Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient or their family, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [257], C).

   In a cardiac arrest, it may not be possible to gain consent. E
2. 2.Show
   Wash hands with bactericidal soap and water or an alcohol‐based handrub, apply an apron and sterile gloves, and assemble and open the necessary equipment.
   To minimize the risk of infection (DH [64], C; Fraise and Bradley [98], E).

   To prepare the equipment for use. E

Procedure

1. 3.Show
   Remove the extension set from the needle hub.
   To facilitate the removal of the needle. E
2. 4.Show
   Carefully remove the dressing.
   To allow the safe removal of the needle. E
3. 5.Show
   Attach a 10 mL sterile syringe with a Luer‐Lok fitting.
   To act as a handle and cap the open port. E
4. 6.Show
   Grasp the syringe and continuously rotate it clockwise while gently pulling the catheter out, maintaining a 90° angle to the bone. Do not rock or bend during removal.
   To enable the catheter to be removed easily without damaging the bone. E
5. 7.Show
   Dispose of the intraosseous catheter into a sharps container.
   To ensure safe disposal and avoid injury to staff (HWR [137], C; MHRA [201], C; NHS Employers [227], C; NHS Employers [228], C).
6. 8.Show
   Apply pressure to the site with sterile gauze until bleeding has stopped.
   To ensure bleeding has stopped. E
7. 9.Show
   Apply an adhesive dressing.
   To protect the puncture site from infection. E

Post‐procedure

1. 10.Show
   Dispose of waste in the correct containers.
   To ensure safe disposal (HWR [137], C).
2. 11.Show
   Document the time and date of removal.
   To maintain accurate records, provide a point of reference in the event of any queries and prevent any duplication of treatment (NMC [257], C).