Intraosseous access device: Overview, Uses and Top Manufacturer Company

Posted on February 26, 2026 | by drthomas

Introduction

An Intraosseous access device is a clinical device used to obtain rapid vascular access by inserting a specially designed needle into the bone marrow (medullary) space. From there, fluids and medications can enter the venous circulation through the marrow’s vascular network. In many emergency and time-critical situations, this method can provide access when traditional intravenous (IV) cannulation is difficult, delayed, or unsuccessful.

For hospitals, ambulances, and clinics, intraosseous (IO) access matters because it can support resuscitation workflows: it helps teams deliver life-saving therapies without waiting for a peripheral IV line or a central venous catheter. It is used across emergency medicine, anesthesia, critical care, pediatrics, and prehospital care, and it has operational implications for training, stocking, infection prevention, and biomedical support.

This article explains what an Intraosseous access device is, when it is typically used, how it is operated in a general (non-brand-specific) way, and how to think about patient safety, troubleshooting, cleaning, and procurement. It also provides a practical overview for hospital administrators and procurement teams, including manufacturer/OEM concepts and a country-by-country market snapshot.

What is Intraosseous access device and why do we use it?

Definition and purpose (plain language)

An Intraosseous access device is a piece of medical equipment designed to create a temporary route into the body’s circulation via the bone marrow. The purpose is to establish rapid access for fluid resuscitation and medication delivery when IV access cannot be obtained quickly or reliably.

In simple terms: instead of placing a cannula into a vein, an IO needle is placed into the marrow cavity of certain bones, and the marrow’s blood vessels act as the “pipeline” into the bloodstream.

Common clinical settings

IO access is commonly considered in settings where time, physiology, or environment make IV access challenging:

Emergency Department (ED) resuscitation (trauma, shock, cardiac arrest)
Prehospital care/EMS (Emergency Medical Services) where lighting, space, and patient condition limit IV success
Operating room (OR) and anesthesia when urgent access is needed unexpectedly
Intensive Care Unit (ICU) for unstable patients when IV access is repeatedly unsuccessful
Pediatrics and neonatology (varies by protocol) where veins may be small or difficult to visualize
Disaster medicine and mass casualty incidents, where speed and standardization matter

Key benefits in patient care and workflow

Benefits are best understood as workflow and access advantages, not as a replacement for all vascular access:

Speed in time-critical situations: IO can be established quickly by trained staff, supporting early delivery of medications and fluids.
Reliability when veins are hard to access: shock, dehydration, obesity, edema, burns, or collapsed veins can make peripheral IV access unreliable.
Standardized technique: Many IO systems are designed to be easier to teach and reproduce under stress compared with difficult IVs.
Bridge to definitive access: IO is often used as an interim route while a peripheral IV, ultrasound-guided IV, or central line is being planned (timing and sequencing vary by local protocol).
Team coordination: IO access can reduce delays and task saturation during high-acuity resuscitations when multiple procedures compete for attention.

How it functions (general mechanism of action)

The core concept is anatomical and physiologic:

Needle enters cortical bone at an approved site using manual force or a powered driver (varies by manufacturer).
The needle tip rests in the medullary cavity.
The medullary space contains a vascular network that drains into central circulation.
Fluids and medications infused into this space can reach systemic circulation, similar in intent to IV administration (compatibility and administration details must follow local protocol).

A practical implication: flow through IO access may depend on needle position, site selection, infusion pressure, and patient factors. Many teams use pressure-assisted infusion to improve flow (practice varies).

Common device types (non-brand-specific)

IO systems differ in how insertion is achieved and how components are supplied:

Manual IO needles: rely on operator technique; may be used in certain settings but can be more physically demanding.
Powered IO systems: use a battery-powered driver to advance the needle through bone; commonly used in ED/EMS settings.
Sternal IO systems: designed for specific anatomic placement; availability and local acceptance vary.
Single-use vs reusable components: many IO needles are sterile single-use consumables; some drivers are reusable hospital equipment (policy varies).

Device capabilities such as needle gauges, lengths, depth control features, stabilization accessories, and confirmation aids vary by manufacturer.

How medical students encounter this device in training

Medical students and trainees typically learn IO access through:

Resuscitation courses and simulation labs, emphasizing indications, landmarks, and safety checks
ED/ICU rotations, where IO may be used in codes or severe shock
Skills stations with task trainers (bone models) to practice insertion angle, stabilization, and confirmation
Interprofessional team training, because IO placement is often performed by physicians, nurses, paramedics, or advanced practice clinicians depending on jurisdiction and policy

Trainees should treat IO access as both a procedural skill and a system-dependent workflow: success depends on equipment readiness, team roles, infection prevention, and post-insertion monitoring.

When should I use Intraosseous access device (and when should I not)?

Appropriate use cases (typical indications)

In general terms, an Intraosseous access device is considered when vascular access is urgently needed and IV access is not quickly achievable. Common scenarios include:

Resuscitation where medications or fluids are time-sensitive
Cardiac arrest when IV access is delayed
Severe shock or hypotension, where peripheral veins may be collapsed
Major trauma, especially with difficult access due to hypovolemia or environmental constraints
Critical pediatric cases where rapid access is required and IV attempts are failing (local practice varies)

It is best framed as a time-and-access problem: when delays in IV access could meaningfully affect care, IO becomes an important alternative route.

