Intraosseous Needle Placement

Mentally practice placing an intraosseous needle. Imagine yourself proceeding through all of the steps listed below. Refer to the checklist when you are stuck. Watch the point-of-view video to visualize the procedure. Sign up for spaced repetition reminders at the bottom of the page. Test yourself with the quiz.

  1. Select appropriate bone
  2. Select an appropriately sized needle
  3. Identify anatomic landmarks and locates insertion site (for proximal tibia, one finger breadth medial and distal to tibial tuberosity)
  4. Prepare site
  5. Insert needle correctly (for drill, stop once you feel it give, then disconnect drill and unscrew the stylet)
  6. Connect tubing
  7. Aspirate blood
  8. Infuse an appropriate fluid (may use 2% preservative-free lidocaine for anesthesia; adult/max dose is 2 mL)
  9. Assess for infiltration
  10. Secure the needle appropriately (gauze rolls on either side along length of bone)