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It is clear that intraosseous infusion is the new treatment modality of choice in many emergency departments. In fact, it has in some areas become the first choice in vascular access, bypassing the more traditional intravenous access routes. The reasons for this involve many variables, not the least of which are the condition of the patients initial vasculature, obesity, age, or poly trauma producing low pressure and volume whereby vascular access by intraosseous routes makes sense, is easy, affordable, safe and long lasting. 

In Pyng Medical’s new user experience paper, Sternal or Peripheral? A Review of Intraosseous Infusion Sites, Dr. David Morehouse discusses and evaluates the best route for Intraosseous Infusion: Sternal or Peripheral (humeral and tibial).

Because few studies exist that evaluate or compare the effectiveness of different routes for IO, Dr. Morehouse has compiled extensive first hand user experience based on his years in emergency and military medicine, and in training hundreds of practitioners on emergency medicine techniques, supplemented by limited clinical studies and articles, to compare the effectiveness of the Sternal and Peripheral routes for IO in five key areas:

  1. Ease of use
  2. Learnability
  3. Flow rates
  4. Efficacy
  5. Pain

The determination to use either peripheral or sternal IO access routes will continue to be debated, and there will be those who can find pros and cons for both. However, in this new paper Dr. David Morehouse outlines why sternal is the optimal IO access route for all of the five data points used in the analysis. 

Peripheral routes require more tools or device accessories, they are complex devices that are not considered simple to use.  As some users interviewed in this document conclude, there are too many moving parts, too many variables, the insertion sites are not simple to locate, and insertion is not simple to master.  

Efficacy and flow rates are in most cases higher or equal in the sternal access routes to either of the peripheral access points.  And pain, the direct reaction of patients to the insertion and administration of medications and fluids through peripheral access, is express as far more painful than that of the sternal access, regardless of the device used. 


Download the User Experience Paper by Dr. David Morehouse to learn more.