Clinical contexts and patient populations

IO access may be encountered across age groups and care environments:

Adults: common sites include tibia and humerus (site preferences vary by protocol).
Children: certain sites may be preferred due to anatomy and growth considerations; training emphasizes careful landmarking.
Prehospital patients: IO is often selected due to limited time, poor lighting, moving vehicles, and fewer staff.
Disaster and austere settings: IO can be a standardized technique when ultrasound or central line supplies are limited.

Local protocols determine who can place IO access (scope of practice), preferred sites, and medication administration guidance.

Situations where it may not be suitable

IO access is not universally appropriate. It may be less suitable when:

A reliable IV line is easily obtainable and time allows for routine access.
Anatomic landmarks cannot be identified or patient positioning prevents safe placement.
There is concern for local injury or infection at the intended insertion site (details below).
The patient requires longer-term vascular access and the team can safely place a more durable line (timing varies by protocol).
The clinical setting lacks trained staff or the correct equipment, increasing the risk of malposition or complications.

Safety cautions and contraindications (general)

Contraindications and cautions vary by manufacturer and local policy, but commonly cited themes include:

Fracture in the target bone or near the intended site (risk of extravasation and poor delivery)
Previous orthopedic procedures at or near the site (for example, prostheses or hardware; risk varies)
Local infection, cellulitis, or burns over the insertion area (infection risk and tissue integrity concerns)
Compromised bone integrity (for example, certain metabolic bone conditions; assessment varies)
Inability to confirm correct placement after insertion attempts
Repeated attempts in the same bone (tissue damage and extravasation risk may increase)

These points are intentionally general: the correct decision depends on patient specifics, anatomy, clinician expertise, and institutional protocols.

Emphasize clinical judgment, supervision, and local protocols

IO access sits at the intersection of emergency decision-making and procedural safety. For learners:

Seek supervision until competency is demonstrated.
Use the facility’s approved insertion sites, needle selection guidance, and medication policies.
Treat IO as temporary access unless your protocol explicitly defines duration and monitoring requirements.

For hospitals and EMS systems:

Standardize indications and contraindications in policy.
Align device selection with training models.
Ensure documentation and incident reporting pathways are clear.

What do I need before starting?

Required setup, environment, and accessories

A safe IO procedure starts before the needle touches the patient. Typical requirements include:

Appropriate clinical environment
Adequate lighting and patient positioning
Resuscitation equipment available (airway, monitoring, suction)
A clean workspace with sharps disposal within reach
Core IO kit components (exact contents vary by manufacturer)
Sterile IO needle set (correct size/length selection per protocol)
Insertion tool/driver (if the system uses a powered driver)
Skin antiseptic (facility-approved)
Sterile gloves and basic barrier protection
Stabilization/securement dressing or device
Extension tubing and needleless connector (as used locally)
Saline flush syringes (size/volume per protocol)
A method for infusion pressure support if needed (pressure bag or pump; facility practice varies)
Comfort and analgesia resources (protocol-dependent)
Some protocols include local anesthetic measures for conscious patients; selection and dosing are clinical decisions and not covered here.

From an operations perspective, the “accessories” are often where failures happen: missing extension sets, expired needles, dead batteries, or unclear securement steps.

Training and competency expectations

Because IO is often used during high-stress events, competency must be defined in advance:

Initial training
Anatomy and landmarking
Contraindications and risk recognition
Device-specific insertion technique
Confirmation, securement, and infusion workflow
Ongoing competency
Annual or periodic skills refreshers
Simulation drills (code blue/mock trauma) that include IO as an option
Post-event debriefing and review of any complications
Scope of practice
Clarify which roles may insert IO access (physicians, nurses, paramedics, etc.), under what conditions, and with what documentation.

Hospitals often underestimate the training “tail”: IO is fast, but only when the team has practiced the entire sequence, including troubleshooting and removal.

Pre-use checks and documentation

Before use, teams typically confirm:

Packaging integrity and sterile barrier intact (single-use components)
Expiration date and lot identification (important for recalls and incident tracking)
Correct needle size/length selection based on patient and site (per protocol)
Driver readiness (if powered)
Battery status (if applicable)
Functional check per local process (do not improvise beyond manufacturer instructions)
Availability of securement and flush supplies
Patient-side documentation plan
Time of insertion
Site used
Number of attempts
Any complications observed
Confirmation method per protocol

Documentation isn’t “administrative overhead” here—it is part of safety, particularly if extravasation, infection, or device malfunction is suspected later.

Operational prerequisites: commissioning, maintenance readiness, consumables, and policies

For hospital administrators and biomedical engineering teams, IO readiness is a system design problem.

Commissioning and rollout

Define where IO kits are stored (ED, ICU, OR, crash carts, ambulances).
Standardize kit composition to reduce cognitive load during emergencies.
Align device model selection with training resources and anticipated use cases.

Maintenance readiness (for reusable drivers or components)

Assign ownership for battery charging/replacement, periodic checks, and physical inspection.
Define cleaning workflow and storage conditions between uses.
Track devices with an equipment management system when applicable.

