In managing patients who have gone into shock especially hypovolemic shock or cardiac arrest, most times, getting Intravenous, IV access becomes challenging as peripheral veins are usually hard to access in such states. Medical recommendations in resuscitation protocols put the option of intraosseous access if intravenous access fails. This is usually accomplished using an intraosseous drill with its accompanying needle (fig.1). These are readily available in High Income Countries. Low and Middle Income Countries, LMICs usually resort to doing the process manually using a firm needle as the 18-gauge needle in a blood giving set. Bones of adults and older children are hard to drill in manually. Logistically, an emergency unit can exist well with one or two intraosseous drills but should have continuous supply of the accompanying intraosseous needles. Getting one or two drills to a unit in an LMIC can be possible, but the logistics around supplying the intraosseous needles which come at an average unit cost of 15 USD is not sustainable.
