Indications: An actual need or a potential need for intravenous medications or fluid therapy and intravenous access in unobtainable and cardiac arrest or “near arrest” state.
- If presented with an unconscious patient with rapidly deteriorating vital signs, and peripheral veins can be seen or palpated, attempt at least one peripheral IV. If IV access fails following two attempts or after 90 seconds, proceed to an intraosseous line.
- Landmark the site appropriate to the specific device being used (sternum or proximal tibia).
- Place IV solutions in a pressure bag inflated to a maximum of 300 mmHg or “push” the fluid bolus with a large bore syringe for more-rapid infusion. Infuse fluid volumes as per the Intravenous Access & Fluid Administration Protocol.
- Intraosseous access will be limited to a maximum of two (2) attempts only.
- Monitor the site near the point of skin penetration to ensure fluid is not infiltrating the tissues.
- Update the receiving facility en route.