Consumables management

Ensure adequate stock of needles in various sizes (as used locally).
Control expiration and stock rotation (especially on crash carts and remote units).
Plan for surge demand (disasters, outbreaks, mass casualty incidents).

Policies and governance

Define indications, contraindications, insertion sites, maximum attempts, and escalation steps.
Specify how IO access is labeled on the patient (site labeling to prevent confusion).
Establish incident reporting expectations for infiltration, burns, fractures, or device failures.

Roles and responsibilities (clinician vs. biomedical engineering vs. procurement)

Clear role separation improves speed and safety:

Clinicians (ED/ICU/EMS/OR)
Patient assessment, decision to place IO, site selection
Aseptic technique, insertion, confirmation, securement, monitoring
Documentation and clinical escalation if complications occur
Biomedical engineering/clinical engineering
Maintenance of reusable drivers (if applicable)
Repair coordination, device tracking, functional checks per policy
Support for post-incident device evaluation (quarantine, inspection)
Procurement/supply chain
Vendor qualification and contract management
Ensuring consistent availability of compatible needles and accessories
Managing substitutions carefully (avoid mixing components that are not compatible)
Infection prevention
Defining cleaning/disinfection workflows
Auditing practice and responding to infection risks
Education department/clinical leadership
Competency frameworks, simulation, and ongoing training documentation

IO access succeeds when these stakeholders coordinate before the emergency happens.

How do I use it correctly (basic operation)?

Workflows vary by model, but the fundamentals are consistent: select the right patient and site, insert correctly, confirm placement, secure, infuse, and monitor.

A basic, commonly universal workflow

Decide that IO access is indicated – Based on urgency and IV access difficulty per protocol.
Select an appropriate insertion site – Choose based on patient anatomy, injuries, and local guidance.
Prepare equipment – Open IO kit, prepare antiseptic, flush, extension tubing, securement.
Position the patient and identify landmarks – Take time to locate the exact insertion point; errors here cause many failures.
Perform skin antisepsis – Use facility-approved antiseptic and allow appropriate contact time per policy.
Insert the IO needle – Use the manufacturer’s technique (manual or powered).
Confirm placement – Use confirmation steps described below; recognize limitations.
Secure the device – Stabilize to prevent dislodgement during movement or transport.
Flush and begin infusion – Follow protocol for flushing, infusion pressure, and medication delivery.
Monitor continuously – Watch for infiltration, pain, flow failure, and device displacement.
Document – Record site, time, attempts, and any issues.
Plan transition – IO is often used as a bridge to another access route depending on the clinical plan and policy.

Site selection and landmarking (general principles)

Site choice is protocol-driven and depends on patient size, injury patterns, and clinician familiarity. General principles include:

Prefer sites with reliable landmarks that can be identified quickly.
Avoid areas with suspected fracture, local infection, or compromised tissue.
Consider how ongoing procedures (CPR, splinting, imaging) will affect device stability.
Think ahead about transport and movement—securement is harder when the site is near areas of frequent handling.

Because anatomy and pediatric growth plates are specialized topics, clinicians should use local training materials and manufacturer instructions for site-specific landmarking.

Insertion: what “good technique” usually means

While details vary, good technique commonly includes:

Stabilize the limb and minimize movement.
Maintain aseptic technique from skin prep through connection.
Use appropriate insertion angle and depth control per device design.
Avoid excessive force once correct position is achieved.
Do not reuse single-use needles; do not attempt to “sterilize” and reuse disposables.

Powered insertion systems often provide consistent penetration through cortical bone, but they can also advance quickly; operators must understand how their device signals endpoint (varies by manufacturer).

Confirmation of placement (general, non-exclusive)

Confirmation methods differ by protocol and device type, but commonly include:

Stability: the needle feels firmly seated in bone and does not wobble.
Aspiration attempt: marrow or blood may be aspirated, but lack of aspiration does not necessarily mean failure (a common pitfall).
Flush test: flushing should be possible without obvious soft tissue swelling at the site (interpretation varies; avoid forcing against high resistance without reassessment).
Visual/tactile monitoring: absence of rapidly developing swelling, leakage, or severe pain at the site during infusion.

Facilities may incorporate additional confirmation steps depending on clinical context and equipment availability.

Infusion basics and typical “settings”

An IO system itself usually has limited “settings” compared with electronic monitors. The settings that matter are often in the connected infusion equipment:

Infusion pump settings (rate/volume) are set on the pump, not the IO needle.
Pressure-assisted infusion (e.g., pressure bag) may be used to improve flow; this is a local practice decision.
Some powered drivers may have basic indicators (e.g., battery status) or standardized operation modes; specifics vary by manufacturer.

A practical operational point: IO flow may be lower than expected without added pressure, depending on site, needle position, and patient factors. Teams should be prepared for pump alarms and should distinguish between pump issues and IO placement issues.

Securement and labeling

Securement is a safety step, not a cosmetic one:

Use the manufacturer-recommended stabilizer/securement method if provided.
Ensure tubing is routed to reduce traction and accidental pulling.
Label the line clearly as IO (facility labeling practice varies), including the insertion site and time if required by policy.
Reassess after transfers (bed-to-stretcher, CT scanner, ambulance loading) because these are high-risk moments for dislodgement.

