Nurse Elizabeth is administering medication via the intraosseous route to a child. Intraosseous drug administration is typically used when a child is:
A. Under age 3
B. Over age 3
C. Critically ill and under age 3
D. Critically ill and over age 3
Correct Answer: C. Critically ill and under age 3
In an emergency, intraosseous drug administration is typically used when a child is critically ill and under age 3. IO access provides a means of administering medications, glucose, and fluids, as well as (potentially) a means of obtaining blood samples. Such a situation would include any resuscitation; cardiopulmonary arrest; shock, regardless of etiology; life-threatening status epilepticus; or lack of venous access resulting from burns, edema, or obesity.
Option A: In the 1980s, IO access was rediscovered as an immediately available tool in resuscitation situations, when time is of the essence and conditions may be adverse. Since then, IO access has become widely accepted in pediatric settings, especially because these patients often provide a particular challenge to obtaining rapid intravascular access.
Option B: Initiation of IO access is indicated in adults, children, infants, or newborns in any clinical situation where vascular access is emergently needed but not immediately available via a peripheral vein.
Option D: A retrospective study by Carlson et al found that in 2011, among out-of-hospital critical procedures provided for pediatric patients by emergency medical services in the United States, IO access was one of the most common.