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.
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