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

Abstract

Purpose: Intraosseous infusion is a safe and effective vascularaccess route in critically ill patients, especially in thepediatric population. Use of intraosseous access hasshown a recent increase in Korea, but this procedure is notwell reported. The aim of this study is to evaluate the clinicalcharacteristics and outcomes of intraosseous infusion.

Methods: This study was a retrospective chart review ofpediatric patients who received intraosseous infusion at atertiary emergency department between April 2010 andMarch 2014. Their clinical characteristics and outcomeswere evaluated.

Results: A total of 30 patients participated; 25 patientswere cardiac arrest, three were status epilepticus, one wasseptic shock, and one was severe hypovolemic shock. Final procedure success rate was 90% and average 1.63attempts were performed per child. Finally 12 patients survivedover 24 hours. In particular, all patients of non-cardiacarrest survived and were discharged successfully from ourhospital. Median maintenance time of the intraosseousdevice among survived patients was 112 minutes. No complicationswere reported.

Conclusion: Intraosseous infusion in the emergencydepartment was a very effective procedure for cardiacarrested patients and critically ill patients in whom access tothe vascular route was difficult.