Tibial IO

Thank you for your question. In trauma patients, the most important prehospital treatment is to ensure rapid transport to hospital, preferably a trauma center if possible. In a patient with hypotension, IV access for fluid bolus would be the best choice if this will not delay transport or interfere with other more crucial treatments such as hemorrhage control. If IV access is not achievable, IO access may be used for fluid or any other IV treatments.  In a patient with presumed pelvic fracture, humeral IO would be the preferred site as fluids would reach the central circulation faster and there would be less concern for fluid extravasation via injured pelvic vessels.