CIRCUMFERENTIAL PRESSURE AS A RAPID METHOD TO ASSESS INTRAOSSEOUS NEEDLE PLACEMENT

This study was done to determine whether the application of circumfere ntial pressure about an intraosseous (IO) site can be used as a rapid method to detect incorrect placement of an IO needle. We used a prospe ctive, randomized, controlled canine tibial IO model, According to ran dom assignment, 10 needles were placed either intramedullary (correct placement) or extramedullary (incorrect placement) in the anteromedial tibias of 12 euthanized mongrel dogs, Neonatal blood pressure cuffs w ere placed contiguously above and below the IO needles, One-liter bags of solution were connected to the IO needles via blood tubing. The gr avity-dependent rate of flow at each site was measured with and withou t the blood pressure cuffs inflated to 120 mmHg, Eleven IO needles wer e correctly placed and 13 were incorrectly placed, Following inflation of the blood pressure cuffs, the mean percent decrease in flow was 48 % for the correctly placed IO needles, and 95% for the incorrectly pla ced IO needles, A two-way repeated measure of analysis of variance was significant between groups (P = 0.006), and a significant interaction was found between groups and flow rates over time (P = 0.033), We con clude that circumferential pressure about an IO infusion site can be u sed as a rapid method to detect incorrect placement of the IO needle.