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Reasons for not using intraosseous access in critical illness
  1. Peter Hallas,
  2. Mikkel Brabrand,
  3. Lars Folkestad
  1. The Danish Society for Emergency Medicine, c/o Emergency Department, Slagelse Hospital, Slagelse, Denmark
  1. Correspondence to Dr P Hallas, Hojdevangs Allé 9 St, DK-2300 Copenhagen S, Denmark; hallas{at}


Aim To identify reasons for not using intraosseous access (IO) when intravenous access is difficult during resuscitation.

Methods Questionnaire made available to members of selected Scandinavian medical societies.

Results Of 759 responders to the questionnaire, 23.5% (n=178) had experienced one or more situations where there was a need for IO but none was placed. The most common stated reasons for not performing IO were a lack of equipment (48.3%), a lack of knowledge about the procedure (32.6%), and intravenous access preferred over IO (23.0%).

Conclusions The main reasons for not using IO were lack of equipment and lack of training. The authors recommend increased training in IO use and greater availability of IO equipment for front-line staff in Scandinavian countries. The use of non-purpose-designed needles for IO should be evaluated.

  • Infusions
  • Intraosseous
  • adult resuscitation, guideline adherence
  • resuscitation
  • equipment design
  • equipment evaluation
  • paediatrics
  • paediatric resuscitation
  • resuscitation

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.