds

Step-by-Step Procedure

1. Preparation

• Gather necessary supplies (IO needle, sterile gloves, antiseptic, extension set, and syringe)
• Select appropriate insertion site (proximal tibia or distal femur)
• Prepare and stabilize the limb

2. Insertion Technique

• Clean the insertion site with antiseptic
• Insert the IO needle perpendicular to the skin using firm and controlled pressure
• Advance the needle until resistance decreases (indicating entry into the bone marrow cavity)
• Remove the stylet and attach the extension set

3. Confirmation and Use

• Flush with saline to confirm patency
• Secure the IO line to prevent dislodgement
• Administer fluids and medications as needed

Complications and Precautions

• Extravasation and compartment syndrome
• Bone fractures or infection (osteomyelitis)
• Monitor for signs of infiltration or improper placement

Conclusion

The intraosseous access technique is a vital skill in pediatric emergencies, ensuring prompt administration of critical interventions. Proper training and practice with mannequins can improve success rates in real-life scenarios.