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Intraosseous?

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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Intraosseous?

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  1. Think ! Intraosseous? www.waismed.com

  2. Think Let’s Discuss B.I.G.TM - Bone Injection Gun How to operate Competition FAQ www.waismed.com

  3. Think B.I.G.TM- Bone Injection Gun Novel, automatic IOI injector. One of its kind in the world. www.waismed.com

  4. Think The BIG Movie www.waismed.com

  5. 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

  6. Think BIGAdvantages • Disposable. • Quick and accurate infusion into the bone • marrow. • FDA and CE approval. • Patented in the USA www.waismed.com

  7. 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

  8. 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

  9. Think Design of the B.I.G™… Instrument in locked position (before triggering). www.waismed.com

  10. Think Design of the B.I.G™… After triggering. www.waismed.com

  11. 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

  12. 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 www.waismed.com

  13. Think Technique of insertion… Movie www.waismed.com

  14. 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. www.waismed.com

  15. 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. www.waismed.com

  16. Think 2. Adjust Penetration Depth Recommended penetration depths www.waismed.com

  17. Think 3. Position the BIG with one hand to the site 4. pull out the Safety Latch with the other hand. www.waismed.com

  18. Think 5. Trigger the BIGat 90º to the surface. www.waismed.com

  19. Think 6. Remove the BIG. 7. Pull out the stylet trocar. www.waismed.com

  20. Think 8.Fix the cannula with the Safety Latch. 9.Connect IV Set with a stopcock www.waismed.com

  21. 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

  22. 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

  23. 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%. www.waismed.com

  24. 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

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