Intravenous literature: Ahrens, K.L., Reeder, S.B., Keevil, J.G. and Tupesis, J.P. (2013) Successful Computed Tomography Angiogram Through Tibial Intraosseous Access: A Case Report. The Journal of Emergency Medicine. 29th May. [Epub ahead of print].
BACKGROUND: Intraosseous access has been used increasingly with proven efficacy in emergent situations for adults when intravenous access could not be obtained.
OBJECTIVE: Our aim was to demonstrate if tibial intraosseous (IO) is an effective route for iodinated contrast administration and pulmonary vasculature visualization.
CASE REPORT: We report on an obtunded patient requiring a computed tomography angiogram to help with diagnosis and tibial IO was the only viable access appropriate to withstand the pressure of a computed tomography iodinated contrast load. Tibial IO access was used successfully for administration of iodinated contrast to evaluate for massive pulmonary embolism in an obtunded patient in extremis secondary to cardiovascular instability.
CONCLUSIONS: The pulmonary arteries were opacified and demonstrated a high-quality CT angiogram can be done via tibial IO device.