Comparing three infant positions in paediatric life support

Abstract

right proximal tibia was placed using a power driven device EZ-IO (Vidacare, San Antonio, TX, USA) and a15mm needle. The purpose of this study was to analyse the possible technical and anatomical factors leading into this complications. Material and methods: We measured the size of medullary diameter of the proximal tibia at the recommended site of IO access in 30 X-rays in three age groups: 1–28 days old full term neonates, 1–12 month old infants and 3–4 year old children. Children with syndromes or deformities in lower extremities were excluded. Results: The mean medullary diameter of the proximal tibia in neonates was 7.7mm, in infants 9.9mm and in 3–4 years old 12.4mm. The length of tip of the stylet and Y-shaped EZ-IOpaediatric needle, which had to be placed within the medullary cavity, is 4mm. Conclusion: The small size of intraosseous space especially in neonates and infants makes the correct placement of the IO needle and the avoidance of needle dislocation extremely challenging. In this patient group, the possibility of the rare complications: compartment syndrome and leg amputation should be taken into consideration.