Removal and transition planning (general)

IO access is typically intended for short-term use and is often replaced by another vascular access route when feasible. Removal technique and timing should follow local protocol and manufacturer instructions. Operationally, hospitals should define:

Who is authorized to remove an IO line
How removal is documented
How the site is dressed and monitored afterward
How complications are escalated and reported

How do I keep the patient safe?

Patient safety with IO access depends on preventing malposition, minimizing infection risk, managing pain and tissue injury, and maintaining continuous monitoring during infusion.

Safety practices before insertion

Confirm indication: IO should solve an urgent access problem, not create unnecessary risk.
Screen for site-specific risks: injury, infection, prior procedures, or anatomy that makes landmarking unreliable.
Choose the correct needle size/length per patient and site; wrong length can contribute to failure (selection guidance varies by manufacturer).
Aseptic technique: treat IO insertion as an invasive procedure, even in emergencies.
Team briefing: in a code or trauma, say out loud: “placing IO in [site],” so others can support monitoring and labeling.

Monitoring during infusion

Continuous observation matters because IO complications can evolve quickly:

Inspect the insertion site frequently for swelling, leakage, or discoloration.
Assess limb perfusion and distal status as appropriate for the site (local practice varies).
Monitor patient comfort and pain; pain can be a warning sign of extravasation or high-pressure infusion, especially in conscious patients.
Track infusion performance: unexpected resistance, pump occlusion alarms, or poor flow should trigger reassessment.

Many IO problems are not “device failures” but recognition failures—the device is in, but the line is not delivering safely into the marrow space.

Common risks to anticipate (general)

Risks associated with IO access can include:

Extravasation/infiltration (fluid leaking into soft tissue)
Compartment syndrome (a rare but serious consequence of infiltration; recognition and escalation are critical)
Fracture during insertion (risk varies by patient factors and technique)
Infection, including local infection and deeper bone infection (risk influenced by asepsis, dwell time, and patient factors)
Growth plate injury in pediatric patients if site selection/landmarking is incorrect
Needle dislodgement during transport or repositioning
Needle occlusion or poor flow due to malposition, clot, or inadequate infusion pressure
Skin injury from leakage of infusates into soft tissue (risk depends on agent and exposure)

These risks are why IO use should be paired with clear protocols for monitoring, documentation, and timely reassessment.

Alarm handling and human factors

Most alarms come from infusion pumps, not the IO needle. Human factors safety tips include:

Treat pump occlusion alarms as a clinical assessment trigger, not just a technical nuisance.
Avoid “alarm fatigue” by designating a team member to watch the IO site during high-rate infusions.
During CPR or transport, assume higher risk of dislodgement and perform quick checks after movement.
Standardize the IO kit so staff do not waste time searching for extension sets, flushes, or securement.

In high-acuity scenarios, errors often come from workarounds: missing supplies, incompatible connectors, or unclear responsibility for monitoring.

Follow facility protocols and manufacturer guidance

Safety depends on aligning three documents:

Your facility’s clinical protocol (indications, sites, medication guidance)
The device Instructions for Use (IFU) (device-specific insertion, needle selection, warnings)
Your facility’s infection prevention policy (skin prep, cleaning, PPE)

If there is a conflict, escalate through governance channels rather than improvising at the bedside.

Risk controls, labeling checks, and incident reporting culture

Hospitals that use IO routinely often implement practical risk controls:

Label the access route clearly to prevent confusion with IV lines.
Use standard documentation templates for IO insertion and monitoring.
Encourage a non-punitive culture for reporting:
Suspected infiltration or compartment concerns
Device malfunction (driver failure, bent needles, packaging defects)
Near-misses (wrong needle size opened, missed contraindication caught late)

Reporting is essential for procurement feedback, training improvement, and safe device selection.

How do I interpret the output?

Unlike many diagnostic medical devices, an Intraosseous access device does not primarily generate numerical outputs. The “output” is mainly clinical feedback: confirmation cues, infusion performance, and patient response.

Types of outputs/readings you may encounter

Common “outputs” include:

Tactile feedback during insertion (changes in resistance; endpoint feel varies by device and site)
Visual confirmation: stable needle position, absence of swelling or leakage
Aspiration results: presence or absence of marrow/blood on attempted aspiration
Flush and flow behavior: resistance during flushing, ability to infuse fluids
Infusion pump feedback: occlusion alarms, pressure trends (pump-dependent)
Device indicators (if powered): battery status, operational readiness cues; varies by manufacturer

How clinicians typically interpret them

Clinicians usually interpret IO function by combining several cues:

Stable placement + acceptable flush/infusion + no swelling supports correct function.
Swelling, leakage, severe pain, or worsening resistance suggests malposition or infiltration until proven otherwise.
No aspiration is interpreted cautiously: it may occur even with correct placement, so teams rely on additional checks.
Pump alarms prompt assessment of the IO site, tubing, connectors, and infusion setup.

Interpretation should always be tied to the patient’s condition: if therapy is not having the expected clinical effect, access function should be reassessed.

