Failed intraosseous contrast injection

Case contributed by Mr Andrew Murphy

Presentation

GCS 3 no IV access, contrast scan to be performed via intraosseous injection.

Patient Data

Age: Unknown

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. 

Case Discussion

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. 

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Case information

rID: 55487
Case created: 9th Sep 2017
Last edited: 9th Sep 2017
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

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