Pain with Intraosseous Infusion

Intraosseous (IO) catheter insertion and use for the infusion of medications and fluids can be associated with significant pain for conscious patients. Many factors contribute to the severity of pain experienced by patients, including the pressure required for IO infusion, patients’ preexisting pain tolerance, and other patient-specific factors. This chapter describes the anatomical and physiological considerations relevant to pain perception with IO infusion, as well as current and experimental evidence for pain mitigation strategies in awake subjects. Current evidence on the efficacy of existing pain control measures will be discussed, as well as promising areas of future research.