Palliative Sedation via Intraosseous Vascular Access: A Safe and Feasible Way to Obtain a Vascular Access End of Life

J Palliat Med. 2019 Jan;22(1):109-111. doi: 10.1089/jpm.2018.0398.

Abstract

Intraosseous (IO) access is normally reserved for emergencies and critical care conditions when venous cannulation is not possible. Nonetheless, we present a case of IO insertion to a 56-year-old man, tetraplegic for many years due to progressive spinal muscular atrophy and with refractory suffering. The IO access was used for palliative sedation with propofol in a home care setting. The patient died after 11 days of palliative care, of which the last 4 days were with palliative sedation using an IO cannula as a vascular access. No complications were noted from this route of administration. We advocate the use of IO access in the palliative care of terminal ill patients when a venous cannulation is not possible.

Keywords: home care setting; intraosseous vascular access; palliative sedation.

Publication types

  • Case Reports

MeSH terms

  • Drug Administration Routes
  • Home Care Services
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Infusions, Intraosseous*
  • Male
  • Middle Aged
  • Muscular Atrophy, Spinal / drug therapy
  • Pain / drug therapy
  • Palliative Care / methods*
  • Patient Safety
  • Propofol / administration & dosage*
  • Quadriplegia / drug therapy
  • Terminal Care
  • Terminally Ill*

Substances

  • Hypnotics and Sedatives
  • Propofol