Proximal Humerus Site for Anesthesia

When using IO access in the perioperative and OR settings, abduction of the arms to the shoulder level prevents use of the traditional proximal humerus insertion site due to the rotation of the humeral head under the acromion process. An alternate proximal humerus IO insertion technique has been developed to meet the needs of anesthesia patient positioning that uses a slightly more distal insertion site and a superior angle of insertion. However infusion flow rate in the proximal humerus using the anesthesia technique has not been measured. This study is needed to evaluate the anesthesia proximal humerus IO insertion technique to determine if the IO infusion flow rates remain unchanged by the alternate method.

Inclusion criteria

• Age 21 years or older
• Have no amputation of the upper extremities
• Able to lay flat on table for up to 2 hours
• Self-reported as healthy, as confirmed by the PI

Exclusion criteria

• Have an active infection in the body
• Imprisoned
• Pregnant
• Cognitively impaired
• Fracture in humerus, or significant trauma to the site
• Excessive tissue and/or absence of adequate anatomical landmarks in humerus
• Infection in target area
• Humeral IO insertion in past 48 hours, prosthetic limb or joint or other significant orthopedic procedure in humerus
• Current use of anti-coagulants
• Current cardiac condition requiring pacemaker or anti-arrhythmic drugs
• Prior adverse reaction to lidocaine
• Volunteers with any of the following characteristics may be excluded from the infusion pathway evaluation involving administration of contrast dye at the discretion of the PI:
• Prior adverse reaction to contrast dye
• Allergy to any food or drug
• History of impaired renal function
• History of impaired hepatic function
• History of cardiac disease
• History of pheochromocytoma