Parrish G A, Turkewitz D, Skiendzielewski J J
Am J Emerg Med. 1986 Jan;4(1):59-63. doi: 10.1016/0735-6757(86)90253-6.
For most emergency physicians and pediatricians, the frustrations encountered when obtaining intravenous access in infants involved in traumatic or medical emergencies are well known. Although it is rare that parenteral access is absolutely unobtainable in a pediatric patient, minutes and sometimes hours are often lost as futile attempts are made to cannulate a collapsed vein of such a patient. Many alternatives to such a crisis situation, including the intratracheal, intracardiac, and sublingual routes of administration, have been proposed and efficaciously used. Disadvantages to these alternatives, however, include the inability to administer volume-expanding colloids or crystalloids, and a relatively narrow spectrum of useful medications. One relatively safe, well-proven, and technically easy method for giving replacement fluids, blood products, and numerous resuscitative drugs is infusion by the intraosseous route. Although not recommended as a replacement for current modes of intravascular access, we feel it has definite utility in selected situations and warrants the awareness of emergency physicians. The value, historical aspects, technique, and complications of this procedure are discussed.
对于大多数急诊医生和儿科医生来说，在处理创伤或医疗紧急情况的婴儿身上建立静脉通路时遇到的挫折是众所周知的。虽然在儿科患者中绝对无法获得胃肠外通路的情况很少见，但由于徒劳地试图给此类患者塌陷的静脉插管，往往会浪费几分钟甚至几个小时。针对这种危机情况已经提出并有效使用了许多替代方法，包括气管内、心内和舌下给药途径。然而，这些替代方法的缺点包括无法给予扩容胶体或晶体液，以及可用药物的种类相对较窄。一种相对安全、经过充分验证且技术上简便的给予替代液体、血液制品和许多复苏药物的方法是通过骨内途径输注。虽然不建议将其作为当前血管内通路模式的替代方法，但我们认为它在特定情况下具有明确的实用性，值得急诊医生了解。本文将讨论该操作的价值、历史背景、技术和并发症。
