Manual Intraosseous Devices

The earliest reports of intraosseous (IO) cannulation were all achieved via manual insertion, and this technique for IO catheter insertion continues to be taught and utilized in the modern era. Although many automatic and semiautomatic IO devices are currently marketed, providers may still use and encounter manual IO devices in clinical practice. Thus, techniques for manual insertion of IO catheters remain relevant despite recent advances in IO technology. This chapter describes both traditional and modern manually driven IO catheters, including relevant references from historical and contemporary sources, to illustrate key concepts and familiarize the reader with the various devices that are available to utilize this technique of vascular access. Important limitations and advantages of manual IO devices are also discussed.