A 4 year old child presents with shock and circulatory collapse. It is not possible to get iv access. Then What must be done nect -
Ans. is 'a' i.e., Intraosseus cannulation Intraosseus transfusiono For patients in respiratory failure or shock, securing vascular access is crucial, along with establishing an airway and ensuring adequacy of breathing and ventilation. Peripheral intravenous catheter insertion is often difficult, if not impossible, in infants and young children with circulatory collapse. An intraosseous line is as efficient as an intravenous route and can be inserted quickly, even in the most poorly perfused patientso The marrow of long bones has a rich network of vessels that drain into a central venous canal, emissary veins, and, ultimately, the central circulation. Therefore, the bone marrow functions as a noncollapsible venous access route when peripheral veins may have collapsed because of vasoconstriction. This approach is particularly important in patients in shock or cardiac arrest, when blood is shunted to the core due to compensatory peripheral vasoconstriction. The intraosseous (IO) route allows medications and fluids to enter the central circulation within secondso Intraosseous (IO) insertion was typically recommended for use in children younger than 6 years; however, it is now recognized to be both safe and effective in older children and adultso The problems with IO use in older patients arise from the increased difficulty of insertion through thicker cortex of the bone and the smaller marrow cavity. Inability to enter the marrow may increase the likelihood of fracturing the bone.
Intraosseus cannulation
Intracardiac Infusion
Thoracotomy
CPR
Blood Transfusion