Acute cardiac care & resuscitationCohort study
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
- retrospective study
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. Further controlled studies may be needed to help guide possible protocol changes when discussing optimal IO placement in cardiac arrest.
Study context
- Population
- Patients (≥16 years) with non-traumatic out-of-hospital cardiac arrest treated by emergency medical service (EMS) agencies in Riverside County, California, between 2020 and 2023 who received intraosseous (IO) placement for medication administrationcases examined · humeral IO placement 246 · tibial IO placement 1,674
- Participants
- 1,920 patients
- Exposure
- humeral IO versus tibial IO placement
- humeral IOn = 246
- tibial IOn = 1,674
Main finding
As reported in the abstract
ROSC
- unadjusted; nearly two times more likely to achieve return of spontaneous circulation (ROSC) with humeral IO
- 1.85 (CI 1.39–2.50); P < 0.0001
- adjusted for age, sex, initial rhythm, and compression fraction
- 2.55 (CI 1.54–4.22); P = 0.0003
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Discharge · twice as likely to be discharged with humeral IO | 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:10.1016/j.resuscitation.2026.111179
Summarised from the published abstract; every number is checked against it