b. If you are unable to initiate peripheral IV access, consider initiating a sternal
intraosseous (IO) line. Although there are many other IO methods available, the sternal
kit known as F.A.S.T.1TM has been chosen.
Intraosseous means "within the bone."
(1) The sternum is protected by body armor and the cortex of the bone is
much thinner than the tibia. Many injuries are to the lower extremities.
If the patient no longer has a sternum, he will not likely benefit from an
Indications for the need of an IO infusion include:
(a) Inadequate peripheral access.
(b) Need for rapid access for medications, fluid, or blood.
Failed attempts at peripheral or central venous access.
SOLUTIONS USED IN INTRAVENOUS THERAPY
a. Resuscitation Solutions. Different types of IV fluids can be used for
different medical conditions. These solutions are generally categorized as colloid or
(1) Colloids. Colloids contain protein, sugar, or other high molecular weight
molecules and are used to expand intravascular volume. Examples include:
Whole blood (most common) (see figure 1-1).
(b) Packed red blood cells (PRBC).
Fresh frozen plasma (FFP).
(d) Plasma protein fraction (PPF).
(e) Hypertonic saline and dextran (HSD).
Hextend (a 6 percent hetastarch solution in a balanced electrolyte