J Korean Soc Emerg Med.  2014 Dec;25(6):690-695. 10.0000/jksem.2014.25.6.690.

Experience of Using the Intraosseous Access to Critical Pediatric Patients in a Tertiary Emergency Department

• Lee JJ
• Min YG
• Kim AJ
• Lee JS

• KMID: 2101246
• DOI: http://doi.org/10.0000/jksem.2014.25.6.690

Abstract

PURPOSE
Intraosseous infusion is a safe and effective vascular access route in critically ill patients, especially in the pediatric population. Use of intraosseous access has shown a recent increase in Korea, but this procedure is not well reported. The aim of this study is to evaluate the clinical characteristics and outcomes of intraosseous infusion.
METHODS
This study was a retrospective chart review of pediatric patients who received intraosseous infusion at a tertiary emergency department between April 2010 and March 2014. Their clinical characteristics and outcomes were evaluated.
RESULTS
A total of 30 patients participated; 25 patients were cardiac arrest, three were status epilepticus, one was septic shock, and one was severe hypovolemic shock. Final procedure success rate was 90% and average 1.63 attempts were performed per child. Finally 12 patients survived over 24 hours. In particular, all patients of non-cardiac arrest survived and were discharged successfully from our hospital. Median maintenance time of the intraosseous device among survived patients was 112 minutes. No complications were reported.
CONCLUSION
Intraosseous infusion in the emergency department was a very effective procedure for cardiac arrested patients and critically ill patients in whom access to the vascular route was difficult.

Keyword

Intraosseous infusions; Pediatrics; Cardiac arrest

MeSH Terms

Child
Critical Illness
Emergency Service, Hospital*
Heart Arrest
Humans
Infusions, Intraosseous
Korea
Pediatrics
Retrospective Studies
Shock
Shock, Septic
Status Epilepticus