Paediatrics: Intracardiac injection

Intracardiac injection

Indicated only during resuscitation when all other attempts at securing vascular access have failed.

Equipment

•   Alcohol impregnated swab.

•   21G needle and syringe containing resuscitation drug.

Procedure

•   Attach needle and syringe. Flush needle with drug to expel air.

•   Locate site: 4th intercostal space immediately lateral to the left sternal edge (immediately below the line joining the nipples).

•   Clean site with an alcohol impregnated swab.

•   Insert needle and aspirate syringe as needle is inserted.

•   Once blood flashes back, stop advancing.

•   Inject resuscitation drug(s).