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[Intraosseous infusion in children]
Insights
Intraosseous infusion (IOI) provides rapid vascular access in pediatric emergencies when other methods fail. This technique is effective but carries minor risks like extravasation.
Area of Science:
- Pediatric Emergency Medicine
- Vascular Access Techniques
- Critical Care
Context:
- Intraosseous infusion (IOI) is a crucial emergency procedure for pediatric patients.
- Rapid vascular access is vital in critical situations like cardiopulmonary resuscitation and trauma.
- Established guidelines recommend IOI when peripheral venous access is delayed or unsuccessful.
Purpose:
- To evaluate the efficacy and safety of intraosseous infusion (IOI) in pediatric emergency care.
- To identify the primary indications and potential complications associated with IOI in children.
- To assess the feasibility of IOI as a first-line or alternative vascular access method.
Summary:
- A retrospective study analyzed 46 intraosseous infusions in 41 children (median age 18 months) for emergencies including near-drowning, trauma, and resuscitation.
- The tibia was the primary site for IOI using specific trocars.
- Complications were minimal, including one joint puncture and nine subcutaneous extravasations, with five requiring contralateral limb puncture.
Impact:
- Intraosseous infusion (IOI) is confirmed as a straightforward and valuable technique for pediatric emergency vascular access.
- The findings support the use of IOI in critical pediatric scenarios, particularly when initial attempts at other methods exceed five minutes.
- This study contributes to the evidence base for pediatric emergency protocols, highlighting IOI's role in improving patient outcomes.
Objective:
To assess the benefits and drawbacks of intraosseous infusion (IOI) for emergency therapy in children.
Study Design:
Retrospective, non comparative study of IOI carried out between January 1994 and June 1998.
Patients:
Forty-one children requiring without delay IOI either in the emergency medical ambulance or the emergency admission and intensive therapy units.
Methods:
The tibia was punctured by paediatricians either with Mallarmé's trocars in 1994 or Cook Critical Care trocars from 1995 on.
Results:
Overall, 46 IOI have been carried out in 41 children with a median age of 18 months (range: 8 days-9 years). The main indications for IOI were the management of near drowning, road traffic accidents and cardiopulmonary resuscitation. Complications included one articular puncture and nine subcutaneous extravasations, requiring the puncture of the other limb in five cases.
Conclusion:
IOI is an easy technique for vascular access. It is indicated in emergency cases when, after a delay of five minutes, other techniques have failed.