> Since we are getting brave, I wonder if we should be
> considering the benefits of infusion through the outer
> table of another nice big bone: the skull. -- long as
> we don't push too hard, that is! Serious suggestion.
>
An interesting suggestion. My concern would be that a specific feature of
the skull is that the inner table is much thinner than the outer. It's easy
enough to push an IO straight through a tibia where the cortices are of
broadly similar thickness, so this would be even more of a concern with the
skull. Not sure about the inner cortex of the sternum- looks pretty similar
thickness on x-ray. Anyone actually know? If so, while the consequences of
transfixation are as serious as those with the skull, the risks are lower).
Having said that, there are parts of the prefrontal cortex that tolerate
penetrating injury pretty well (my understanding of the issue, not based on
personal experience and I can't quote references), so as long as you used
sterile technique and were careful about the site, might not matter too much
as a last ditch effort. I'd still be happier going for iliac crest or
humeral head though- or pretty much anywhere else, even if it meant going
through soft tissue before I hit bone.
Matt Dunn
Warwick
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