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PerSys Paediatric Bone Injection Gun B.I.G.

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... Malplacement Bone Injection Gun Two devices Blue = Adults Red = Paediatrics ... femoral fracture Osteogenesis imperfecta Recent prior attempt in ... – PowerPoint PPT presentation

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Title: PerSys Paediatric Bone Injection Gun B.I.G.


1
PerSysPaediatric Bone Injection Gun B.I.G.
  • Simply Saving Lives

2
INTRAOSSEOUS ACCESS
  • Penetration of the bone in order to access the
    intravascular compartment
  • Device inserted into medullary cavity
  • Tibial approach only in children
  • Appropriate for adult and paediatric application
  • Temporising, emergency measure

3
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4
Indications
  • Difficult or impossible IV Access
  • Appropriate for Adult or Paediatric application
  • Urgent requirement for fluid and/or drug
    administration (Cardiac Arrest, Hypovolaemia,
    Shock)

5
CONTRAINDICATIONS
  • Infection at insertion site
  • Local fracture
  • Existing trauma at insertion site
  • Same bone osteomyelitis
  • Ipsilateral femoral fracture
  • Osteogenesis imperfecta
  • Recent prior attempt in same bone

6
Complications(Generic for all devices)
  • Compartment Syndrome
  • Osteomyelitis
  • Local tissue infection
  • Pain (most often with fluid infusion in awake
    patient)
  • Malplacement

7
Bone Injection Gun
  • Two devices
  • Blue Adults
  • Red Paediatrics (0-12 years)

8
Paediatric Bone Injection GunHow it works
  • Trocar and Cannula contained within red plastic
    barrel
  • Powered by spring loaded piston in white plastic
    handle
  • Trocar and cannula propelled from barrel, into
    bone, when device is triggered

9
How to use the PAEDIATRIC Bone Injection Gun
10
You will need .
  • Paediatric Bone Injection Gun
  • Disposable dressing pack
  • Skin clean up solution
  • Gloves
  • Adhesive surgical tape (1 cm wide)
  • 10ml syringe
  • 10ml Normal Saline
  • Giving Set
  • IV Fluid

11
Location
  • Place a rolled towel under knee with the foot
    facing outward .
  • Find the outset point
  • Tibial Tuberosity-
  • A rounded protrusion
  • distal to the patella.

12
Location
  • From the Tibial Tuberosity
  • Go approx. 1 cm to the inner part of the leg to
    find a flat site.
  • This is the Tibial Plateau.

13
Location
From Tibial plateau go DOWN approx. 1cm toward
the foot.
14
Location
  • Summary (paediatric patient)
  • From Tibial Tuberosity Go
  • approx. 1 cm IN (inner leg).
  • And approx. 1 cm
  • DOWN (toward foot).

15
Setting Insertion Depth
  • Adjust red barrel to determine depth of cannula
    insertion according to patient age
  • Proximal tibia only
  • Depth of cannula insertion also available in cm
    markings on red barrel

16
Positioning
  • With one hand holding
  • firmly, Position the BIG
  • At a 90 degree angel to
  • the surface of the skin.
  • use aseptic technique throughout

17
Safety latch
  • With one hand holding the
  • BIG firmly, pull out the
  • safety latch by squeezing
  • its two sides together.
  • Do not discard, it will later be used.

18
Important
  • The red safety latch is NEVER removed before the
    B.I.G. is correctly positioned at the insertion
    site
  • Do not discard the safety catch
  • Used to stabilise cannula following insertion

19
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 , but firmly
  • pressing down .
  • Note
  • Extra force is not required.

20
Stylet trocar
  • Pull out the stylet
  • Trocar. Only Cannula
  • remains in the bone.

21
Fixation
  • The safety latch
  • provides additional
  • stability.

22
Aspiration
  • Blood can now be
  • aspirated into a syringe
  • for laboratory sampling.
  • Note
  • Lack of blood return
  • does not mean the IO is
  • improperly placed.

23
Flushing
  • Flush cannula with 5ml normal saline prior to
    infusion or drug administration
  • In conscious patients-
  • consider local anesthesia prior
  • to administrating fluids.

24
Administration
  • Fluids and drugs may now
  • be administered
  • A pressure infusion cuff may be required
  • Optional
  • Connect a stopcock to
  • the cannula and then use
  • a standard I.V set.

25
TO ORDER
  • implox Pty Ltd
  • Units 23-24, 60-66 Richmond Road
  • Keswick
  • South Australia, 5035
  • T. 08 83511455
  • E. CustomerService_at_implox.com
  • www.implox.com
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