Event Title

Subcutaneous Tissue Depth Over Intraosseous Infusion Sites in a Cadaveric Model

Location

Hager-Lubbers Exhibition Hall

Start Date

15-4-2015 3:30 PM

Description

BACKGROUND: When emergent intravenous access is not available an intraosseous (IO) infusion is performed. To accurately perform an IO infusion the provider must precisely palpate and identify the associated anatomical landmark for placement. A thicker layer of subcutaneous tissue over the insertion site can make this process difficult, therefore, leading to an increased risk of misplacement and dislodgment. PURPOSE: To identify and rank the depth of subcutaneous tissues overlying each IO infusion insertion sites, to better understand where to attempt IO placement first, in relation to subcutaneous tissue depth. The hypothesis to relate the subcutaneous tissue depth with the level of obesity was tested. SUBJECTS: Male and female cadavers (n=22) between the ages of 54-95 years old were provided by the Willed Body Program in association with Michigan State University College of Human Medicine in Grand Rapids, MI. METHODS AND MATERIALS: Subcutaneous tissue depth was measured by the insertion of a taper gauge into the skin over six IO infusion sites. Five bilateral skinfold measurements per cadaver were taken using a Lange skinfold caliper to obtain percent body fat which was converted into level of obesity. RESULTS: The distal tibia has the thinnest subcutaneous tissue depth, whereas, the calcaneus has the thickest. There is a correlation between increased subcutaneous tissue depth and increase percent body fat and BMI. CONCLUSIONS: These findings suggest that an increase of subcutaneous tissue depth correlates with an increased range of obesity. When assessing where to place an IO infusion, sites with the least amount of subcutaneous tissue should be considered first, with consideration of injuries.

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Apr 15th, 3:30 PM

Subcutaneous Tissue Depth Over Intraosseous Infusion Sites in a Cadaveric Model

Hager-Lubbers Exhibition Hall

BACKGROUND: When emergent intravenous access is not available an intraosseous (IO) infusion is performed. To accurately perform an IO infusion the provider must precisely palpate and identify the associated anatomical landmark for placement. A thicker layer of subcutaneous tissue over the insertion site can make this process difficult, therefore, leading to an increased risk of misplacement and dislodgment. PURPOSE: To identify and rank the depth of subcutaneous tissues overlying each IO infusion insertion sites, to better understand where to attempt IO placement first, in relation to subcutaneous tissue depth. The hypothesis to relate the subcutaneous tissue depth with the level of obesity was tested. SUBJECTS: Male and female cadavers (n=22) between the ages of 54-95 years old were provided by the Willed Body Program in association with Michigan State University College of Human Medicine in Grand Rapids, MI. METHODS AND MATERIALS: Subcutaneous tissue depth was measured by the insertion of a taper gauge into the skin over six IO infusion sites. Five bilateral skinfold measurements per cadaver were taken using a Lange skinfold caliper to obtain percent body fat which was converted into level of obesity. RESULTS: The distal tibia has the thinnest subcutaneous tissue depth, whereas, the calcaneus has the thickest. There is a correlation between increased subcutaneous tissue depth and increase percent body fat and BMI. CONCLUSIONS: These findings suggest that an increase of subcutaneous tissue depth correlates with an increased range of obesity. When assessing where to place an IO infusion, sites with the least amount of subcutaneous tissue should be considered first, with consideration of injuries.