PerSys Paediatric Bone Injection Gun B.I.G.

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PerSysPaediatric Bone Injection Gun B.I.G.

• Simply Saving Lives

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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

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Indications

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

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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

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Complications(Generic for all devices)

• Compartment Syndrome
• Osteomyelitis
• Local tissue infection
• Pain (most often with fluid infusion in awake
  patient)
• Malplacement

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Bone Injection Gun

• Two devices
• Blue Adults
• Red Paediatrics (0-12 years)

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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

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How to use the PAEDIATRIC Bone Injection Gun
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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

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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.

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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.

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Location
From Tibial plateau go DOWN approx. 1cm toward
the foot.
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Location

• Summary (paediatric patient)
• From Tibial Tuberosity Go
• approx. 1 cm IN (inner leg).
• And approx. 1 cm
• DOWN (toward foot).

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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

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Positioning

• With one hand holding
• firmly, Position the BIG
• At a 90 degree angel 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.
• Do not discard, it will later be used.

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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

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

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Stylet trocar

• 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

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

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Flushing

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

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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.

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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