Intraosseous Infusion Rates under High Pressure: A Cadaveric Comparison of Anatomic Sites

When traditional vascular access methods fail, emergency access through the intraosseous IO route can be lifesaving. Fluids, medications, and blood components have all been delivered through these devices. We compared the performance of IO devices placed in the sternum, humeral head, and proximal tibia utilizing a fresh human cadaver model. Commercially available IO infusion devices were placed into fresh human cadavers sternum FAST-1, humeral head EZ-IO, and proximal tibia EZ-IO. Sequentially, the volume of 0.9 saline infused into each site under 300-mmHg pressure over 5 minutes was measured. Rates of successful initial IO device placement and subjective observations related to the devices were also recorded. This is the first study comparing the rate of flow at the three most clinically utilized adult IO infusion sites in an adult human cadaver model. Our results showed that the sternal site for IO access provided the most consistent and highest flow rate compared to the humeral and tibial insertion sites.