INTRAOSSEOUS INFUSION IN LIFE-THREATENING PEDIATRIC EMERGENCIES

As the bone marrow is a vascular tissue which cannot collapse, it may be used as a vascular access to treat life-threatening emergencies esp ecially in children. Two cases reported here underline the value of th is life-saving procedure. Both children were 9 months old, and were ad mitted for severe dehydration, having lost 15 and 10 % of body weight respectively. All attempts to set up an intravenous infusion in a peri pheral vein failed in both. The fontanelles were closed, and the centr al veins (internal jugular and subclavian veins) easily accessible, ho wever collapsed. Intraosseous infusion was decided as a last ditch pro cedure. A 15-gauge Mallarme's trocar was inserted at the proximal end of the tibia. In both children, this allowed rehydration to be carried out, and, in the second child, anticonvulsive and antibiotic therapy to be started. The intraosseous line was replaced, in the first child, at the third hour, by a conventional infusion line, set up by denudat ion, and in the second one, by a subclavian line. This technique has f ew contra-indications, and the complication rate is low. However, this technique should remain limited to a few indications only.