Transcript Novel, automatic IOI injector. One of its kind in the world.

Intraosseous?
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B.I.G.TM - Bone Injection Gun
How to operate
Competition
FAQ
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TM
B.I.G. - Bone Injection
Gun
Novel,
automatic IOI injector. One of its
kind in the world.
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The BIG Movie
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BIG Advantages
• Easily used by a single rescuer after short training.
• Allows immediate vascular access of infusion,
medications and fluids.
• Minimizes exposure to the patient’s bodily fluids.
• Can be successfully used by any physicians and
paramedics.
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BIG Advantages
• Disposable.
• Quick and accurate infusion into the bone
marrow.
• FDA and CE approval.
• Patented in the USA
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Competition
There are mainly 2 Manually inserted
hand-held infusion needles in the market:
1. Jamshidi – Baxter
A bone marrow aspiration needle
2. Sussmane-Raszynski - Cook critical care
An IOI needle
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Competition
There is one semi-automatic device
For Adults - FAST 1
Disadvantages
• Adults only
• Double cost
• Sternal device
• Semi automatic
• Larger dimensions
• Heavier Weight
• Longer time to
establish
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Design of the B.I.G™…
Instrument in locked position (before triggering).
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Design of the B.I.G™…
After triggering.
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Indications for I.O. infusions
Emergencies
• All cardiac arrests.
• Acute respiratory syndromes (COPD, Asthma, APE).
•When ever rapid vascular access is required.
TRAUMA
• Fluid replacement in shock.
• Rapid vascular access during mass casualty
incidents.
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FROM THE ECC GUIDELINES 2000
Rescuers should increase attention to early
vascular access, including immediate
Intraosseous access for victims of cardiac
arrest, and extend the use of Intraosseous
techniques to victims >6 years
ECC Guidelines 2000: Pediatric Advanced Life Support
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Technique of insertion…
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Insertion site
In adults, 1-2 cm medially and
1 cm proximally to the tibial
tuberosity.
In pediatrics and the elderly, 12 cm medially and 1-2 cm
distally to the tibial tuberosity.
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Insertion Technique
1. Mark Penetration Site
In adults, 1-2 cm medially and
1 cm proximally to the tibial
tuberosity.
In pediatrics and the elderly, 12 cm medially and 1-2 cm
distally to the tibial tuberosity.
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2. Adjust Penetration Depth
Recommended penetration depths
Adults –
Pedies 0-3
Pedies 3-6
Pedies 6 – 12
2.5 cm
0.5 - 0.7 cm
1.0 cm
1.5 cm
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3. Position the BIG
with one hand to the
site
4. pull out the Safety
Latch with the other
hand.
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5. Trigger the BIG
at 90º to the
surface.
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6. Remove
the BIG.
7. Pull out the stylet
trocar.
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8. Fix the cannula
with the Safety
Latch.
9. Connect IV Set
with a stopcock
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Now 2 – 5 cc of bone marrow can be aspirated
into a heparin-coated syringe for laboratory
sampling, or proceed to inject medications or
infuse fluids.
To reduce pain in the adult patient inject
Lidocaine in concentration of 20 mg/cc (2%) or
10 mg/cc (1%).
To maintain optimal flow, high pressure, up to
300 mmHg to the infusion bag may be
necessary.
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Medications and fluids…
• All medications and fluids can be safely injected into
the B.I.G™.
• I.O. medication and fluid boluses remain the same as
those for I.V. injection.
• It is not recommended that large boluses of hypertonic
solutions be infused through the I.O. cannula.
• In case of user inaccuracy, or technical malfunction, it is
strongly recommended to always have a second B.I.G. On hand.
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FAQ
Q: What are the flow rates?
•
Gravity – 20 – 40 ml/min
•
300 mercury – 110 – 130 ml/min
Q: What about Osteomyelitis?
•
A study was done by Rosseti in 1985 over 4,000 patients
shows the chance for Osteomyelitis is less than 0.6%.
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FAQ
Q: Does it painful?
•
The needle penetrates the bone in 0.02 seconds.
Penetration is much less painful than manual devices.
Q: Who uses the BIG?
•
The BIG is in use for the past 1.5 years in Europe,
Australasia and Israel.
•
In the US it was introduced on March 2002.
Q: Are there any reported complications?
•
The only complications we faced are user’s errors.
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