Extravasation from a Misplaced Intraosseous Catheter

A 75-year old female presented in cardiac arrest with a right tibial intraosseous (IO) catheter through which prehospital medications were administered. The catheter, which had been placed by emergency medical services, was noted in the emergency department to be misplaced and was removed. Due to extravasation of the medications, the patient suffered localized tissue necrosis and eventually required skin grafting. This case illustrates the importance of confirming appropriate IO placement.