The position of the Association for Vascular Access is that intraosseous (IO) cannulation should be employed by qualified clinicians in all critical situations when vascular access is not established.

The insertion of an intraosseous device is a necessary tool. Central venous access device (CVAD) or peripheral intravenous (PIV) insertion should not be attempted under such conditions. In conscious patients, use a lidocaine protocol for infusions. Education and training must be established to have qualified operators and to decrease the barriers to appropriate use.

Reviewed by AVA Clinical Review Team Jan 2023

Adopted by the AVA Board of Directors

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