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Emergency Medical Minute


Jan 30, 2019

 Author: Aaron Lessen, MD

Educational Pearls:

  • Choose the longest needle for the humeral IO
  • Internally rotate and adduct the patients hand (resting on umbilicus) for best access to the site
  • Aim 1 cm superior to the greater tuberosity of the humerus with the needle angled 45 degrees inferiorly
  • Maintaining the line is critical - keep arm internally rotated with sling, tape or whatever works




Kovar J, Gillum L. Alternate route: the humerus bone - a viable option for IO access. JEMS. 2010 Aug;35(8):52-9. doi: 10.1016/S0197-2510(10)70207-2. PubMed PMID: 20708143.

Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD