Pediatric Intraosseous Access

Insertion Sites

  • Proximal tibia – 1 cm below the tibial tuberosity and then 1 cm medially
  1. Sodium, Potassium, CO2, and calcium levels – Potassium is often elevated due to hemolysis
  2. CANNOT use IO blood for CBC – WBCs are higher and platelet counts are lower
  3. Liver function tests 
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Holliday-Segar Method

 

  • 100 ml/kg/day for the first 10 kg
  • 50 ml/kg/day for the next 10 kg
  • 20 ml/kg/day for each additional kilogram.
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