Osteomyelitis at the injection site of adrenalin through an intraosseous needle in a 3-month-old infant

Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

“…There are three case reports of local complications in children (compartment syndrome, tissue necrosis, osteomyelitis. [163][164][165] However, these occurred in very young children (6 years, 7 month, 3 months) receiving large resuscitative doses of vasopressors, and are not clearly relevant to adults. Given that the intra-osseous compartment is considered a non-compressible central vein, it seems reasonable to conclude that intra-osseous administration of vasopressors may yield a low incidence of complications from the vasopressor itself.…”

A severe complication following intraosseous infusion used during resuscitation of a child

“…At present there is no clear consensus from the literature regarding: the length of time an intraosseous needle should remain in place, the maximum rate or volume that should be infused through this route and what drugs should be avoided or be used in altered concentrations through this route. [2][3][4][5] Musculoskeletal complications as a result of intraosseous infusions are rare and occur in less than one percent of patients. 3 Reported complications include: compartment syndrome and resultant amputation, 5-11 osteomyelitis 3 and myonecrosis.…”

“…[2][3][4][5] Musculoskeletal complications as a result of intraosseous infusions are rare and occur in less than one percent of patients. 3 Reported complications include: compartment syndrome and resultant amputation, 5-11 osteomyelitis 3 and myonecrosis. 12 We report a patient who had a severe complication as a result of intraosseous infusion, the cause of the complications is unclear and may be attributed to a combination of factors.…”

Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings: A Consensus Paper

“…32 Since that 1985 study, only single case studies have been reported, all in pediatric patients. [33][34][35][36][37] The most commonly reported complication is extravasation, 38 which is generally the result of poor insertion technique, inadequate device stabilization, or device design.…”