IO as in intraosseous access. An old concept that is now getting more attention as an alternate access for infusion therapy in emergent and non-emergent situations. IO access uses the intraosseous space that contains thousands of non-collapsible intertwined blood vessels that absorbs any fluids. In situations where the peripheral vascular system shuts down, the IO space acts like a non-collapsible vein providing speed and bioavailability of the vascular route.
My experience with IO access dates back to my ICU days (yes, a few years ago) where we needed a vascular access in a patient in full cardiac arrest. At that time, we didn’t have the technology and equipment available now, and we used a spinal needle to access the proximal tibia. Now, several IO access devices are available in the United States, all designed to make IO access a simple, easy procedure. I would like to disclose that this is in no way an advertisement or endorsement of any of those products. However, I found this video on You Tube that demonstrated how easy it is to use one of the products.
The Infusion Nurses Society (INS) has released a position statement on “The Role of the Registered Nurse in the Insertion of Intraosseous (IO) Access Devices” and includes the indication for use as “emergent and nonemergent IO access when IV access cannot otherwise be obtained and when the patient might be at risk of increased morbidity or even mortality if access is not obtained”. A qualified registered nurse, who is proficient in infusion therapy and who has been appropriately trained for the procedure, may insert, maintain, and remove intraosseous access devices. Traditional therapies given by IV route may be given by the IO route and studies have shown both routes have the same pharmacologic effects (Von Hoff et al 2008).