Pediatric Bone Injection Gun B.I.G. Simply Saving Lives
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.
Indications IO is the most appropriate option for vascular access when IV is difficultor impossible . Experience with the BIG: Cardiac Arrest, all kinds of Shock, Dehydration, Respiratory failure, Trauma, O.D Burns, Seizures, Diabetic Emergencies…
Location (1) Place a rolled towel under knee with the foot facing outward. Find the outset point : TibialTuberosity- A rounded protrusion right down the patella. *Locate the Tuberosity and feel it on your leg .
Location (2) From the TibialTuberosity Go 1-2 cm (about 0.5-1 inch) to the inner part of the leg to find a flat site. (This is the Tibial Plateau)
Location (3) FromTibialplateau Go DOWN 1-2 cm (about 0.5-1 inch) toward the foot.
Location (4) Summary (pediatric patient): From TibialTuberosity Go 1-2 cm (0.5-1 inch) IN (inner leg) And 1-2 cm (0.5-1 inch) DOWN (toward foot) *Try to find the insertion site on your leg.
Adjustment Adjust the penetration depth according to the patient’s age : 0-3 years 0.5-1 cm 3-6 years 1- 1.5 cm 6-12 years 1.5 cm *For your convenience- The age is also marked on the device.
Positioning With a rolled towel under knee and foot facing outward, Position the BIG with one hand firmly at 90 degree 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. Trigger the BIG by gently pressing down . Note: Extra force is not required.
Stylet Trocar Gently 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 5-10cc of saline is recommended before the injection of fluids or drugs. *In conscious patients- consider 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.
Avoid this… Think BIG! www.waismed.com