Intraosseous line is placed in which bone in children?
Ans. (b) TibiaRef.: Nelson's 18" ed./ch. 66* If venous access is not available in an arrest situation within 1 min, an intraosseous line should be placed in the anterior tibia (with care taken to avoid traversing the epiphyseal plate)* The needle should penetrate the anterior layer of compact bone, with its tip advanced into the spongy interior of the bone.* Intraosseous needles are special rigid, large-bore needles that resemble those used for marrow aspiration. Current recommendations urge the use of intraosseous cannulation in patients for whom intravenous access proves difficult or unattainable, even in older children.* Once the patient has received initial drug and fluid therapy through the IO line, every effort should be made to obtain more conventional central venous access and remove the 10 line as soon as possible.* Alternative sites for intraosseous (IO) insertion include the distal tibia, distal femur, sternum, and humerusComplications of 10 Infusion* Extravasation of fluid is the most common complication and occurs when a needle is misplaced* Compartment syndrome is a risk with IO insertion.* Extravasation of hypertonic or caustic medications, such as sodium bicarbonate, dopamine, or calcium chloride, can result in necrosis of the muscle.* Infection and osteomyelitis are relatively rare complications and occur most commonly if aseptic technique is not followed during insertion.* Other possible complications include local hematoma, pain, fracture and growth plate injuries (with incorrect placement), and fat microemboli (not clinically significant) and compartment syndrome
Femur
Tibia
ASIS
Iliac crest
Fluid and Electrolyte Treatment of Specific Disorders