Being a medic student and never having done a 'real' IO except on chicken bones, we were taught for children use the anterior tibia. If that location was compromised then try the following distal femur, distal tibia, or anterior superior iliac spine(older children). On adult start with the anterior tibia and if unable to access then, if you have the correct tools, go to the sternum or humerus.
Has anyone ever done an illiac spine?
I don't know all the protocols for the services in my area but one service is allowed two attempts for peripheral IV and if both fail go straight to IO. What are y'all's protocols for using an IO?