There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Comparison of IV and IO Access
- The available studies primarily focus on the comparison of intravenous (IV) and intraosseous (IO) access in the context of cardiac arrest, with limited information on their use outside of this specific scenario 1, 2, 3, 4, 5.
- Studies have shown mixed results regarding the effectiveness of IV and IO access in cardiac arrest patients, with some indicating higher return of spontaneous circulation (ROSC) rates with IV access 4, while others found no significant difference in sustained ROSC between the two methods 3.
- A randomized controlled trial found that tibial intraosseous access had the highest first-attempt success rate and the most rapid time to vascular access compared to humeral intraosseous and peripheral intravenous access during out-of-hospital cardiac arrest 5.
Limitations and Gaps in Research
- The current evidence is largely limited to the context of cardiac arrest, with a lack of high-quality studies comparing IV and IO access in other scenarios 1, 2, 3, 4, 5.
- Many of the existing studies have methodological limitations, such as small sample sizes, retrospective designs, and significant heterogeneity across studies 1, 4.
- Further research is needed to fully understand the comparative effectiveness of IV and IO access in various clinical settings and to inform evidence-based guidelines for vascular access 2, 3.