Procedural Skills for Medical Students
Intraosseous (IO) vascular access
Objectives:
1. Learners should be able to verbalize the indications and
contraindications for IO placement.
2. Learners should be able to perform an IO on the pediatric
HPS or adult IO trainer.
Material to review prior to lab: Video on Intraosseous
Placement in Children (need access to New England
Journal of Medicine, available to students through the UofA
Health Sciences Library)
Indications:
1. As an alternative to a central line for short-term infusions.
2. Any emergency conditions that require immediate vascular access.
3. When IV access cannot be obtained.
Contraindications:
1.
2.
3.
4.
5.
Ipsilateral fracture or crush injury of an extremity
Previous orthopedic procedure near the selected insertion site.
Previous recent IO attempts in the same bone
Infection at the selected insertion site
Brittle bones (i.e. osteogenesis imperfecta)
Equipment: HPS, IO trainer
Instructional Procedure & Endpoints:
1.
2.
3.
4.
Learners will be oriented to trainers and equipment in ASTEC.
ASTEC staff will demonstrate proper technique for IO placement.
Learners will verbalize landmarks for insertion of IO needle and possible complications.
Learners will return demonstration of correct IO placement to ASTEC staff.
References:
Jarris, R.F. & Fowler, G.C. (2011). Intraosseous vascular access. In J.L. Pfenninger, & G.C.
Fowler (Eds.), Procedures for Primary Care, 3rd Ed (1355-1359). Philadelphia:
Elsevier Mosby.
Nagler, J. & Krauss, B. (2011). Intraosseous catheter placement in children. The New
England Journal of Medicine, 364(e14). Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJMvcm0900916#figure=preview.jpg
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