Failed intraosseous contrast injection
GCS 3 no IV access, contrast scan to be performed via intraosseous injection.
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Extravasation of contrast into the subcutaneous tissues with no cortical breach to suggest intraosseous needle insertion. Small volume intraarticular gas likely related with soft tissue insertion of the needle.
Increased air space opacities and ground glass opacification of bilateral upper lobes in keeping with pulmonary contusion/haemorrhage. Left sided pneumothorax with a left sided chest drain.
Although the literature overwhelmingly states intraosseous injections have a low complication rate, it is important to ensure proper placement of the intraosseous needle before injection.
CT contrast media extravasation occurs relatively infrequently but can have severe side effects associated with skin changes and possible skin necrosis.
- 1. ACR Manual on Contrast Media. ACR Manual on Contrast Media. ACR Committee on Drugs and Contrast Media, 2017.