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Amputation and intraosseous access in infants

Amputation and intraosseous access in infants
Amputation and intraosseous access in infants
Vascular access in critically ill children is a priority for emergency administration of fluid and therapeutic agents. Intraosseous access is an alternative when attempts at venous access fail. The proximal tibia is the preferred site for intraosseous needle insertion, with an accessible subcutaneous cortex. Manual insertion of the intraosseous needle can be supplemented with approved impact driven and power driven needle systems.

Intraosseous access has low failure and complication rates, but compartment syndrome has been reported in association with this procedure, and preventive measures have been recommended. Three cases of amputation have been reported, preceded by clinical features of compartment syndrome within a few hours of admission.

We describe two cases of leg amputation after intraosseous infusion to emphasise the risk of limb ischaemia during paediatric resuscitation by this route.
0959-8138
Taylor, Colm C.
773e979d-aca8-43e9-82c8-c79931730ab7
Clarke, N.M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Taylor, Colm C.
773e979d-aca8-43e9-82c8-c79931730ab7
Clarke, N.M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac

Taylor, Colm C. and Clarke, N.M.P. (2011) Amputation and intraosseous access in infants. British Medical Journal, 342, [d2778]. (doi:10.1136/bmj.d2778). (PMID:21622504)

Record type: Article

Abstract

Vascular access in critically ill children is a priority for emergency administration of fluid and therapeutic agents. Intraosseous access is an alternative when attempts at venous access fail. The proximal tibia is the preferred site for intraosseous needle insertion, with an accessible subcutaneous cortex. Manual insertion of the intraosseous needle can be supplemented with approved impact driven and power driven needle systems.

Intraosseous access has low failure and complication rates, but compartment syndrome has been reported in association with this procedure, and preventive measures have been recommended. Three cases of amputation have been reported, preceded by clinical features of compartment syndrome within a few hours of admission.

We describe two cases of leg amputation after intraosseous infusion to emphasise the risk of limb ischaemia during paediatric resuscitation by this route.

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More information

Published date: 27 May 2011
Organisations: Human Development & Health

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Local EPrints ID: 338781
URI: http://eprints.soton.ac.uk/id/eprint/338781
ISSN: 0959-8138
PURE UUID: 820c6628-b7d6-4cdf-a0b8-a21e5049a74b

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Date deposited: 17 May 2012 10:58
Last modified: 14 Mar 2024 11:04

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Contributors

Author: Colm C. Taylor
Author: N.M.P. Clarke

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