Common pitfalls and limitations

Over-reliance on aspiration: absence of aspirate can be misleading.
Delayed swelling: infiltration may not be obvious immediately, especially in low-light or during transport.
Confusing pump occlusion with IO failure: kinked tubing, closed clamps, or connector issues can mimic IO resistance.
Assuming flow should be “like a large IV”: IO flow depends on multiple factors and may require pressure assistance per protocol.
Inadequate securement: a well-placed IO can become unsafe if it dislodges slightly.

Clinical correlation is essential

Because IO “outputs” are indirect, they require continuous clinical correlation:

Vital signs and perfusion response
Medication effect (as appropriate to context)
Ongoing reassessment of the insertion site and limb
Readiness to switch to an alternate access route if performance is questionable

What if something goes wrong?

IO access is often used when patients are unstable, so troubleshooting must be fast, structured, and safety-first.

A practical troubleshooting checklist (general)

If infusion is not working as expected:

Stop and look – Inspect for swelling, leakage, or displacement.
Check the simple setup issues – Clamps open, tubing not kinked, connectors tight, pump settings correct.
Reassess securement and limb position – Movement can change needle position; reposition carefully if allowed by protocol.
Attempt a gentle flush per protocol – Do not force against high resistance without reassessment.
Consider infusion pressure – If your protocol uses pressure assistance, confirm it is applied correctly.
Re-check patient factors – Pain, agitation, and movement can compromise the line.
If still uncertain, treat as potential malposition – Stop infusion and escalate to alternative access.

If insertion fails (needle won’t seat, feels unstable, or landmarks were wrong):

Confirm correct needle size/length selection per patient and site.
Consider whether the chosen site is appropriate given injuries or anatomy.
Do not exceed attempt limits defined by local protocol; consider alternate sites or alternate access methods.

When to stop use

General stop signals include:

Rapid swelling, leakage, or tissue firmness around the site during infusion
Severe, escalating pain at the site (especially in a conscious patient)
Suspected fracture related to insertion or unstable needle position
Contamination of a sterile component before insertion
Device malfunction that compromises control (e.g., driver abnormal operation)
Inability to confirm placement and safely infuse

Stopping does not mean abandoning the patient’s need for access—stop unsafe IO use and transition to another route.

When to escalate to biomedical engineering or the manufacturer

Escalate beyond the clinical team when the issue involves equipment performance or recurring failures:

Biomedical/clinical engineering
Driver not functioning, battery issues, mechanical damage
Reusable component cleaning/inspection concerns
Need to quarantine equipment after an incident for evaluation
Manufacturer (through your facility process)
Suspected device defect, packaging failure, or lot-related issues
Requests for IFU clarification, training materials, or technical bulletins
Formal complaint handling (process varies by region and organization)

From an operations standpoint, recurring “insertion difficulty” may be a signal of training gaps, wrong needle stocking, or mismatch between device design and patient population.

Documentation and safety reporting expectations (general)

When problems occur, documentation should be timely and objective:

Time, site, and number of attempts
Observations: swelling, pain, leakage, resistance, device instability
Actions taken: stopped infusion, removed IO, alternative access obtained
Any device identifiers available (lot number, model; varies by packaging)
Internal incident report submission per facility policy

A strong reporting culture helps procurement and clinical leadership identify patterns early.

Infection control and cleaning of Intraosseous access device

Cleaning principles: understand what is reusable

Infection control starts with knowing what parts are:

Single-use, sterile disposables (commonly the needle set and some accessories)
Reusable components (commonly powered drivers in some systems; varies by manufacturer)

Single-use components should not be reprocessed unless the manufacturer explicitly states a validated reprocessing method (often not the case).

Disinfection vs. sterilization (general)

Cleaning removes visible soil and organic material.
Disinfection reduces microbial load to a safer level for non-sterile surfaces (levels vary by disinfectant and policy).
Sterilization eliminates microorganisms, typically required for instruments that enter sterile tissue.

An IO needle is a sterile invasive item and is typically provided sterile and disposed of after use. Reusable drivers are usually treated as non-sterile external equipment, cleaned and disinfected according to the IFU and facility policy.

High-touch points and contamination risks

For reusable drivers or any non-sterile components that enter the patient care area, high-touch points typically include:

Trigger or activation button
Grip surfaces
Battery compartment seams (if present)
Chuck or needle attachment area (risk of contamination with blood/body fluids)
Exterior surfaces that contact gloves, beds, or drapes

Even if a driver does not enter the sterile field, it is frequently handled during emergencies, increasing contamination risk.

Example cleaning workflow (non-brand-specific)

Always follow the manufacturer IFU and your infection prevention team’s approved disinfectants. A general workflow may look like:

Immediate point-of-use wipe-down – If visible soil is present, remove it promptly using approved wipes while wearing appropriate PPE (personal protective equipment).
Safe handling and transport – Move reusable equipment in a designated container to avoid contaminating hallways or clean areas.
Cleaning – Use approved cleaning agents per policy, focusing on seams and high-touch points.
Disinfection – Apply disinfectant with correct wet-contact time per product instructions.
Inspection – Check for cracks, loose parts, or fluid ingress indicators (varies by design).
Functional readiness check – Confirm basic operation per local process; do not perform unapproved tests.
Drying and storage – Store in a clean, dry, designated location with controlled access.
Documentation – Record cleaning/processing if required (common in equipment tracking programs).

