Editing Trauma - circulation (section)

=== Intra-osseous access: ===

* Identify the puncture site 2cm below the tibial tuberosity, on anteromedial surface
* Attach cannula to drill - usually in the kit, pink is for paediatric, blue for most sites, yellow is longer for humerus or obese patients
** Medial malleolus where shaft meets ankle
** Distal femur, anterior, two finger-breadths above wide condyles
** Humeral head, into greater tuberosity
* Clean skin
* LA?
* Introduce the needle and advance to bone. Fire drill until you feel give and then push into the cavity. Don't advance too far, you'll go into the back wall.
* Attach the needle to a 10mL syringe and should be able to aspirate bone marrow
* Inject saline - if it goes ok, likely correctly located
* Infusion via the catheter  of 2mL 2% lignocaine over two minutes provides good analgaesia

[[Category:Trauma]]