Vascular physiology of bone and Intraosseous infusion (IOI) were first described by Drinker in 1922.¹ In 1941 the method of IOI was introduced for clinical use by Tocantis mainly in children.^{2, 3}  Bone-marrow transfusion was practiced in Great Britain and in South America for emergency cases in the 1940s.^4-7 In the Former Soviet Union, the intraosseous route was used in the 1960s for injection of local anesthetics.^{8, 9} Intraosseal regional anesthesia (IORA) is a tested and efficient method originally described by Thorn-Alquist and further developed at the Carmel Medical Center.^{10, 11} The need for minimum time spent in the field, and the benefit of rapid transportation to the trauma center without time wasted by multiple attempts to place an IV line, is extensively discussed in the current literature.^12-14

In emergency situations, such as air and road transports of severely compromised patients and mass casualties from accidents, fires, or explosions, it may be difficult, even for experienced physicians, to gain IV access. In situations when vascular access is imperative, the intraosseous (IO) route may be established. Vascular access via the IO route is recommended by the American Heart Association, the American Academy of Pediatrics, and The American College of Surgeons in emergency situations involving children, when venous access is not immediately possible.^{15, 16}  The IO route is also suitable for use in premature babies, term neonates, infants, children, and adults.^{11, 13, 14, 17-25}

The advantages of using the IO route have been studied in acutely ill children and adults in the prehospital seting.^{13, 22, 23, 26}

References