What is the recommended needle gauge for intraosseous access?

The recommended needle gauge for intraosseous (IO) access is 18 gauge. This size is optimal because it provides sufficient flow rate for the rapid administration of fluids and medications, which is critical during emergency situations, especially in pediatric patients. The larger lumen of an 18-gauge needle can handle viscous solutions and facilitate effective resuscitation.

Smaller gauge needles, such as 20 or 22 gauge, may not allow for adequate fluid flow under the pressures typically used in resuscitative scenarios. A 16-gauge needle, while it is larger than the recommended size and can also provide sufficient flow, is not commonly used in practice for intraosseous access, as it can be more difficult to insert and may not be necessary for most clinical situations. Thus, the 18-gauge needle strikes a balance between being large enough for adequate fluid administration while still being practical for insertion in the intraosseous setting.