Intraosseous cannulation technique

(A) Insert the needle in the proximal tibia on the flat surface located distal and medial to the tibial tuberosity. Direct the needle caudad (away from growth plate) at a 10 to 15 degree angle. Use downward pressure from the heel of the hand, and a twisting motion until resistance decreases. See text for details.
(B) Marrow can sometimes be aspirated.
(C) The needle will flush easily when it is in the marrow cavity and should stand without support.
Once successful placement is established, immobilize the leg and secure the needle.