Intraosseous access in the management of paediatric emergencies: a report from Gabriel Toure hospital

Abstract

When access to peripheral veins is delayed or impossible, intraosseous access must be rapidly considered. The aim of our study was to determine the epidemiological, clinical and therapeutic characteristics of children who have benefited from intraosseous access, as well as the practical details of its implementation. Materials and methods: It was a prospective study, on the assessment of aspects of intraosseous access in the management of pediatric emergencies. Children under 15 years of age who received this procedure were included. The study was performed over a 14-month period from March 2018 to April 2019 at the pediatric emergencies of Gabriel Touré hospital. Results: Twenty-two patients were included. The sex ratio was 2.14. The mean age was 9 months (2 months-36 months). Dehydration complicated by shock represented 45.5% of treated diseases. All intraosseous access points were placed in the proximal tibia. Manual insertion was used in all cases. The most frequent early complication was deperfusion (13.6%). Difficulty with peripheral venous access was the main indication (77.3%). The procedure was performed by a physician in 91% of cases, with a success rate of 86.4%. Vascular filling was the most common treatment used by this route, accounting for 82% of cases. Conclusion: Intraosseous device insertion has saved children in life-threatening emergencies. The main factors limiting the insertion of the intraosseous device in our study were high cost of devices and lack of appropriate training about veins access in case of pediatric emergencies.