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PEDIATRICS Vol. 111 No. 6 June 2003, pp. e732-e734

EXPERIENCE AND REASON

Strangulation With Intravenous Tubing: A Previously Undescribed Adverse Advent in Children

Daniel Garros, MD*,{ddagger}, W. James King, MD§,||, Barbara Brady-Fryer, RN, MN{ddagger},¶ and Terry P. Klassen, MD*,{ddagger}

* Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
{ddagger} Stollery Children’s Hospital, Edmonton, Alberta, Canada
§ Department of Pediatrics, University of Ottawa, Ontario, Canada
|| Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada

Nonintentional strangulation in children is a widely recognized risk as a result of the vulnerability of their airway to occlusion by relatively low pressures. We describe 2 cases of strangulation by intravenous (IV) tubing in infants, 1 of which was fatal. This is the first documentation in the health science literature of this as a potential adverse consequence of IV therapy in young children. It is important that hospitals that care for such children recognize this potential risk and implement the appropriate strategies to minimize or eliminate it. Preventive interventions may include ongoing assessment of the need for continuous rather than intermittent IV infusions (saline or heparin locked IV sites), individualized level of supervision according to the child’s age and behavior, and engineering modifications to the IV equipment.

Key Words: wounds and injuries • asphyxia • suffocation • accident • infants • safety management • beds • airway obstruction • prevention • hospital practice

Abbreviations: IV, intravenous • PICU, pediatric intensive care unit

Received for publication Nov 14, 2002; Accepted Feb 12, 2003.