Sharps safety and waste management

Dispose of IO needles immediately in an approved sharps container.
Handle blood-contaminated materials per facility biohazard waste policy.
During resuscitations, assign someone to manage sharps safety to prevent injuries amid clutter and urgency.

Emphasize IFU and facility policy

Different IO systems tolerate different disinfectants and cleaning methods; some may be damaged by certain chemicals or immersion. Because this varies by manufacturer, the safest operational rule is:

Follow the IFU for the device and the facility infection prevention policy for disinfectant selection and reprocessing workflow.

Medical Device Companies & OEMs

Manufacturer vs. OEM (Original Equipment Manufacturer)

A manufacturer is the company that markets the finished medical device under its name and is typically responsible for regulatory filings, labeling, and post-market surveillance within applicable jurisdictions.

An OEM (Original Equipment Manufacturer) may design or produce components or even complete devices that are then branded and sold by another company. In some cases, the “brand” company and the OEM are the same entity; in other cases, manufacturing is partially or fully outsourced.

How OEM relationships impact quality, support, and service

For hospital decision-makers, OEM relationships matter because they can affect:

Supply continuity: if a key component is single-sourced, disruptions can affect availability.
Service and parts: warranty handling, repair parts, and turnaround times may depend on who controls the supply chain.
Consistency and training: rebranded systems may share hardware but differ in kits, accessories, or IFU wording.
Change control: minor manufacturing changes can alter user experience; robust change management helps maintain clinical reliability.

Procurement teams often request clarity on who manufactures key components, how recalls are handled, and how long consumables will remain available.

Top 5 World Best Medical Device Companies / Manufacturers

Because “best” depends on criteria and public rankings vary by methodology, the list below is presented as example industry leaders (not a ranking) with broad global visibility across multiple device categories (not limited to IO access).

Medtronic – Medtronic is a well-known multinational medical technology company with a broad portfolio spanning implantable and hospital-based therapies. Its footprint includes many international markets and large hospital customer segments. Buyers often associate the company with established clinical support structures and standardized training resources, although offerings vary by region and business unit.
Johnson & Johnson (Medical Technology) – Johnson & Johnson operates across medical technology categories through multiple business lines. The organization is widely recognized for surgical and interventional device portfolios, with distribution in many countries. For purchasers, the relevance is often in contracting, education support, and integration with hospital systems, which can differ by geography.
BD (Becton, Dickinson and Company) – BD is commonly associated with medication delivery, vascular access, and infection prevention-related medical equipment. The company has a broad international presence and frequently serves high-volume hospital consumable needs. Product availability, configurations, and support models vary by country and channel partners.
Siemens Healthineers – Siemens Healthineers is widely known for diagnostic and imaging technologies and associated service ecosystems. While not centered on IO access, it is a major reference point in hospital equipment procurement due to enterprise-scale service contracts and long-term support models. Its global footprint is significant, with local service presence varying by market.
Stryker – Stryker is a global medical device company known for hospital and surgical technologies across several specialties. It is commonly encountered in operating rooms and trauma systems, which often overlap operationally with resuscitation workflows where IO may be used. Support structures, training, and availability depend on local subsidiaries and distributor networks.

Vendors, Suppliers, and Distributors

Role differences between vendor, supplier, and distributor

These terms are often used interchangeably, but they can describe different roles in the healthcare supply chain:

Vendor
A general term for an entity that sells products or services to a hospital or clinic. A vendor could be a manufacturer, distributor, or reseller depending on the arrangement.
Supplier
Often emphasizes the function of providing goods reliably (stock availability, order fulfillment). A supplier may be a distributor, wholesaler, or sometimes the manufacturer directly.
Distributor
Typically holds inventory, manages logistics, and delivers products to end users. Distributors may also provide value-added services such as kitting, consignment programs, and returns handling.

For IO programs, the practical questions are: Who holds inventory locally? Who replaces expired stock on crash carts? Who provides training support? And who manages backorders?

Top 5 World Best Vendors / Suppliers / Distributors

As with manufacturers, “best” depends on geography and criteria, so the list below is presented as example global distributors (not a ranking) that are widely known in healthcare supply chains.

McKesson – McKesson is widely recognized for large-scale healthcare distribution and supply chain services, particularly in certain major markets. For hospitals, value often comes from catalog breadth, logistics reliability, and integration with procurement systems. Service scope and geographic coverage vary by country.
Cardinal Health – Cardinal Health is commonly associated with medical and laboratory product distribution and supply chain solutions. Buyers may engage with Cardinal for standardized delivery, inventory programs, and broad consumable portfolios. Offerings and reach depend on the region and contractual structures.
Medline – Medline is known for distributing and manufacturing a wide range of hospital consumables and clinical supplies. Many facilities use Medline for standardized products, logistics support, and private-label alternatives where appropriate. Distribution models and service depth vary globally.
Henry Schein – Henry Schein is recognized for distribution networks serving healthcare providers, historically strong in dental and outpatient channels while also participating in broader medical supply in certain markets. Buyer profiles often include ambulatory clinics and office-based practices, though services differ by geography. Product availability and contracting options vary by region.
Owens & Minor – Owens & Minor is known for supply chain and distribution services, including support for hospital logistics and inventory programs in certain markets. Organizations may work with such distributors for warehousing, delivery, and supply chain visibility. The exact service footprint and product scope vary by country and local partnerships.

