title: Intra-articular Placement of an Intraosseous Catheter.
abstract: Gaining vascular access is essential in the resuscitation of critically ill patients. Intraosseous (IO) placement is a fundamentally important alternative to intravenous (IV) access in conditions where IV access delays resuscitation or is not possible. This case report presents a previously unreported example of prehospital misplacement of an IO catheter into the intra-articular space of the knee joint. This report serves to inform civilian and military first responders, as well as emergency medicine physicians, of intra-articular IO line placement as a potential complication of IO vascular access. Infusion of large amounts of fluid into the joint space could damage the joint and be catastrophic to a patient who needs immediate IV fluids or medications. In addition, intra-articular IO placement could result in septic arthritis of the knee.
authors.affiliation: Department of Orthopaedics,Warren Alpert Medical School of Brown University,Providence,Rhode IslandUSA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Grabel
authors.affiliation: Department of Orthopaedics,Warren Alpert Medical School of Brown University,Providence,Rhode IslandUSA.
authors.forename: J Mason
authors.initials: JM
authors.lastname: DePasse
authors.affiliation: Department of Orthopaedics,Warren Alpert Medical School of Brown University,Providence,Rhode IslandUSA.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Lareau
authors.affiliation: Department of Orthopaedics,Warren Alpert Medical School of Brown University,Providence,Rhode IslandUSA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Born
authors.affiliation: Department of Orthopaedics,Warren Alpert Medical School of Brown University,Providence,Rhode IslandUSA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Daniels
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D002406:Catheterization, Peripheral / Q000379:methods*; D006801:Humans; D007719:Knee Joint; D008297:Male
keywords: AP anteroposterior; ED emergency department; EMS Emergency Medical Services; IO intraosseous; IV intravenous; vascular access