Transcript Bone Injection Gun – B.I.G.

Adult Bone Injection Gun
B.I.G.
Common IO Myths
BIG Insertion is extremely painful
The BIG insertion is very rapid and no more
painful than an IV line. In Conscious patients it
is recommended to add Lidocaine to the initial
solution.
85% of the patients are unconscious.
Common IO Myths
BIG Insertion Is a Difficult
Procedure To Perform
The BIG insertion can be done after a short training
session.
After learning the location differences between Adults
and Pediatrics you will be able to insert the BIG with
no effort.
Common IO Myths
BIG Infusion Can Be Done Only In
Red Bone Marrow
Researches in various animal models showed that
drugs are being delivered to center circulation in
both Red and Yellow Bone Marrow.
Anatomy
Indications
IO is the most appropriate option for vascular access
when IV is difficult or impossible .
Experience with the BIG:
Cardiac Arrest, all kinds of Shock, Dehydration,
Respiratory failure, Trauma, O.D
Burns, Seizures, Diabetic Emergencies…
Indications
MCI Conventional threat
Indications
MCI Conventional threat
Indications
MCI Unconventional threat
How to use
the AdultB.I.G. device?
Location (1)
Place a rolled towel under
knee with the foot facing
outward .
Find the outset point :
Tibial TuberosityA rounded protrusion
right down the patella.
*Locate the Tuberosity
and feel it on your leg .
Location (2)
From the Tibial Tuberosity
Go approx. 2 cm (1 inch) to
the inner part of the leg to
find a flat site.
This is the Tibial Plateau.
Location (3)
From Tibial plateau Go UP
approx. 1cm (0.5 inch)
toward the patella.
*You are looking for the
thinnest portion of the
cortex.
Location (4)
Summary (adult patient):
From Tibial Tuberosity Go
approx. 2 cm (1 inch) IN
(inner leg).
And approx. 1 cm (0.5 inch)
UP (toward patella).
*Try to find the insertion
site on your leg.
Positioning
Positioning
With one hand holding
firmly, Position the BIG
At a 90 degree angel to
the surface of the skin.
*use aseptic technique
throughout
Safety latch
With one hand holding the
BIG firmly, Pull out the
safety latch by squeezing
its two sides together.
(The safety latch should be at
the farthest point of the leg).
*Do not discard, it will later be
used.
Triggering
While continuing to hold the
bottom part firmly against the
leg, Place 2 fingers of your other
hand under the ‘winged portion’
and the palm of that hand on the
top. Leanining on the device with straight
elbows will activate the B.I.G.
Trigger the BIG by gently
pressing down .
Note:
Extra force is not required.
Stylet trocar
Pull out the stylet
Trocar. Only Cannula
remains in the bone.
Fixation
The safety latch
provides additional
stability.
Aspiration
Bone marrow can be
aspirated into a syringe
for laboratory sampling.
Note:
Lack of bone marrow
does not mean the IO is
improperly placed.
Flushing
Flushing 10-20cc (5-10cc in
Pediatrics) of saline is
recommended before the
injection of fluids or drugs.
*In conscious patientsconsider local anesthesia prior
to administrating fluids.
Administration
Now you can administrate
fluids and drugs as
required.
Optional :
Connect a stopcock to
the cannula and than use
a standard I.V set.