Hi, we have IO-devices on our Resuscitation trolleys as well as in the emergency backpacks for our mobile teams. We do at least 1 regular simulation training with various scenarios a year for every member of our team. But still the use of the IOs in real life very seldom occurs. To me the length of the needle seems to be a critical point as well. So as a consequence wrong positioning or difficulties in fixation is a frequent problem.