What is the preferred site for intraosseous (I/O) access in children?

The proximal tibia is the preferred site for intraosseous (I/O) access in children due to its ease of access and the large size of the marrow space available, making it suitable for rapid fluid administration in emergencies. This site is located just below the knee on the medial side of the tibia, where the bone is relatively superficial and accessible even in infants and young children.

Intraosseous access is a critical technique in pediatric emergencies when intravenous access is not feasible, as it allows for immediate access to the central circulation. The proximal tibia is favored because it provides a safe and effective means to deliver medications and fluids directly into the vascular system, mimicking the effects of IV access.

While other sites like the distal femur, proximal humerus, and sternum can also be used for intraosseous access, they may not be as commonly preferred or as straightforward to locate as the proximal tibia, especially in the younger pediatric population. For instance, the distal femur may have more complications associated with it, and the sternum, while useful in specific situations, requires special techniques and may not always be readily accessible.