Anatomical Basis of Successful Intraosseous Access in Paediatric Resuscitation at Intensive Care Units in Zamfara State

Intraosseous access is a critical emergency procedure used in paediatric resuscitation when peripheral venous access cannot be rapidly established. The technique involves inserting a needle through the cortex of a long bone, typically the proximal tibia or distal femur, into the medullary cavity to administer fluids and medications directly into the venous circulation. Success rates are directly linked to knowledge of bony landmark anatomy, insertion depth, and the medullary vascular anatomy of target sites. This study aims to assess the anatomical basis of successful intraosseous access in paediatric resuscitation among healthcare staff at paediatric intensive care units in Zamfara State specialist hospitals, North West Nigeria. Clinical simulation assessments using paediatric bone models will be combined with a structured anatomy knowledge questionnaire. Landmark identification accuracy, insertion angle, and simulated flow rates will be recorded. Findings will be stratified by professional cadre and training history. The study anticipates identifying anatomy knowledge deficits that contribute to failed intraosseous access attempts in paediatric emergencies and recommending anatomy-integrated simulation training protocols for adoption across paediatric intensive care units in the North West zone.

Keywords: intraosseous access, paediatric resuscitation, tibial anatomy, Zamfara State, emergency procedure