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

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.