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This study looked at the success rates of femoral vs proximal tibial IOs in the prehospital setting. Over a 9 year period, there were 163 pediatric patients who received either a tibial or femoral IO. Femoral IOs were introduced into the EMS protocol in this study area in 2015 as a location option and were the recommended site starting in 2019. The success rate of femoral IO placement was 89% and for proximal tibial sites was 84.7%. After further data analysis the study found an adjusted odds ratio of 2 for successful IO placement in the distal femur compared to the proximal tibia. The complication rates for both sites were similar.
Bottom line: This study suggests that the distal femur is a reasonable site for IO access in the pediatric population.
References
Zitek T, Antevy P, Garay S, Thorn M, Buckley E, Coyle C, Scheppke KA, Farcy DA. Evaluating the Success Rate of Distal Femur Intraosseous Access Attempts in Pediatric Patients in the Prehospital Setting: A Retrospective Analysis. Prehosp Emerg Care. 2024 Sep 4:1-8. doi: 10.1080/10903127.2024.2398185. Epub ahead of print. PMID: 39230342.