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A Novel Non-invasive Method for the Detection of Elevated Intra-compartmental Pressures of the Leg

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Compartment Syndrome Resulting From Improper Intraosseous Cannulation: A Case Report.

Kishan K Desai^1,2, Adam J Mann^1,2, Faris Azar^1,2

¹Department of Surgery, Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.

|January 10, 2024

Summary

This summary is machine-generated.

Intraosseous (IO) access is vital for critical care when intravenous (IV) access fails. Improper IO line placement can cause severe complications like compartment syndrome, emphasizing the need for proper training.

Keywords:

acute care surgery and trauma acute compartment syndrome of leg acute trauma care emergent fasciotomy extravasation injury intraosseous access intraosseous infusion lower extremity swelling pre-hospital intervention transfusion in trauma

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Area of Science:

Emergency Medicine
Trauma Surgery
Critical Care

Background:

Vascular access is crucial for timely medical interventions in critical patients.
The intraosseous (IO) route provides rapid vascular access when intravenous (IV) access is challenging.
Proper IO line placement is essential to prevent serious complications.

Observation:

A 30-year-old female sustained trauma from a motor vehicle collision.
Emergency Medical Services placed an intraosseous line in the right proximal tibia due to inability to obtain IV access.
The patient developed acute compartment syndrome in the right lower extremity secondary to extravasation of blood products.

Findings:

Computed tomography confirmed the IO catheter had penetrated both cortices of the right tibia.
Surgical fasciotomy released all four compartments of the right lower leg, evacuating a significant hematoma.
The improper IO line placement led to severe limb edema, loss of pulses, and compartment syndrome.

Implications:

This case underscores the critical importance of intraosseous access in emergency resuscitation.
It highlights the potential risks associated with improper IO line placement, including compartment syndrome.
Enhanced education and standardized training for healthcare providers in IO access techniques are crucial to improve patient outcomes.