Cardiac arrest & resuscitation
Comparison of intraosseous line placement location and rates of return of spontaneous circulation and survival to discharge among patients with out-of-hospital cardiac arrest
Authors' conclusion
The data suggests that humeral IO placement may be associated with higher rates of ROSC and survival to hospital discharge when compared to tibial IO placement.
Study context
- Population
- Patients (≥16 years) with non-traumatic out-of-hospital cardiac arrest (OHCA) treated by emergency medical service (EMS) agencies in Riverside County, California, 2020–2023
- Participants
- 1,920 patients
- Exposure
- Humeral vs tibial intraosseous (IO) placement for medication administration
- Humeral IOn = 246
- Tibial IOn = 1,674reference
- Outcome
- Return of spontaneous circulation (ROSC)
Methodological detailsregistry-based, multi-agency
- Registry-based
- Multi-agency
Main finding
As reported in the abstract
Unadjusted
1.85
CI 1.39–2.50P < 0.0001
Adjusted for age, sex, initial rhythm, compression fraction
2.55
CI 1.54–4.22P = 0.0003
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Survival to discharge | 2.04 (CI 1.03–4.17) | P < 0.050 |
Neurologic status at discharge
- Insufficient power to assess (n = 49)
Original publication
Comparison of intraosseous line placement location and rates of return of spontaneous circulation and survival to discharge among patients with out-of-hospital cardiac arrest. Resuscitation. Published 18 June 2026. doi:10.
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