Intraosseous vs. Intravenous Access for Adults with Out-of-Hospital Cardiac Arrest

Intraosseous vascular access has emerged as a safe and fast alternative to intravenous access in patients with out-of-hospital cardiac arrest. To compare first-attempt success rates, researchers randomized 182 adults with nontraumatic out-of-hospital cardiac arrest to attempted access by paramedics in the field by one of three routes: tibial intraosseous, humeral intraosseous, or intravenous.

First-attempt success rates were significantly higher for the tibial intraosseous route (95%) than for the humeral intraosseous (71%) or intravenous (49%) routes. Humeral intraosseous lines were significantly more likely to be dislodged than tibial intraosseous or intravenous lines (24% vs. 5% and 5%). Time to access was significantly faster with the ti…