The patient is symptomatic for hemorrhage, likely from an internal injury to the femoral artery. The most immediate concern is to rapidly obtain IV access to administer blood products as quickly as possible. Establishing access using an intraosseous site (IO) will be the quickest way of obtaining IV access. Attempting to establish an IV site again will be slower than using an IO, especially after two failed attempts. Inserting a central line will take longer to place than an IO will. Using ultrasound guided IV placement may be appropriate when it is difficult to establish IV access, but will take longer than an IO will, and is not best for this emergent situation.