On the issue of IO needles, we had looked into it last year for our
division. The Cook needle with a 45 degree trocar, screw off needle and
protective flange offered a pretty easy to use version. We have been
stocking this in our ED. The Jamshidi needle by Baxter I believe, was
also pretty user friendly. Interestingly our cost for the two supplies
was different from what Dr. Yamamoto said. The Cook needle was $ 18-20
and the Jamshidi was around $20-22. I am curious to know what range of
costs Dr. Yamamoto was encountering in his region.
Other options include a spinal needle, which has the disadvantage of
bending easily & not having a flange to hold. Alternatively a 14-16 G
angiocath needle could be used. It's downside is that bone particles
could block it during insertion. There is a Sherwood IO product out
there as well, but it's design is inferior to the Cook or Jamshidi and
not significantly cheaper.
LMA's are an excellent option for a failed RSI.They are a superior
adjunct when compared to traditional BVM. Technically they are very easy
to use; which is their big advantage.I personally don't have hands on
experience with them yet. But, aspiration is a definite risk especially
with prolonged use. Was wondering if Dr. Sachetti could comment on this.
Also the blind ETI through the LMA is available in sizes 1-5
corresponding to ETT size of 3.5 to 7.5. Hence should be usable in
almost all pediatric age groups. Cook makes these products.
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