Intraosseous (IO) puncture is considered for the administration of drugs and fluids when vascular access cannot be achieved rapidly. @entity1425 / @entity1425 , @entity859 , crystalloids, colloids and blood products can be applied and administered effectively using this route during resuscitation of @entity1 . This technique is relatively simple with complications of <1%. These may include @entity174 , @entity2054 and @entity4034 . A case is described in which a 3-month-old male @entity1 presented for emergency resuscitation requiring IO infusion utilising both tibial bones. High doses of @entity1425 (1:1000; 0.1 mg/kg) were administered in the right tibial epiphysis only after the standard initial concentration (1:10000; 0.01 mg/kg) had minimal effect. A local inflammatory reaction was noted 24 h later in the right tibial region, which developed into @entity39 , and was eventually resected. Radiologically, no @entity75 could be demonstrated, however, a bone scintigram revealed @entity4034 . Upon surgical revision, purulent destruction was evident requiring removal of the epiphysis and part of the metaphysis. Although @entity4034 is a rare complication which may be caused by @entity295 , or contamination during insertion, we speculate that @entity1425 in high concentrations may promote the development of @entity4034 and the drug should be applied cautiously in more diluted concentrations.

@entity4034 at the injection site of adrenalin through an intraosseous needle in a 3-month-old XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'infant'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity859 :: ('MESH:D000241', 'Chemical') :: ['adenosine'] @entity174 :: ('MESH:D050723', 'Disease') :: ['tibial fracture'] @entity39 :: ('MESH:D009336', 'Disease') :: ['cutaneous necrosis'] @entity75 :: ('MESH:D001927', 'Disease') :: ['osseous lesion'] @entity1425 :: ('MESH:D004837', 'Chemical') :: ['epinephrine', 'Adrenaline', 'adrenaline'] @entity4034 :: ('MESH:D010019', 'Disease') :: ['osteomyelitis'] @entity2054 :: ('MESH:D003161', 'Disease') :: ['lower extremity compartment syndrome']
@entity1 :: (9606,Species) :: ['infant']
