Risk stratification of extravasation during semi‐automatic intraosseous device use in a pediatric emergency setting

Background The semi‐automatic intraosseous device (EZ‐IO®) is useful for safely securing intraosseous access. There are some complications associated with its use but few studies have examined the risk factors. The present study aimed to investigate the risk factors for extravasation as a complicati...

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Bibliographic Details
Published in:Pediatrics international 2023-01, Vol.65 (1), p.e15686-n/a
Main Authors: Sasaoka, Yuta, Mori, Takaaki, Takei, Hirokazu, Hagiwara, Yusuke, Nomura, Osamu
Format: Article
Language:English
Subjects:
Child
complication
Diagnosis
Emergency medical care
Emergency Medical Services
Extravasation
EZ‐IO
Heart Arrest
Humans
intraosseous line
Lidocaine
Patients
Pediatrics
Resuscitation
Retrospective Studies
Risk Assessment
Risk factors
Statistical analysis
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Summary:Background The semi‐automatic intraosseous device (EZ‐IO®) is useful for safely securing intraosseous access. There are some complications associated with its use but few studies have examined the risk factors. The present study aimed to investigate the risk factors for extravasation as a complication of EZ‐IO use in pediatric patients. Methods This study is a secondary analysis of a previous, monocentric, retrospective study conducted in Japan describing the use of EZ‐IO in a pediatric emergency department. The patients included in the study were younger than 16 years of age with EZ‐IO use at the Tokyo Metropolitan Children's Medical Center between January, 2013 and August, 2018. The factors analyzed included demographic information (sex, age, weight), Glasgow Coma Scale (GCS), diagnosis, bolus infusion, and lidocaine use. The primary endpoint was the odds ratio (OR) and 95% confidence interval (CI) for extravasation incidence. Results Seventy‐two patients were enrolled; 14 of these had extravasation, 39 (54.2%) had a diagnosis of cardiac arrest, and 50 (69.4%) had a GCS score of 8 or less. Statistical analysis demonstrated that the group with a high GCS score was significantly associated with extravasation: GCS (
ISSN:1328-8067
1442-200X
DOI:10.1111/ped.15686