Complication of inadvertent intra-articular intraosseous access

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“This report serves to inform civilian and military first responders, as well as emergency medicine physicians, of intra-articular IO line placement as a potential complication of IO vascular access” Grabel et al (2014).

Reference:

Grabel, Z., DePasse, J.M., Lareau, C.R., Born, C.T. and Daniels, A.H. (2014) Intra-articular Placement of an Intraosseous Catheter. Prehospital and Disaster Medicine. December 8th. [epub ahead of print].

Abstract:

Gaining vascular access is essential in the resuscitation of critically ill patients. Intraosseous (IO) placement is a fundamentally important alternative to intravenous (IV) access in conditions where IV access delays resuscitation or is not possible. This case report presents a previously unreported example of prehospital misplacement of an IO catheter into the intra-articular space of the knee joint. This report serves to inform civilian and military first responders, as well as emergency medicine physicians, of intra-articular IO line placement as a potential complication of IO vascular access. Infusion of large amounts of fluid into the joint space could damage the joint and be catastrophic to a patient who needs immediate IV fluids or medications. In addition, intra-articular IO placement could result in septic arthritis of the knee.

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