Intraosseous infusions via the calcaneus.

OBJECTIVES: To demonstrate that intraosseous infusions via the calcaneus could deliver fluids to systemic veins and that intraosseous infusions do not require bones with medullary cavities. To demonstrate that intraosseous infusions could be successful in adults.

DESIGN: Ten adult cadavers were injected with 16 gauge intraosseous needles and infused with 10 ml of methyl green dye at a concentration of 10 mg/ml.

MAIN OUTCOME MEASURES: Observation of methyl green dye in the great saphenous, medial malleolar and dorsal veins of the foot recorded by digital photography on injection and at 1 min post-injection.

RESULTS: Immediate entry of methyl green dye into the superficial veins of the leg was seen in 14 out of the 20 legs trialled and delayed entry was noted in the two legs of another cadaver. No venous entry was seen in one cadaver and intraosseous access failed in one cadaver.

CONCLUSIONS: Successful intraosseous infusions can be performed via the calcaneus. Intraosseous infusions can be successful in adult populations. While not a substitute for intraosseous infusions in other sites, the calcaneus provides an easily accessible site free of overlying vital structures.