Global Market Snapshot by Country

India

Demand for an Intraosseous access device in India is closely tied to the expansion of emergency care, trauma services, and prehospital systems, which vary significantly by state and city. Large private hospitals and academic centers often drive adoption through standardized resuscitation training, while smaller facilities may prioritize lower-cost alternatives and rely on distributor availability. Import dependence can be significant for branded IO systems, and service ecosystems tend to be stronger in metropolitan areas than in rural settings.

China

China’s market is influenced by large hospital networks, increasing focus on emergency medicine capability, and evolving domestic medical device manufacturing capacity. Urban tertiary hospitals are more likely to have standardized resuscitation carts and training pathways that include IO access, while adoption may be uneven across smaller county hospitals. Procurement may involve a mix of imported products and local manufacturers, with distributor relationships shaping training and consumable availability.

United States

In the United States, IO access is a well-established component of many emergency and prehospital protocols, supported by widespread simulation training and mature EMS systems. Hospitals often emphasize standardization, device traceability, and readiness on crash carts, with strong expectations for vendor support and consistent consumable supply. A robust service ecosystem exists for both hospital and EMS procurement, though rural areas may face different stocking and training constraints than major trauma centers.

Indonesia

Indonesia’s demand is shaped by geographic dispersion, varying EMS development, and differences in capability between urban referral hospitals and remote facilities. In major cities, emergency departments and intensive care services may incorporate IO access into resuscitation workflows, supported by distributor-led training. Import dependence for specific IO systems can be meaningful, and logistics across islands can affect consistent consumable supply and device availability.

Pakistan

In Pakistan, adoption is often driven by tertiary care hospitals, private healthcare groups, and emergency departments seeking reliable access options during trauma and shock. Availability can depend on import channels and distributor support, and training may be concentrated in urban centers and larger institutions. Outside major cities, uneven supply chains and limited simulation infrastructure can affect standardization and routine readiness.

Nigeria

Nigeria’s market reflects high need for emergency and trauma care alongside variable infrastructure and procurement constraints. Larger teaching hospitals and private urban facilities may adopt IO systems as part of resuscitation capability building, frequently relying on distributors for supply continuity and training. Rural access is often limited by logistics, cost constraints, and workforce training gaps, making consistent availability of single-use consumables a key challenge.

Brazil

Brazil has a diverse healthcare landscape with advanced tertiary centers in major cities and variable access in remote regions. Demand for IO access is influenced by emergency medicine growth, trauma systems, and hospital accreditation priorities, with procurement pathways spanning public and private sectors. Service and training support are generally stronger in urban areas, while consistent distribution and stocking can be more challenging outside major metropolitan hubs.

Bangladesh

In Bangladesh, IO adoption is often concentrated in larger hospitals and emergency care settings where difficult IV access is a recurring operational problem. Import dependence and distributor reach can shape which IO systems are available, and training resources may be limited outside major academic centers. The operational focus frequently centers on kit availability, staff competency, and ensuring that consumables are consistently stocked and not expired on emergency carts.

Russia

Russia’s market is influenced by a mix of centralized procurement structures and regional variability in hospital capability. Tertiary centers and emergency services in larger cities are more likely to incorporate IO access into resuscitation practices, while smaller facilities may use it less frequently due to training and supply constraints. Import channels, local distribution, and regulatory pathways can affect product availability and support options.

Mexico

In Mexico, demand for IO access is linked to emergency care modernization, trauma burden, and differences between private hospital networks and public facilities. Urban centers often have stronger training ecosystems and more consistent supply chains, while rural areas may face challenges in device availability and staff skill maintenance. Distributor support and standardized kits can be important for consistent readiness in ambulances and emergency departments.

Ethiopia

Ethiopia’s market reflects significant need for emergency access solutions alongside variable infrastructure and procurement capacity. Tertiary hospitals and major urban centers may integrate IO access into resuscitation training, often depending on imports and donor-supported supply channels in some contexts. Outside urban centers, constraints commonly include limited consumable availability, fewer simulation resources, and logistical barriers to reliable restocking.

Japan

Japan’s healthcare system supports high standards of hospital care and strong expectations for device quality and training. Adoption of IO access depends on local clinical practice patterns and institutional protocols, with tertiary centers more likely to maintain standardized emergency carts and competency programs. The service ecosystem is generally strong, with structured procurement processes and emphasis on documentation, traceability, and consistent consumable supply.

Philippines

In the Philippines, IO demand is shaped by urban-rural differences, disaster preparedness needs, and variability in EMS development. Major hospitals in metropolitan areas are more likely to maintain IO capability with training support, while smaller facilities may face barriers related to cost and consistent consumable availability. Distribution across islands can complicate logistics, making supply chain reliability and shelf-life management central operational concerns.

Egypt

Egypt’s market is influenced by large public hospital systems, private healthcare expansion, and a growing focus on emergency care capability. IO access adoption is often strongest in tertiary centers and high-acuity emergency departments, supported by distributor networks for imported medical equipment. Outside major cities, variability in training infrastructure and procurement cycles can affect routine readiness and consistent stocking.

