Intraosseous blood

[bbbirder]

A question has come up at my hospital about intraosseous blood collection. I am not familiar with this, but apparently intraosseous access is used (commonly?) for infusions in emergency settings when peripheral or central venous access is impossible, especially in children.

So, can blood collected from the bone be used for crossmatching? what about anything else?

It has been many years since I assisted with bone marrow collections and it seems to me that even though we might be able to get a blood type, there would not be much plasma to be used for the antibody screen, etc.

Would a potassium or any other tests be accurate?

Thanks,

Linda Frederick

[John C. Staley]

Wow Linda, just about when I start thinking I've heard of everything some one surprizes me. I've never heard of this. From your description I can't even think of how it could be done. I would be interested in any references anyone come up with. Purely acedemic curiosity, I sure don't want to get involved.

:surrender

[bbbirder]

This has been an interesting investigation and well, this is what I found when searching on the web about it:

References from Anathesiologists in Belgium: "The marrow cavity is in continuity with venous circulation and can therefore be used to infuse fluids and drugs, and to take blood samples for crossmatch, for example."

And Austria, an article on "Intraosseous blood gases during hypothermia..." (...blood gas values obtained from bone marrow aspirates may be helpful to adjust ventilation and optimize fluid and drug therapy...")

And similar references from Germay and UK

From WebMD (Dept of Pediatrics, UMass) "Of note, the levels of chemistries, drugs, and hemoglobin; the blood typing; and the acid base status obtained from the blood in the marrow aspirates...have been found to be reliable predictors of serum levels..."

And some research studies in piglets from the Pediatric Dept at the University of Florida.

So, it sounds like it can be done, but it would be nice to know how it works in practice. I don't think this will ever really happen at our hospital.

Linda Frederick