Nearly 4 million patients sustain out-of-hospital cardiac arrest (OHCA) worldwide each year.  International guidelines for the resuscitation of patients with OHCA recommend early administration of epinephrine in those with an initial nonshockable rhythm.  Both intravenous (IV) and intraosseous (IO) access are routinely attempted to gain vascular access to administer medications.  While IV access is recommended, this is based on very low certainty evidence.  In this podcast, we discuss three recently published randomized trials that investigated IO and IV access in patients with OHCA.