June 12th, 2014

Labs and IOs

By Cameron Wangsgard, M.D.

If you truly need labs, do a femoral stick or place a central line. I don't think you can justify ever bothering to drawoff an IO  until better data becomes available. First drawing from an IO hurts, and honestly, nobody really knows how reliable results are – even for the results that do correlate. If you’re going to change management based on the labs, you need them to be accurate. If it’s not going to change management, you shouldn’t be drawing them anyways.

If you are going to draw off an IO, looks like the only labs that correlate are HCO3, Hct/Hgb, BUN, Creatinine, Sodium, Chloride, and glucose – and honestly, the glucose is probably the only one you could maybe justify to get quickly with an IO that would change management. So… fem stick! Even these few labs that have the best correlation have been seen to be way off of serum results at times. Correlation does not mean you'll have an accurate lab result.

And more #FOAMed resources:

  1. Academic Life in EM: Paucis Verbis card: Interpretation of intraosseous blood
  2. The Trauma Professional's Blog: Lab Values From Intraosseous Blood

 

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