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Evaluation of the bone injection gun as a method for intraosseous cannula placement for fluid therapy in adult dogs.

OBJECTIVE
To evaluate the Bone Injection Gun (BIG) for placement of intraosseous cannulas through impact penetration and compare it with a standard Jamshidi bone marrow needle (JBMN) and to compare fluid delivery dynamics through each device.


STUDY DESIGN
Randomized in vivo study.


ANIMALS
Forty-eight mature dogs.


METHODS
During surgical laboratories, dogs were randomly assigned to 2 groups (n = 24), and intraosseous access in the proximal tibial metaphysis was obtained using a BIG or JBMN. Variables measured during placement included insertion success, time required for placement, and alterations in respiratory rate (RR), heart rate (HR), and systolic blood pressure. After placement, maintenance fluids were administered to 6 dogs from each group, and fluids were administered under pressure to 6 dogs from each group to compare rates of delivery through each device. After euthanasia, the tibiae were harvested to evaluate and compare the morphologic consequences of needle and cannula placement.


RESULTS
Successful placement occurred in 20 (83%) dogs for the BIG and 23 (96%) dogs for the JBMN, which was not significantly different (P =.3475). Time required for placement was significantly less (P =.0024) for the BIG (mean, 22.4 +/- 8.2 seconds) compared with the JBMN (mean, 42.0 +/- 28.1 seconds). Significant increases in RR occurred in both groups and in the HR for the BIG group, but significant differences were not noted between groups. Mean rate of pressurized fluid administration was similar for both groups. Two distinct patterns of cortical bone damage occurred, but the clinical significance of this observation is uncertain.


CONCLUSIONS
The BIG provides more rapid access to the intraosseous space for fluid administration than the JBMN.


CLINICAL RELEVANCE
The BIG is an effective alternative for obtaining rapid access to the intraosseous space for emergency fluid and drug administration.