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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.

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Pediatric bone injection gun b i g l.jpg

Pediatric Bone Injection Gun B.I.G.

Simply Saving Lives


Common io myths l.jpg
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.


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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.


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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.



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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…


Indications mci conventional threat l.jpg
Indications MCI Conventional threat


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Indications MCI Conventional threat


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IndicationsMCI Unconventional threat


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How to use the Pediatric B.I.G. device?


Location 1 l.jpg
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 .


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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)


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Location (3)

FromTibialplateau

Go DOWN 1-2 cm

(about 0.5-1 inch)

toward the foot.


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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 l.jpg
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 l.jpg
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


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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.


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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.


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Stylet Trocar

Gently pull out the stylet

Trocar. Only cannula

remains in the bone.


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Fixation

The safety latch

provides additional

stability.


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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.


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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.


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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.


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Avoid this…

Think BIG!

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