Paramedic National Registry Practice

What indicates correct placement of an intraosseous (IO) line?

1. Blood pressure stabilizes after administration

2. Bone marrow can aspirate and flushes with normal saline

3. Patient reports no pain in the insertion area

4. Visual confirmation of bone penetration

The correct answer is: Bone marrow can aspirate and flushes with normal saline

The indication of correct placement of an intraosseous (IO) line is confirmed when bone marrow can be aspirated and it flushes with normal saline. This is essential because the primary purpose of the IO line is to provide access to the vascular system via the marrow of the bone, especially in situations where intravenous access is difficult or impossible. When an appropriate amount of resistance is felt during the insertion, and subsequently, the marrow is aspirated, it confirms that the needle is in the correct location within the medullary cavity. Flushing with normal saline demonstrates that the line is patent and functioning properly. This helps ensure that medications and fluids can be effectively administered into the circulatory system, which is crucial for patient care in emergency situations. The other options do not directly indicate correct placement of the IO line. Blood pressure stabilization after administration could result from various interventions, not solely from correct IO placement. A patient reporting no pain in the insertion area could be subjective and does not confirm the correct position of the needle. Visual confirmation of bone penetration is less reliable and does not guarantee that the tip of the needle is correctly placed within the marrow, as it may still be positioned improperly despite appearance. Therefore, the best indicator of successful intraosseous access