Indications As a temporary alternative to venous catheterization when peripheral and central venous access are difficult, particularly in emergency situations (eg, shock, cardiac arrest) Contraindications Absolute contraindications Bone fracture or recent cannulation attempt; infused fluids will extravasate into soft tissues through the cortical defects Injured inferior vena cava; use sites that drain into the superior vena cava Relative contraindications Infection or burn at needle-insertion site Osteoporosis and osteogenesis imperfecta; bone is easily fractured during procedure Complications Complications are uncommon and include Extravasation of fluid into soft tissues (poor control during insertion results in the needle either not entering the bone; exiting the opposite cortex; or creating a too-large, leaky hole in the cortex) Bleeding, causing compartment syndrome Infection (osteomyelitis in < 2 to 3% of intraosseous cannulations) Skin sloughing Fat embolism Growth-plate damage has not been reported.