[The intraosseous access in preclinical emergency medicine - indication, equipment and procedure]

The peripheral venous access remains the first-line method to administer drugs in emergency cases. The intraosseous injection, however, represents a good alternative in difficult situations. In this way the therapy-free period ? the "no flow time" ? and the preclinical rescue time are essentially minimised. The procedure is simple and quickly learnt, also no special features with regard to pharmacotherapy need to be observed. The low flow rate can mostly be compensated for by changing the treatment strategy. In principle, there are no absolute contraindications. The risks can be neglected in the acute emergency situation. Endobronchial and central venous routes for the administration of drugs have now lost their position in the primary preclinical management of emergency patients, except for a few exceptional circumstances.