Clinical Case Database / Category: Practical Procedure

Intra-osseous access

Publication details

Dr Jane Archer, Dr Richard Brown
Foundation Years Journal, volume 8, issue 8, p.33 (123Doc Education, London, September 2014)


A 23 week old girl with a one day history of high pyrexia was presented to the emergency department by her parents who had awoken to find her with an extensive non-blanching purpuric rash.

On admission, the infant appeared acutely unwell and was clinically shocked. Urgent circulatory access was required. Peripherally shut-down, gaining peripheral venous access would have been difficult and time-consuming. Intra-osseous (IO) access was secured enabling bloods to be taken and fluids to be administered.

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Dr Jane Archer (Corresponding author)

GP Trainee
Frimley Park Hospital NHS Foundation Trust
Portsmouth Road, Frimley, Surrey, GU16 7UJ

Dr Richard Brown

Consultant Paediatrician
Peterborough and Stamford Hospitals NHS Foundation Trust
Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough, PE3 9GZ


1.  Emergency Circulatory Access, Fluid Administration and Medications. In: European Paediatric Life Support Manual. 3rd edn. Resuscitation Council (UK). Chpt 6.

2.  Resuscitation Guidelines 2010. In Advance Life Support Manual. Last accessed at 10 Nov 11.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.