In the last decade, endorsements for the use of intraosseous (IO) vascular access devices in the emergency care setting have grown. The American Heart Association (AHA), the International Committee on Resuscitation, the European Resuscitation Council, the Infusion Nurses Society (INS), the National Association of EMS Physicians, and the American Association of Critical-Care Nurses are examples of international organizations that support the insertion of IO vascular access devices to reduce the time to first drug and fluid administration during resuscitation. While peripheral venous structures remain the preferred route for vascular access, updated clinical practice recommendations and advances in available vascular access devices have supported the skill evolution for the registered nurse to include the insertion of IO vascular access devices. This joint position statement by Infusion Nurses Society and Emergency Nurses Association updates and replaces the supported 2009 INS Position Paper, The Role of the Registered Nurse in the Insertion of Intraosseous (IO) Access Devices. [Approved December 2019]

As the result of requests from several state boards of nursing, INS convened a task force to determine if insertion of central vascular access devices by appropriately trained registered nurses (RNs) should be recommended. The task force consisted of RNs and advanced practice registered nurses with infusion therapy experience in various practice settings. The results are presented in the following INS position paper. [Approved September 2017]