An unusual alternative: the intraosseous route

Abstract

After an intensive literature review, we seek here to implement a recommendation guide when using this route. There is a discussion of the indications and contraindications of the route and insertion techniques and of the key anatomical regions affected.
We should note that this is an emergency vascular access for infusion of drugs and fluids, so we will define the specific indications and who is responsible for its implementation and offer a description of the technique in all its steps.

The theoretical basis of using this approach is based on the fact that the long bone marrow cavity is occupied by a rich network of sinusoids which drain the large central venous sinus and allowed these drugs and fluids to pass into the general circulation with a speed similar to that at which they would pass to any other peripheral vein. It is a little-known route of choice by the health staff, but very useful in patients with difficult venous access due to circulatory collapse of pathological or traumatic origin. The article therefore seeks to facilitate its use for all concerned.