Prof. T.K.Partha Sarathy
Alternative methods of fluid therapy when I.V. access is not available
When a few attempts at I.V. cannulation in a child less than 6 years old are unsuccessful a viable alternative method is to utilize tibial puncture and give the fluid intraosseously.
Preconditions for the procedure:
1. Not indicated above the age of 6
2. When I.V. access is not possible and the situation is an emergency
3. Aseptic precautions should be followed very carefully (Serile technique)
4. To be utilized only for a short period until venous access is made possible
5. Use only if the limb is uninjured.
Requirements:
1. Betadine solution for scrub
2. Sterile drapes
3. Sterile gloves
4. 10 cc syringe half filled with Normal Saline
5. A large caliber bone marrow aspiration needle or a 18 gauge spinal needle with stylet
6. Xylocaine
Comments
well this explanation guided me a lot but it will be more productive if it has been explained with a video.2nd it does not mention the proper size of the needle and criteria for selecting this rout