Abstract:
Shock is a life-threatening clinical condition in the pediatric age group. The most common types of shock in children include hypovolemic, septic, cardiac, obstructive, distractive, and anaphylactic. Among these, a septic shock is a complex form that requires knowledge and experience in order to properly define and manage it. It is vital to support airway/breathing/circulation soon after its identification. It is very important to identify sepsis within the first 5 minutes. Moreover, establishing a vascular access is crucial to initiate fluid resuscitation and antibiotherapy as soon as possible.
It is not always possible to find a vascular access in young children. If the vascular access cannot be found, intraosseous pathways should be considered. Multiple venous thrombosis might occur due to recurrent central venous catheter attempts in pediatric intensive care or in patients with a history of recurrent hospitalization. In these cases, it may become impossible to establish a vascular access and to wear a central venous catheter. Hence, intraosseous access becomes the only way for patients to survive both for emergency as well maintenance treatments. Here, we present a pediatric case in which we have demonstrated the relevance of the intraosseous access both for emergency and subsequent treatments as an alternative route in a patient who has had thrombosis due to repeated central venous catheter insertion.4-6 The humerus is one of the alternatives used for intraosseous pathway.
Reference:Öztürk G, Balaban B, Kendirli T. Is Humerus a Good Choice for Intraosseous Access During Fluid Resuscitation in a Child with Severe Septic Shock? Turk Arch Pediatr. 2022 Mar;57(2):237-238. doi: 10.5152/TurkArchPediatr.2022.21299. PMID: 35383022.