How to Use a Bone Insert Replacement for IO Access

By Products With A Mission | North American Rescue | Published: 2026-10-26

Category: How-to Guides

Learn how to replace and use a bone insert for intraosseous infusion training. Step-by-step guide for maintaining realistic IO access practice with the IO in a Box system.

Quick Answer

To use a bone insert replacement for IO access, swap out the used or expired bone insert in your IO in a Box system with a fresh one from the 3-pack, then practice needle insertion and fluid infusion as you would on a real patient.

Why Replace the Bone Insert Regularly

The bone insert in your IO training system simulates the feel of penetrating real bone cortex. Over time, repeated needle insertions can wear down the insert, making it less realistic. Using a fresh bone insert ensures consistent resistance and tactile feedback during intraosseous infusion practice.

The IO in a Box Bone Insert Replacement (3 pack) from North American Rescue provides three replacement inserts, so you always have spares on hand. Keeping a stock of replacements means your training stays effective without unexpected downtime.

Step-by-Step Guide to Replacing and Using a Bone Insert

1. Remove the old bone insert: Open your IO in a Box system and carefully take out the used bone insert. Dispose of it properly according to your training facility's guidelines. Check the old insert for cracks or excessive wear before discarding; this helps you gauge how many uses it endured.
2. Insert the new bone replacement: Take a fresh bone insert from the 3-pack and place it securely into the IO in a Box system. Ensure it sits flush and does not wobble. Make sure the insert is oriented correctly—most models have a specific top and bottom. Reversing it can affect needle insertion.
3. Practice needle insertion: Using an IO needle or training needle, apply steady downward pressure and a slight twisting motion to penetrate the bone insert. Aim for the center of the insert to simulate real-world placement. Do not force the needle if it feels stuck; you may be hitting the edge of the insert. Reposition and try again to avoid damaging the needle or the system.
4. Confirm proper placement and flush: Once the needle is seated, attach a syringe and attempt to aspirate marrow (simulated) or flush with saline. A successful flush with minimal resistance indicates correct placement. If you feel excessive resistance or see fluid leaking around the insertion site, the needle may be bent or the insert may be misaligned. Remove the needle and inspect both.
5. Clean and store the system: After training, remove the needle and wipe down the IO in a Box system with a mild disinfectant. Store the system with the remaining bone inserts in a cool, dry place. Do not reuse a bone insert that has been punctured multiple times—replace it after each training session to maintain realism and hygiene.

Product Facts

IO in a Box Bone Insert Replacement (3 pack): The IO in a Box Bone Insert Replacement (3 pack) provides three replacement bone inserts for your IO in a Box system, compatible with the NARescue brand line. Having spare inserts ensures your IO access training remains realistic and uninterrupted, allowing repeated practice without degrading the training experience.
IO in a Box Bone Insert Replacement (3 pack)