| It was recognized in the early 1920s that the bone marrow could represent a noncollapsible "vein",thereby providing a means for obtaining rapid vascular access. Intraosseous infusion techniques were widely used in emergency situations during the 1940s and 1950s, when blood,fluids,and drugs infused into the red marrow of the sternum or tibia were shown to rapidly and reliably enter the circulation. For example, Tocantins showed that Congo red dye injected into the rabbit tibia took approximately 10 seconds to reach the central circulation .In fact, a review of the literature in 1990 indicated that any substance infused intravenously could be injected into bone marrow and that substances injected into the bone marrow were almost immediately absorbed into the general circulation. In conventional warfare, acute hemorrhage is the major cause of battlefield deaths ,accounting for 50% of fatalities. In addition ,in about 30% of injured soldiers who die from wounds, hemorrhage is the primary cause of death. Many improvements in prehospital combat casualty care will be necessary before these traditionally high death rates can be decreased. The most viable routes appear to be traditional venous cannulation with plastic catheters or intraosseous access. However ,the injured soldier's hypotensive state and collapsed peripheral veins, combined with environmental and tactical conditions and/or the presence of mass casualties ,are significant factors that may impede obtaining vascular access in a timely manner. Therefor,investigations have bagun to address improved methods for obtaining vascular access more rapidly and reliably, particularly in farforward, austere battlefield settings.With some medical elements of the U.S.military having recently been reissued intraosseous devices,we thought it timely to review the literature on this technique. In recent 30 years ,there weren't the reports on the intraosseous infusion in the domestic,through searching the literature and the patent. We should carry out the investgation to the intraosseous infusion in order to the preparation for the sanitation and logistic duties of the military affairs.The present study was designed to observe the characteristics about limb firearm injury and to study the effectiveness and the reliability of the intraosseous infusion. This topic was adopted that the rabbit had been the tiba and fibula compound fractur under limb firearm injury to modelling adult war wound.To observe the characteristics and the change ofpathophysiology. At first,evaluationing the resuscitation effect of the intraosseous infusion through the tibia of the healthy limb,investgationing it's effectiveness through comparisoning with the drug or fluid infused intravenously. In the reliability respect, it was firstly designed to investigate whether it could develop the fat emboli. Then the bone that the intraosseous infusion site located was taken to make the patholog examination in order to observe the changes of the constitution formation.Secondly, it was designed to investigate if the intraosseous infusion existed influence to the hematopoietic microenviroment of the red bone marrow. The last, it was designed to investigate if the intraosseous infusion caused the bone marrow infection and the long-term changes of the bone marrow constitution formation.On account of the above-mentioned investigation, we carried out two pou of the IO clinical utilization in adult emergencies.The following results and conclusions can be obtained from the present study: 1. The limb firearm injury usually united high shock incidence,and the limb was impaired severely. 2. The tibia was attractive as an IO infusion site for adults because the accurate rate was 95.8% and the time was 84±22s.The IV group received the fluid through the femoral venous catheter. And it's accurate rate was 95.8% , the time was 288±34s. 3. The fluid administration by the intraosseous route was virtually identical to the IV route in its ability to reverse intra-arterially measured hypotension induced by rapid hemo...
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