Chapter 194 - intraosseous catheterization

Question 1

most common complication of intraosseous catheterization

Answer 1

osteomyelitis

Question 2

risk of osteomyelitis with intraosseous catheterization

Answer 2

0.6%, possibly less if catheter removed within 72h

Question 3

list risks associated with intracardiac injections

Answer 3

lung laceration, hemopericardium, coronary artery perforation, myocardial ischemia, arrhythmias

Question 4

sublingual access is not advisable T/F

Answer 4

T

Question 5

with intraosseous injection, list the vessels substances travel through to reach the central circulation

Answer 5

capillaries, medullary venous channels, nutrient and emissary veins, central circulation

Question 6

fluid rates achieved with a 20g needle under 300mmHg pressure?

Answer 6

29ml/min

Question 7

fluid rates achieved with a 14g needle under 300mmHg pressure?

Answer 7

47ml/min

Question 8

indications for intraosseous catheterization

Answer 8

failed intravenous access
peripheral vascular thrombosis
peripheral oedema
status epilepticus
burns
obesity

Question 9

list 6 parameters can be reliably measured using intraoessous samples?

Answer 9

Hb level, Hct, BUN, creat, total solids, albumin, bilirubin, sodium, chloride, calcium, phosphorus

Question 10

which 2 parameters are not be reliably measured from intraosseous samples?

Answer 10

glucose, potassium

Question 11

for how long after starting CPR can you reliably take acid-base values from the intraosseous route?

Answer 11

15-30 min as long as no drug infusions

Question 12

what are the most common sites of IO access

Answer 12

flat medial surface of the proximal tibia (1-2cm distal to the tibial tuberosity)
tibial tuberosity
trochanteric fossa of the femur

Question 13

in which position should the hip joint be held for IO catheter placement in the trochanteric fossa?

Answer 13

neutral and inwardly rotated

Question 14

how is positioning confirmed?

Answer 14

catheter firmly seated and moves with limb manipulation
gentle aspiration yields marrow (may not in older animals)
bolus of hep saline flows readily
no sign of fluid extravasation

Question 15

intraosseous lidocaine should be given before infusion in human patients T/F
veterinary patients

Answer 15

T

hasn’t been evaluated, may cause toxicity esp in cats

Question 16

name 3 reported complications of IO infusions

Answer 16

infection (osteomyelitis)
fat embolism
extravasation
nerve injury
compartment syndrome
bone fracture

Question 17

administration of IO fluids and drugs may impair bone growth in young animals T/F

Answer 17

F - studies have not found this

Question 18

contraindications to IO catheter placement

Answer 18

bone fracture
failed previous IO catheterisation with breach of cortex
infected tissues
pneumatic bones of birds

Question 19

what happened to piglets in a dehydration and hemorrhagic shock model who received IO resuscitation with 7.5% hypertonic saline?

Answer 19

compartment syndrome, soft tissue and bone marrow necrosis

Question 20

risk of compartment syndrome with IO infusion in veterinary species

Answer 20

unknown