Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 1: Local anaesthetics in intraosseous access.

A short-cut review was carried out to establish whether flushing an intraosseous needle with local anaesthetic or saline is more effective at reducing the pain injecting drugs or fluid via this route. Two studies were relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 1. The clinical bottom line is that injecting lidocaine both before and after flushing an intraosseous needle is an effective method of reducing the pain of fluid infusion via this route.