Compartment Syndrome Resulting From Improper Intraosseous Cannulation: A Case Report

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.