Difficult access is not uncommon problem in Emergency and Trauma Department. Intravascular route is the standard for venous access in medical practice. Intraosseous (IO) route can be alternative option when the conventional method of intravenous access fail. Most common IO insertion among paediatric patients and has been taught to use Cook needles for many years in life support book. With the advanced of technology, EZ IO, a battery powered drill device getting popular compared to several IO methods such as Bone Injection Gun.
The proximal tibia is well-established site for site for paediatric IO. In adult especially in traumatic cardiac arrest with anticipating difficult intravascular access, IO is preferred alternative to achieve access to a non-collapsible vascular network. With the sternum being use for CPR and neck on cervical collar for trauma patient, proximal humerus has been recommended for IO insertion site. This talk will touch on technical aspect, skill, tips and trick to achieve successful proximal humerus IO approach for trauma patient.
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