Infusion route

Central vein: preferred [1], but cannot be used under pre hospital conditions.

Superficial veins: the most commonly used and almost the only pathway in the absence of bone marrow infusion equipment before hospitalization.

Bone marrow infusion: used in emergency situations [1], especially suitable for pre hospital settings.

The Challenge of Traditional Venous Channels - Central Vein

There are certain sterile requirements that cannot be met in pre hospital settings, and personnel are required. Qualified doctors are required to operate and establish a central venous channel, which takes an average of 10.7 minutes [2]. Even skilled doctors require at least 5-10 minutes/

傳統靜脈通路的挑戰-表淺靜脈

● When patients experience respiratory and cardiac arrest, severe traumatic hemorrhagic shock, and superficial venous collapse, establishing venous channels poses great challenges.

● Research has shown that up to 40% of venous channels fail in emergency situations.

Intramedullary Infusion (10) Technique 

● Intraosseous Infusion (I0) is an emergency infusion method that utilizes the rich vascular network in the bone marrow cavity to quickly inject fluids and drugs into the blood through the bone marrow cavity.

● The channel can be quickly established in an average of 1.2 minutes, with a success rate of up to 91.7% [3]. There are no restrictions on operators, low environmental requirements, and it can be operated on an ambulance.

Working principle of bone marrow infusion channel

● Insert the catheter into the proximal or distal end (epiphysis) of the long bone, as this area is dense.

● The bone is thin and the cancellous bone is rich. The infusion of fluids and drugs can be quickly absorbed and transmitted to the central circulation through the vascular sinus, with the entire process taking only 2.3 seconds.

The importance of bone marrow infusion in emergency treatment

● Recommendations from AHA, ERC, International Recovery Liaison Committee, and US Emergency Physicians Committee.

● In emergency rescue, the use of IO (Intramedullary Vascular Channel) should be considered as early as possible when establishing a liquid venous channel. In adults, after two unsuccessful peripheral venous punctures, the I0 channel should be established as soon as possible; Preferred IO for pediatric patients.

● Establishing a vascular channel within the bone marrow cavity is the standard method for rescuing patients with cardiac arrest.