title: Successful intraosseous infusion in the critically ill patient does not require a medullary cavity.
abstract: OBJECTIVE
  To demonstrate that successful intraosseous infusion in critically ill patients does not require bone that contains a medullary cavity.
  
  
  METHODS
  Infusion of methyl green dye via standard intraosseous needles into bones without medullary cavity-in this case calcaneus and radial styloid-in cadaveric specimens.
  
  
  METHODS
  University department of anatomy.
  
  
  METHODS
  Two adult cadaveric specimens.
  
  
  METHODS
  Observation of methyl green dye in peripheral veins of the limb in which the intraosseous infusion was performed.
  
  
  RESULTS
  Methyl green dye was observed in peripheral veins of the chosen limb in five out of eight intraosseous infusions into bones without medullary cavity-calcaneus and radial styloid.
  
  
  CONCLUSIONS
  Successful intraosseous infusion does not always require injection into a bone with a medullary cavity. Practitioners attempting intraosseous access on critically ill patients in the emergency department or prehospital setting need not restrict themselves to such bones. Calcaneus and radial styloid are both an acceptable alternative to traditional recommended sites.
authors.affiliation: Department of Emergency Medicine, Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: Gerard
authors.initials: G
authors.lastname: McCarthy
authors.forename: Cathal
authors.initials: C
authors.lastname: O'Donnell
authors.forename: Moira
authors.initials: M
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D001682:Biological Availability; D001853:Bone Marrow / Q000187:drug effects*; D002102:Cadaver; D002111:Calcaneus / Q000187:drug effects; D004396:Coloring Agents / Q000494:pharmacology; D016638:Critical Illness / Q000628:therapy; D006801:Humans; D017148:Infusions, Intraosseous; D011884:Radius / Q000187:drug effects; D012680:Sensitivity and Specificity
chemical_list: D004396:Coloring Agents