A Pictorial Guide for Enabling Placement of Intra-Osseous Infusion Tools¹

The World Health Organization (WHO) declared the Ebola outbreak in West Africa to be the “most severe, acute health emergency seen in modern times” [1]. Individuals infected with Ebola virus experience severe dehydration which can ultimately lead to death. A key treatment strategy for Ebola is rehydration of the patient. However, limitations associated with vascular access in dehydrated patients, combined with concerns about the safety of healthcare workers in Ebola treatment units, have made conventional IVs impractical. Intra-osseous (IO) infusion, already a common emergency procedure in the U.S., enables delivery of fluids at equal or greater rates than two large-bore IV lines [2]. Placement of an IO needle in the proximal tibia requires knowledge of lower extremity anatomy and palpation of the tibial tubercle. Thus, current placement techniques require training, which may not be available to community responders, as well as direct patient contact, which places...