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Extravasation from a Misplaced Intraosseous Catheter.

Christopher S Sampson1

  • 1University of Missouri School of Medicine, Department of Emergency Medicine, Columbia, Missouri.

Clinical Practice and Cases in Emergency Medicine
|August 13, 2019
PubMed
Summary

Improper intraosseous (IO) catheter placement in a cardiac arrest patient led to medication extravasation, causing tissue necrosis and requiring skin grafting. Confirming IO line placement is crucial for patient safety and effective emergency care.

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Area of Science:

  • Emergency Medicine
  • Trauma Care
  • Vascular Access

Background:

  • Intraosseous (IO) access is a critical route for medication and fluid administration in emergencies.
  • Proper placement of IO catheters is essential to prevent complications.

Purpose of the Study:

  • To highlight a case of severe complication due to misplaced intraosseous catheter.
  • To emphasize the importance of verifying IO catheter placement in prehospital and emergency settings.

Main Methods:

  • Case report of a 75-year-old female in cardiac arrest.
  • Review of prehospital and emergency department procedures.
  • Documentation of complication and subsequent treatment.

Main Results:

  • A right tibial intraosseous catheter was misplaced during prehospital care.
  • Medication extravasation occurred, leading to localized tissue necrosis.
  • The patient ultimately required skin grafting for treatment.

Conclusions:

  • Misplacement of intraosseous catheters can result in serious patient harm.
  • Confirmation of correct IO placement by emergency medical services and receiving facilities is vital.
  • Vigilance in vascular access techniques can prevent adverse events.