End of life palliative sedation via intraosseous vascular access

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No complications were noted from this route of administration. We advocate the use of IO access in the palliative care of terminal ill patients when a venous cannulation is not possible” Mansfeld et al (2019).

Abstract:

Intraosseous (IO) access is normally reserved for emergencies and critical care conditions when venous cannulation is not possible. Nonetheless, we present a case of IO insertion to a 56-year-old man, tetraplegic for many years due to progressive spinal muscular atrophy and with refractory suffering. The IO access was used for palliative sedation with propofol in a home care setting. The patient died after 11 days of palliative care, of which the last 4 days were with palliative sedation using an IO cannula as a vascular access. No complications were noted from this route of administration. We advocate the use of IO access in the palliative care of terminal ill patients when a venous cannulation is not possible.

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Reference:

Mansfeld, A., Radafshar, M., Thorgeirsson, H., Höijer, C.J. and Segerlantz, M. (2019) Palliative Sedation via Intraosseous Vascular Access: A Safe and Feasible Way to Obtain a Vascular Access End of Life. Journal of Palliative Medicine. 22(1), p.109-111.

doi: 10.1089/jpm.2018.0398.

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