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This video demonstrates the placement of an intraosseous needle in adult patients. Both mechanical, drill-based insertion and manual insertion are shown. Indications for intra-osseous (IO) infusion are increasing in adults requiring administration of fluids and medications during initial resuscitation. However, this route is rarely used nowadays due to a lack of knowlegde and training.

A review of the evolution of intraosseous access in tactical settings and a feasibility study of a human cadaver model for a humeral head approach. Military Medicine. Aug;(8 Suppl) Pepitas F, et al. Use of intra-osseous access in adults: a systematic review. Critical Care. () Greenstein Y, et al. Intraosseous access has recently been revived in adults as an alternative when conventional intravenous access may be difficult or impossible [ 3, 12–15]. The standard IO needle has been compared with needles having a newer design and most recently with IO access devices [3, 11, 12, 16–19]. The EZ-IO™ is one such device for adult IO.

The IO route is an established method of obtaining vascular access in children in acute and emergency situations and is now increasingly being used in adults as an alternative to intravenous access, yet a paucity of evidence exists regarding its use, effectiveness and implementation. Intraosseous infusion has few contra-indications and the success rate is very high, whilst the rate of complications is very low. The use of intraosseous infusion was restricted to use in the resuscitation of children (overtaking saphenous vein cutdown) and military medicine for a number of years but is now increasingly being used in adults.

The Arrow ® EZ-IO ® Intraosseous Vascular Access System creates a stable port into the intraosseous space to access the central vascular system within seconds, causing minimal trauma to the patient. The intraosseous space is a specialized area of the vascular system where blood flow is rapid and continues even during shock. The Life/form Adult Intraosseous Infusion Simulator includes palpable landmarks, replaceable bones and skin, and a pressurized system to allow aspiration of fluid. Included with the simulator are 10 replaceable simulated bones, four replaceable skin pads, simulated blood, lubricating jelly, towels, I/O needle, and syringe with tubing.