Democratic Republic of the Congo

In the Democratic Republic of the Congo, high clinical need often intersects with significant infrastructure and supply chain constraints. IO access may be present in certain urban hospitals and specialized programs, frequently dependent on imports and partner-supported procurement. Availability in rural settings can be limited by logistics, workforce training, and the challenge of maintaining sterile, single-use consumables in consistent supply.

Vietnam

Vietnam’s healthcare investment and hospital modernization in major cities support growing interest in standardized emergency and critical care workflows, including IO access where indicated. Tertiary hospitals often lead adoption through training and protocol development, while smaller provincial facilities may have uneven access to devices and consumables. Import dependence remains relevant for specific branded IO systems, and distributor-led support can influence training consistency.

Iran

Iran’s market includes a mix of domestic manufacturing capability in some medical categories and reliance on imports for specialized devices, with availability shaped by supply chain and procurement pathways. Tertiary hospitals and emergency departments in larger cities are more likely to use IO access within structured resuscitation protocols. Service ecosystems and consistent consumable supply can vary, making standardization and stock management important operational priorities.

Turkey

Turkey’s position as a regional healthcare hub, with a mix of public and private hospitals, supports demand for modern emergency care tools including IO access. Larger urban hospitals and ambulance services are more likely to have standardized training and stocking, while adoption may be less consistent in smaller facilities. Distributor networks and local procurement frameworks significantly shape product availability, training support, and after-sales service.

Germany

Germany’s hospital market emphasizes structured emergency care, high-quality medical equipment standards, and strong integration of procurement with clinical governance. IO access is commonly viewed through the lens of resuscitation readiness, with attention to staff competency, documentation, and infection prevention. The distribution and service ecosystem is mature, supporting reliable stocking and standardized consumable management across many institutions.

Thailand

Thailand’s demand is influenced by urban tertiary centers, private hospital networks, and tourism-linked healthcare services, alongside variable access in rural regions. Major hospitals may maintain IO capability as part of resuscitation preparedness, supported by distributor-led training and procurement programs. Outside urban areas, constraints may include fewer training opportunities, budget prioritization, and less consistent access to specific consumables.

Key Takeaways and Practical Checklist for Intraosseous access device

An Intraosseous access device provides vascular access through the bone marrow when IV access is not quickly achievable.
Treat IO access as a time-critical workflow tool, not a routine replacement for IV cannulation.
Use local protocols to define indications, contraindications, and authorized inserters.
Confirm you have the complete IO kit before starting, including flush, extension tubing, and securement.
Check sterile packaging integrity and expiration dates before opening the needle set.
Ensure powered drivers (if used) are charged, functional, and stored where staff can find them fast.
Choose the insertion site using reliable landmarks and avoid areas with suspected fracture or infection.
Select needle size/length per protocol and manufacturer guidance to reduce malposition risk.
Use aseptic technique even during resuscitations, adapting barriers to the urgency and environment.
Clearly announce the IO plan to the team to support role clarity and monitoring.
Insert using the device’s approved technique; do not improvise beyond the IFU.
Confirm placement using multiple cues (stability, flush behavior, site appearance), not aspiration alone.
Expect that aspiration may be absent even when placement is acceptable, depending on context.
Secure the IO line immediately to prevent dislodgement during CPR, transfers, or transport.
Label the access route as IO to prevent confusion with IV lines during medication administration.
Monitor the site frequently for swelling, leakage, firmness, or unexpected pain.
Treat infusion resistance and pump occlusion alarms as a trigger to reassess the entire setup and the site.
Do not force infusion against high resistance without reassessment per protocol.
Plan early for transition to longer-term vascular access when feasible and clinically appropriate.
Document insertion time, site, number of attempts, and confirmation steps in the patient record.
Build IO competency through simulation because real-world opportunities may be infrequent.
Standardize IO kits across units to reduce cognitive load and prevent missing components.
Stock management should include size range planning, expiration control, and surge-readiness.
Define who is responsible for checking IO readiness on crash carts and in ambulances.
Separate responsibilities: clinicians place and monitor, biomedical engineering supports reusable equipment readiness, procurement ensures supply continuity.
Treat reusable drivers as high-touch hospital equipment requiring cleaning and disinfection per IFU.
Never reprocess single-use sterile IO needles unless explicitly validated by the manufacturer.
Use incident reports for suspected infiltration, dislodgement, infection concerns, or device malfunctions.
Quarantine suspected malfunctioning equipment per facility policy to support investigation and trend analysis.
Avoid mixing components from different IO systems unless compatibility is confirmed by manufacturer documentation.
Include IO access in code blue and trauma debriefs to improve technique, timing, and team coordination.
Ensure infection prevention policies specify approved disinfectants for reusable IO components.
In procurement, evaluate total cost of ownership, including consumables, training, and service support.
In procurement, assess distributor logistics, shelf-life management support, and backorder handling.
In training, emphasize human factors: labeling, securement, monitoring after transfers, and clear escalation triggers.
In operations, ensure IO supplies are available in all likely use locations, including radiology transfer zones and transport bags.
In quality programs, track IO utilization patterns to align stocking, education, and device selection.
In global settings, match device choice to local supply reliability, training infrastructure, and service availability.
Always follow the manufacturer IFU and your facility protocol when steps differ between systems.

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