The Use of a Powered Device for Intraosseous Drug and Fluid Administration in a National EMS: A 4-Year Experience

Schwartz, Dagan; Amir, Lisa Rinanda; Dichter, R.; Figenberg, Zvi

doi:10.1097/ta.0b013e31814db2a6

Cited by 43 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…26 Like the FAST1, the BIG is compact and easily transported and stowed. It can be quickly inserted in the tibial insertion site; insertion in the humeral site is somewhat more problematic because of the potential difficulty in identifying the appropriate anatomical landmarks, particularly in a heavily muscled patient or one with excess adipose tissue at the insertion site.…”

Section: → →mentioning

confidence: 99%

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Day

2011

Critical Care Nurse

View full text Add to dashboard Cite

Three intraosseous devices have been approved by the Food and Drug Administration for use in adult trauma patients when intravenous access cannot be obtained. Sites of insertion are the sternum (FAST1), proximal tibia and humerus (Big Injection Gun), and proximal and distal tibia and humerus (EZ-IO). Insertion generally requires less than 1 minute, and flow rates up to 125 mL/min can be achieved. The devices are used for emergency resuscitation and should be removed within 24 hours of insertion or as soon as practical after peripheral or central intravenous access has been achieved. Contraindications include fractures or other trauma at the insertion site, prosthetic joints near the site, previous attempts to insert an intra osseous device at the same site, osteoporosis or other bone abnormalities, infections at the proposed site, and inability to identify pertinent insertion landmarks. Primary complications are extravasation of medications and fluids into the soft tissue, fractures caused by the insertion, and osteomyelitis.

show abstract

Section: → →mentioning

confidence: 99%

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Day

2011

Critical Care Nurse

View full text Add to dashboard Cite

show abstract

“…The manufacturer sells a training kit that includes one reloadable BIG (pediatric or adult), a reloading tool, an extra safety latch, and written and video learning aids. Several authors have investigated the ease of use, time of insertion, and success rate of the BIG (40,(47)(48)(49). One study comparing use of the different intraosseous devices in special operations medical providers showed a slightly shorter time of insertion with the BIG compared with the manual intraosseous needles or the FAST1 (70 vs. 88 vs. 114 s, respectively).…”

Section: Impact-driven Needlesmentioning

confidence: 97%

Intraosseous Access

Luck

Haines

Mull

2010

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…However, in the United States and Israel, BIG is used in battlefields, prehospital and disaster setting. 18 The primary optimal site for applying the BIG is the flat part of the tibia followed by the radius, medial malleolus and humerus. Under a CS condition, as long as a rescuer can access one of the possible BIG placement sites, the establishment of an IO access is possible.…”

Section: Discussionmentioning

confidence: 99%

Usefulness and Problems of Intraosseous Infusion with the Bone Injection Gun^™ Using Simulators Under Confined Space Conditions

Isayama¹,

Hirakawa

Tsuda

et al. 2014

Hong Kong Journal of Emergency Medicine

View full text Add to dashboard Cite

Introduction:It is important to have a venous line for infusion as an emergency treatment for patients suffering from crush syndrome or bleeding under confined space (CS) conditions in disaster medicine. However, it is not easy to for Emergency Life-Saving Technicians (ELSTs) to establish a venous line in such settings. Although previous studies have described the use of mechanical intraosseous (IO) devices and IO access while wearing chemical protection gears, problems for the use of IO devices under CS conditions have not been considered. This study aimed to investigate usefulness and problems of using a Bone Injection Gun TM (BIG) for IO infusion by ELSTs and rescue workers in CS conditions. Methods: The time required and success rate for IO infusion using a BIG in a manikin leg were measured, and for administering intravenous infusion in a manikin arm using either rescue gloves or plastic gloves by ELSTs or rescue workers under CS conditions. Results: Wearing rescue gloves, ELSTs were significantly faster in placing intraosseous infusion (IOI) compared with rescue workers. The success rate of the placement was not significantly different between ELSTs and rescue workers whether or not they wore rescue or plastic gloves. Conclusions: Although the finite usefulness of IOI with BIG under CS conditions is indicated, some problems such as the timing of removal of the IOI and difficulty in finding the location of the trocar needle after activating BIG are pointed out. Therefore, there are rooms to consider using IOI with BIG under CS condition. (Hong Kong j.emerg. med. 2014;21:23-30) 簡介：在密閉空間（ CS ）的條件下，有一條靜脈輸液管路作為緊急治療患有擠壓綜合徵或出血的患者，在災難醫學是很重要的。然而，在這樣的環境，應急救生技術人員（ ELSTs ）要建立靜脈管路並不容易。儘管以前的研究已經描述了穿化學防護裝備使用機械骨內（ IO ）設備和 IO 輸液，但在 CS 條件下使用 IO 設備的問題還沒有得到考慮。本研究旨在探討在 CS 條件下， ELSTs 和救援人員使用骨注射槍 TM （ BIG ）作 IO 輸注的效用和問題。方法：量度在 CS 條件下， ELSTs 或救援人員穿上救援手套或塑料手套，在假人腿用 BIG 作骨內輸液（ IOI ），所需的時間和成功率。結果：與救援人員相比，戴救援手套的 ELSTs 顯著更快地把 IOI 放置好。不論他們是穿著救援或塑料手套， ELSTs 和救援人員之間放置的成功率並無任何顯著不同。結論：儘管在 CS 的條件下使用 BIG 作 IOI 有一定的效用，但也有一

show abstract

The Use of a Powered Device for Intraosseous Drug and Fluid Administration in a National EMS: A 4-Year Experience

Abstract: The BIG provides an effective alternative IV access for critical patients in whom a peripheral IV line cannot be readily obtained in the prehospital setting.

Cited by 43 publications

References 34 publications

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Intraosseous Access

Usefulness and Problems of Intraosseous Infusion with the Bone Injection Gun^™ Using Simulators Under Confined Space Conditions

Contact Info

Product

Resources

About

The Use of a Powered Device for Intraosseous Drug and Fluid Administration in a National EMS: A 4-Year Experience

Abstract: The BIG provides an effective alternative IV access for critical patients in whom a peripheral IV line cannot be readily obtained in the prehospital setting.

Cited by 43 publications

References 34 publications

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Intraosseous Devices for Intravascular Access in Adult Trauma Patients

Intraosseous Access

Usefulness and Problems of Intraosseous Infusion with the Bone Injection Gun™ Using Simulators Under Confined Space Conditions

Contact Info

Product

Resources

About

Usefulness and Problems of Intraosseous Infusion with the Bone Injection Gun^™ Using Simulators Under Confined Space Conditions