» Intraosseous Standards of Practice

Position Statements

American College of Emergency Physicians Position Statement

Alternative Methods to Vascular Access in the Emergency Department (June 2011).

• There are situations in the emergency department (ED) when standard intravenous access (IV) procedures fail or are insufficient to meet the clinical needs of the patient. Alternative access methods must be available under such circumstances and their usage should be a part of the standard emergency medicine practice privileges. These alternate access modalities include, but are not limited to, intraosseous lines, external jugular lines, and illumination device guided placement of peripheral lines. Policies and procedures for non-physician practitioners performing these procedures should allow for expeditious establishment of IV access via alternate routes when indicated. These policies should include a discussion of the initial and recurrent training requirements and provisions for periodic physician oversight, such as orders and/or protocols.

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National Association of Emergency Medical Physicians Position Statement

• IO access may provide significant benefit for critically ill patients, both by decreasing time to achieve access and by decreasing time to administer indicated medication

INS Position Paper

Endorsed by ENA and AACN

• A qualified registered nurse; appropriately trained for the procedure, may insert, maintain, and remove Intraosseous access devices
• IO access may provide significant time savings which may benefit critically ill patients, both by decreasing time to achieve access and by decreasing time to administer indicated medication

Consensus Statements

The Consortium on Intraosseous Vascular Access in Healthcare Practice
Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings: A Consensus Paper

Endorsed by the Infusion Nurses Society, the Emergency Nurses Association, American Association of Critical Care Nurses, Society of Pediatric Nurses, Air and Surface Transport Nurses.

Who Endorses Intraosseous Access?

• National Nursing Societies
  • Infusion Nursing Society
  • Emergency Nursing Association
  • American Association of Critical Care Nurses
  • Air and Surface Transport Nurses Association
  • Society of Pediatric Nurses
• International Resuscitation
  • American Heart Association
  • International Liaison Committee on Resuscitation
  • European Resuscitation Council
• National Association of EMS Physicians

Clinical Practice Bibliography