Emergency department utilization and success rates for intraosseous infusion in pediatric resuscitations.

OBJECTIVE: To determine the frequency of use and the success rates of intraosseous (IO) vascular access in the emergency department.

DESIGN: A retrospective chart review.

SETTING: A tertiary pediatric emergency department (ED) in a large urban centre.

METHODS: ED resuscitations (ICD-9 code 996) occurring between Oct. 1, 1989, and Sept. 30, 1995, were identified by searching the ED database, inpatient database, ICU admission log and provincial medical examiner's database. From these, all cases involving IO access were selected and comprised the study sample. Demographics, diagnosis, number of IO attempts, success or failure of IO placement, relevant times and patient outcomes were recorded on standard data forms. Frequency of use, success rates and performance times were reported.

RESULTS: IO access was successful in 36 of 42 (86%) patients. In total, there were 68 attempts, or 1.6 attempts per child. All but one child were less than 3 years of age. The median time to successful IO placement was 8 minutes. Two complications, both fractures, occurred in one patient, a 10-day-old neonate.

CONCLUSIONS: IO success rates were high despite infrequent use.