The best site for IO needle insertion is the proximal tibia, medial plateau:

• Hold the leg, prepare site using aseptic technique
• Insert needle almost perpendicular to the bone, pointing away from knee joint and growth plate, in a screwing motion until you get a loss of resistance
• Fix carefully; use as temporary access before obtaining definitive IV access
• May be used for drugs and fluids: fluids must be given by syringe as resistance is high
• Do not move leg afterwards: it's like a fracture
• Remove as soon as possible
• Complications include:
  • Extravasation
  • Infection
  • Compartment syndrome