What is Emergency Medicine - What factors should be taken into account while inserting an intraosseous (IO) line in a child?
IO lines may be added quickly and easily. If a peripheral line cannot be established right away, the insertion of an IO line should be taken into consideration in any critically ill patient. IO lines are secure for administering almost any liquid, blood product, or medication. The rate of infusion is comparable to a 21-gauge IV. White blood cell count, potassium, calcium, and aspartate transaminase/alanine transferase (AST/ALT) tests may not be reliable even if the majority of serum laboratory testing can be sent from an IO aspirate. The proximal tibia beneath the tibial tuberosity is the optimum location. The medial malleolus and the distal femur are additional potential locations. When a youngster has acquired skeletal maturity in late adolescence, the proximal humerus should be avoided. A maximum dose of 40 mg of 0.5 mg/kg of 2% lidocaine (20 mg/mL) may be given to the aware youngster who is suffering pain from an intravenous infusion (2 mL). To avoid damaging the growth plate, IO lines should not be positioned distal to a fracture and should be directed away from the physis. Once peripheral or central IV access has been established, they should be removed within 24 hours. Cellulitis, osteomyelitis, growth plate damage, fat embolism, compartment syndrome, and iatrogenic fractures are among the uncommon complications.
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