Procedure For Needle Intubation Of Introsseous Pedigree Pathway

Determine the insertion site

Clear skin

If the patient is conscious, give a local anaesthetic

The needle is inserted at a 90 degree Angle to the skin

Cooking needle: Advance with a drilling motion (twisting back and forth + pressing) until the cortex is penetrated and feels "given"

Removing the trocar

Vascular access needle: Lead needle + drill hole with driver at insertion. Just press gently. Stop drilling when "giving" is felt. Secure the needle and remove the drill. Unscrew and remove the core from the needle. The intervascular access needle is connected to the tubing.

Attach to syringe and aspirate to confirm intramedullary position (and obtain sample as needed). Aspiration is not always feasible, and a 0.9% saline flush may be sufficient to confirm the location. Watch for oozing!

Connect to a 20-50 ml syringe and inject the infusion in pill form. Installing a three-way tap on the infusion set may help with this, but the fluid must be injected under pressure (usually manually).

Will be fixed to the skin to avoid accidental displacement and monitor exosmosis

Establish more explicit access where possible