P0189 / #1816: PAEDIATRIC IO INSERTION, RETROSPECTIVE AUDIT, FINDINGS AND OUTCOMES FROM A PAEDIATRIC CRITICAL CARE TRANSPORT TEAM 2018-2020

Abstract

Aims & Objectives: Aim was to evaluated the presenting complaint, indications, insertion sites, complications associated with Intraosseous needle (IO) insertion. The objective of this study was to audit the use of IO’s in the paediatric critical care population. Methods: Retrospective case note review of all patients who underwent IO insertion between January 2018-June 2020. Results: A documented 271 patients had IO insertions over a 30 months. 52% were in patients under 1 year old. 30% presenting with a respiratory illness. The commonest indication for IO insertion was for more venous access (22%) along with resuscitation (22%) The commonest sites for insertion were the tibia (56%). 14% of patients underwent > 2 insertion attempts and of these patients the final successful site was the distal femur. Of the patients who had multiple attempts at insertion the majority failed due to extravasation (83%), plus anecdotal reports of inadequate length and placement. 1 out 271 patients reported long term complications from an IO insertion site. Conclusions: Anaylised data shows care with needle size and insertion site is required to minimize short term complications. Longer term complications are rare, making IO insertion a valuable tool in the resuscitation and stabilisation of critically ill children.