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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Open Access

Preferred anatomic site for intraosseous infusion in Danish emergency departments

  • Rune Molin1Email author,
  • Peter Hallas2,
  • Mikkel Brabrand3 and
  • Thomas Andersen Schmidt1
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine201018(Suppl 1):P26

Published: 17 September 2010


Public HealthEmergency DepartmentEmergency MedicineInjection SiteInsertion Site


Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in resuscitation. There has been debate as to whether which anatomic site should be preferred for IOI. Although success and flow rates in e.g. proximal tibia compared with proximal humerus are not significant different some stress that the tibia should be first choice for IOI because of easily identifiable landmarks. We have as part of a project on IOI use in Danish emergency departments (EDs) assessed the preferred anatomic site for IOI. We hope to promote a debate concerning first choice insertion site for IOI.


Links to an online questionnaire were e-mailed to the Chief of Staff of the twenty emergency departments currently established in Denmark; non-responders were contacted by telephone. The questionnaire focused on the use of IOI in the emergency department including training, equipment, and attitudes. Results concerning preferred anatomical site are presented her.


Overall response rate was 95%. Seventy four per cent of Danish emergency department have intraosseous devices. The preferred injection sites were the tibia (84%, n = 16), humerus (10%, n = 2) the medial malleolus (10%, n = 2) and 5% (n = 1) had no preference.


The tibia is the preferred anatomical site for IOI in Danish EDs. We believe that the preference for tibia as first choice for IOI may reflect experiences with children were tibia this is the typical insertion site.

Authors’ Affiliations

Department of Emergency Medicine, Holbæk Sygehus, Holbæk, Denmark
Department of Anaesthesiology, JMC, Rigshospitalet, Copenhagen, Denmark
Department of Medicine, Sydvestjysk Sygehus, Esbjerg, Demark


© Molin et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.