Abstract:
Intraosseous access is a safe and efficient method to administer medications to patients that require advanced life support when intravenous
access is not easily available. This study aims to
narrow down the ideal insertion site for intraosseous access within the proximal tibia in a pediatric
population. The study utilized computed tomography scans that were retrospectively collected
from scans of five infant patients between four weeks and two-years old, seven young children
between two-years and six-years old, and ten
children between six-years and twelve-years of
age. Analysis of the computed tomography scans
started at 10mm and extended to 50mm distally
to the tibial tuberosity at 10mm increments.
The smallest cortical thickness to medullary
space ratio and most desirable cortical thickness to anteromedial border ratio across all three
groups – infants, young children, and child – was
identified as 10mm inferior to the tibial tuberosity. Meanwhile, the largest medullary space to anteromedial border ratio was at 10mm inferior
to the tibial tuberosity for the infants and young
child groups, and at 30mm for the child group.
This study showed that, overall, the ideal needle insertion site to gain vascular access for an
intraosseous infusion procedure in the proximal tibial in infants, young child, and children is
10mm distal to the tibial tuberosity.
