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Paucis Verbis card: Interpretation of intraosseous blood

2017-08-01T23:50:21+00:00

IO needlesThere is a growing number of normal volunteers who agree to get an intraosseous (IO) needle placed. Just search Intraosseous Needle on Youtube. Often you can draw blood out of the needle. How do you interpret the lab values? Are they the same as your peripheral blood draw? Should we even send the blood to the lab?

In a 2010 article in Archives of Pathology and Laboratory Medicine, peripheral IV blood from 10 volunteers was compared to blood drawn twice from a single IO line in the humerus. After discarding the first 2 mL of IO blood, the first IO sample was drawn (4 mL). Then a second IO sample was drawn (4 mL), which is equivalent to a sample with the first 6 mL discarded.

Interesting, not all IO labs correlated with IV labs. The good news is that a few critical ones do show correlation: creatitine, glucose, and hematocrit.

PV Card: Interpreting Labs from the IO Line


Adapted from 1
Go to the ALiEM Cards site for more resources.

Thanks to Dr. Michael McGonigal at Trauma Professional’s Blog for posting about this.

1.
Miller L, Philbeck T, Montez D, Spadaccini C. A new study of intraosseous blood for laboratory analysis. Arch Pathol Lab Med. 2010;134(9):1253-1260. [PubMed]
Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

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  • Just FYI- one electrolyte that was left of there was potassium- according to the trauma professional’s blog it didn’t correlate which would be good to know in a resuscitation setting. Great simple study though- would be interesting to see if it stands up in critically ill patients who happen to have an IO and IV labs.