Adult 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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Simply Saving Lives
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.
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.
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.
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…
Place a rolled towel under knee with the foot facing outward .
Find the outset point :
A rounded protrusion
right down the patella.
*Locate the Tuberosity
and feel it on your leg .
From the TibialTuberosity
Go approx. 2 cm (1 inch) to the inner part of the leg to find a flat site.
This is the Tibial Plateau.
FromTibialplateauGo UP approx. 1cm (0.5 inch) toward the patella.
*You are looking for the thinnest portion of the cortex.
Summary (adult patient):
From TibialTuberosity Go
approx. 2 cm (1 inch) IN
And approx. 1 cm (0.5 inch)
UP (toward patella).
*Try to find the insertion site on your leg.
With one hand holding
firmly, Position the BIG
At a 90 degree angel to
the surface of the skin.
*use aseptic technique throughout
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.
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 .
Extra force is not required.
Pull out the stylet
Trocar. Only Cannula
remains in the bone.
The safety latch
Bone marrow can be
aspirated into a syringe
for laboratory sampling.
Lack of bone marrow
does not mean the IO is
Flushing 10-20cc (5-10cc in Pediatrics) of saline is recommended before the injection of fluids or drugs.
*In conscious patients-
consider local anesthesia prior
to administrating fluids.
Now you can administrate
fluids and drugs as
Connect a stopcock to
the cannula and than use
a standard I.V set.