• • Emergent temporary vascular access during cardiopulmonary resuscitation or during the treatment of uncompensated shock when unable to insert an intravenous line.

  • Volume resuscitation.

  • Administration of blood and blood products.

  • Administration of fluids and electrolytes.

  • Administration of medications.

  • Infusion of inotropes and pressors.

  • Sampling of blood and bone marrow.

Absolute

• • Do not insert in a recently fractured bone.

  • Do not insert through an infected site.

  • Osteogenesis imperfecta.

  • Osteopetrosis.

Relative

• • Osteoporosis or osteopenia.

  • Cystic bones.

• • Intraosseous needle (18 or 20 gauge) or bone marrow aspiration needle.

  • Povidone, chlorhexidine, and alcohol wipes.

  • Gauze.

  • Tape.

  • Extension tubing.

  • T-connector.

  • Syringe.

  • Gloves.

• • Infection.

  • Injury to growth plate.

  • Bone fracture.

  • Hematoma.

  • Extravasation.

  • Compartment syndrome.

  • Severe vasoconstriction if vasoactive substances extravasate.