Lapis ISSN 2398-2969

Intraosseous catheter placement

Synonym(s): IO catheter placement

Contributor(s): Vetstream Ltd, Glen Cousquer, Peter Dobromylskyj, Lesa Longley, Lesa Thompson, David Perpinan

Introduction

  • Purpose: to access the intramedullary cavity of long bones and use it as an alternative route for administering fluid therapy in the absence of a good IV route.
  • The rate of absorption of a substance from the bone marrow is equivalent to that from a peripheral vein.

Uses

  • Fluid therapy   Fluid therapy   and administration of medication in a rabbit with circulatory collapse or in a neonatal rabbit. Anything that can be given IV can be given IO.
  • Drug administration in a case of cardiac arrest.
  • Blood transfusion   Blood: transfusion  can also be done through IO route.
  • The same technique can be used to collect a sample of bone marrow.
  • Reserve IO catheterization for severely ill rabbits or when attempts to get access to a vein have failed.

Advantages

  • Useful when IV sites unavailable or unobtainable.
  • Rate of absorption is greater than that from a peripheral vein in a shocked patient.

Disadvantages

  • Can cause considerable pain and distress and should not therefore be used without appropriate analgesia/anesthesia, particularly in conscious patients.
  • Contraindicated in the presence of local infections over the entry site.
  • Contraindicated in cases of septic shock as risk of osteomyelitis is high.
  • Risk of introducing infection and causing osteomyelitis if sterile technique is not used.
  • Rate of administration can be slower than with the IV route.

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Paul-Murphy J (2007) Critical care of the rabbit. Vet Clin North Am Exot Anim Pract 10 (2), 437-461 PubMed.
  • Foex B A (2000) Discovery of the intraosseous route for fluid administration. J Accid Emerg Med 17, 136-137 PubMed.
  • Ramer J C et al (1999) Evaluating and stabilizing critically ill rabbits - Part 2. Comp Cont Educ Pract Vet 21 (2), 116-125 VetMedResource.
  • Bielski R J, Bassett G S, Tolo F B & Vernon T (1993) Intraosseous infusions: effects on the immature physis - an experimental model in rabbits. J Pediatric Ortho 13 (4), 421-459 PubMed.
  • Otto C M, McCall Kaufmann G & Crowe D T (1989) Intraosseous infusion of fluids and therapeutics. Comp Cont Educ Pract Vet 11 (4), 421-431 VetMedResource.
  • Morris R, Schonfeld N & Haftel A (1987) Treatment of hemeorrhagic shock with intraoseous administration of crystalloid fluid in the rabbit model. Annals of Emergency Medicine 16 (12), 1321-1324 PubMed.

Other sources of information

  • Ward M (2006) Physical Examination and Clinical techniques. In: Manual of Rabbit Medicine & Surgery. Eds: Meredith A & Flecknell P A. 2nd edn. BSAVA, Quedgeley, Gloucester. pp 18-36.


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