Which of the following is a contraindication for intraosseous (IO) access?

Intraosseous (IO) access is a critical procedure used to rapidly deliver medications and fluids when intravenous (IV) access is difficult or impossible. A key contraindication for performing intraosseous access is an injury at the IO site. This is because any trauma or significant injury in the area where you intend to insert the IO needle can lead to further complications. It may compromise the integrity of the insertion site, increase the risk of infection, and hinder the effectiveness of fluid and medication administration.

When there is an existing injury or trauma at the selected insertion point, the risk of complications significantly outweighs the benefits of IO access. In clinical practice, safety and efficacy take precedence, and choosing a site free from injury is essential to ensure safe and effective access.

Considering the other options, minor fractures typically do not contraindicate IO access if the insertion site is unaffected. A prior puncture site may still be viable, provided there are no complications from previous attempts. Though obesity can complicate access techniques, it is not a strict contraindication as IO can still be performed effectively with the right technique and equipment.