title: Bent Metal in a Bone: A Rare Complication of an Emergent Procedure or a Deficiency in Skill Set?
abstract: Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus. Conventional bedside removal was impossible and required surgical intervention in operating room.
authors.affiliation: Department of Internal Medicine, CHI Creighton University Medical Center, Omaha, NE, USA.
authors.forename: Mridula
authors.initials: M
authors.lastname: Krishnan
authors.affiliation: Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Katherine
authors.identifier: 0000-0002-0351-2840
authors.initials: K
authors.lastname: Lester
authors.affiliation: Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Amber
authors.identifier: 0000-0003-0103-4221
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Department of Internal Medicine, CHI Creighton University Medical Center, Omaha, NE, USA.
authors.forename: Kaye
authors.initials: K
authors.lastname: Bardeloza
authors.affiliation: Department of Family Medicine, CHI Creighton University Medical Center, Omaha, NE, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Edemekong
authors.affiliation: Department of Pulmonary and Critical Care, CHI Creighton University Medical Center, Omaha, NE, USA.
authors.forename: Ilya
authors.identifier: 0000-0003-1402-6335
authors.initials: I
authors.lastname: Berim