Vía intraósea en pediatría

the vascular access together with the permeabilization of the airway and the adequate ventilation are the most important procedures in the emergency service. intraosseous infusion began to be used in 1922. in under 6 years-old children, the ideal sites are proximal and distal tibia and distal femur. it is an extremely easy technique that may be quickly applied, through which all the necessary drugs for resuscitation can be administered. it is indicated when there is no vein access after three attempts or 90 minutes elapsed. however, it is contraindicated if cellulitis or osteomyelitis is present in the site of application, or in the case of osteopetrosis and imperfect osteogenesis. multiple substances may be administered through this route. the rate of complications is very low. the vascular access sites should be progressively set in children and applied with the less invasive techniques.