Paramedics Course – Intraosseous Infusion

Intraosseous Infusion

Micro-lecture by the Australian Paramedical College


In this micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis discusses intraosseous infusion as it relates to paramedic practice when deciding what type of route to choose when delivering a drug to the patient.  Enrolled students have unlimited access to a rich library of learning materials such as this.


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Intraosseous Infusion

In today’s session, we are going to talk about intraosseous drug administration. So when you’re a paramedic, you have to make a decision as to what type of route you’re going to choose when delivering a drug to your patient. Now more and more you’re gonna start seeing the IO kits on vehicles, and the reason being is because the absorption rate of an intraosseous injection is very similar to intravenous cannulation. Plus what you will find is that the process of delivering and getting the needle into the situation, in situ, you’re putting it in, is actually much quicker than placing an IV line. And it comes with less complications as well.

Now, not every ambulance service will allow every paramedic to do this skill, because it’s still an emerging area of practice. Instead, what you tend to find is that this type of procedure is reserved for the intensive care paramedics. Now you also have to remember that you can undertake this skill in both the conscious and the unconscious patient, but it has generally been reserved again, for patients who are unconscious and in cardiac arrest.

Now, when you’re administering and intraosseous needle into a patient’s bone, the process of drilling generally speaking isn’t the actual painful part, and I say generally speaking, because it still will be uncomfortable. But on a conscious patient, when you’re trying to suck back on the needle to make sure there’s bone marrow coming out, to make sure you’re in the right place, and then on top of that, administering a drug into the bone, that is the most painful part, which is why most services will tend to reserve it for intensive care paramedics, because they need to give the lignocaine into the bone.

So as we’ve already said then, intraosseous infusion is inserting the needle into the bone, and administering drugs into the bone. As you can see on here, it’s highly vascular. The bones are highly vascular, making it a very good site and very fast absorption rate for your patients. Now there are a number of different bone guns available to introduce this. By far, one of the most popular at the moment is the Easy IO. Now, the Easy IO device is like a drill. It’s a bone drill. Here we have one here.

This is a little bit like your Black and Decker drill. You basically place the needle onto the drill itself, measure up the location, and you can introduce it in certain places. Either the humoral head, or the tibia, the top part of the tibia. As you can see here, this part here is the tibia, and then you just place the needle onto the bone, and just drill. Then you can give the drugs through it, and likewise, you can give however much you need, so you can give large volumes.

Now this one here is called a Kux needle. This one is used primarily in children. Children have a different makeup of bones, so they don’t necessarily need the drill. So you can actually drill through the bone yourself, using the Kux needle. Then of course there are these other types of bone guns as well.

Okay, so that’s a bit of a snapshot into intraosseous infusion.

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