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Think. !. Intraosseous?. www.waismed.com. Think. Let’s Discuss. B.I.G. TM - Bone Injection Gun How to operate Competition FAQ. www.waismed.com. Think. B.I.G. TM - Bone Injection Gun. Novel, automatic IOI injector. One of its kind in the world. www.waismed.com. Think.

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Presentation Transcript
slide1

Think

!

Intraosseous?

www.waismed.com

slide2

Think

Let’s Discuss

B.I.G.TM - Bone Injection Gun

How to operate

Competition

FAQ

www.waismed.com

slide3

Think

B.I.G.TM- Bone Injection Gun

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

www.waismed.com

slide4

Think

The BIG Movie

www.waismed.com

slide5

Think

BIGAdvantages

  • 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.

www.waismed.com

slide6

Think

BIGAdvantages

  • Disposable.
  • Quick and accurate infusion into the bone
  • marrow.
  • FDA and CE approval.
  • Patented in the USA

www.waismed.com

slide7

Competition

  • There are mainly 2 Manually inserted
  • hand-held infusion needles in the market:
  • Jamshidi – Baxter
  • A bone marrow aspiration needle
  • 2. Sussmane-Raszynski - Cook critical care
  • An IOI needle
slide8

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
slide9

Think

Design of the B.I.G™…

Instrument in locked position (before triggering).

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slide10

Think

Design of the B.I.G™…

After triggering.

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slide11

Think

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.

www.waismed.com

slide12

Think

FROM THE ECC GUIDELINES 2000

Rescuers should increase attention to early vascular access, includingimmediate Intraosseous access for victims of cardiac arrest, andextend the use of Intraosseous techniques to victims >6 years

ECC Guidelines 2000: Pediatric Advanced Life Support

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slide13

Think

Technique of insertion…

Movie

www.waismed.com

slide14

Think

Insertion site

In adults, 1-2 cm medially and 1 cm proximally to the tibial tuberosity.

In pediatrics and the elderly, 1-2 cm medially and 1-2 cm distally to the tibial tuberosity.

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slide15

Think

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, 1-2 cm medially and 1-2 cm distally to the tibial tuberosity.

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slide16

Think

2. Adjust Penetration Depth

Recommended penetration depths

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slide17

Think

3. Position the BIG

with one hand to the site

4. pull out the Safety Latch with the other hand.

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slide18

Think

5. Trigger the BIGat 90º to the surface.

www.waismed.com

slide19

Think

6. Remove the BIG.

7. Pull out the stylet trocar.

www.waismed.com

slide20

Think

8.Fix the cannula with the Safety Latch.

9.Connect IV Set

with a stopcock

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slide21

Think

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.

www.waismed.com

slide22

Think

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.

www.waismed.com

slide23

Think

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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slide24

Think

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.

www.waismed.com