Almost any medication that can be administered into a central
or peripheral vein can be safely infused into the bone marrow, including crystalloid
solutions, colloid solutions, blood products, and hypertonic solutions.
In particular, all the medications the American Heart Association
recommends for pediatric advanced life support can be safely and
effectively administered via the intraosseous route, including catecholamine
infusions. Pharmacokinetic variables, such as onset of action and
plasma concentrations, are similar with intraosseous or peripheral
venous administration in cases of circulatory shock or cardiac arrest
with CPR. Emergency medications should be followed by a saline flush
to ensure rapid delivery into the circulation. In addition, the
initial bone marrow aspirate is a reliable specimen for venous pH
and PCO2, blood typing and cross-matching, serum glucose,
electrolytes, and blood cultures. Due to stasis in the bone marrow,
the results of such studies may be less reliable after administering
drugs through the intraosseous needle during CPR.