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One big safety issue is the BIG may be discharged prior to being placed to
the IO site.  We had one fire off during training and the wall suffered a
deep penetration.  

As for being powered, the EZ IO needles can be placed by hand since they
have a self tapping tip and make a perfect round hole which reduces
infiltration.  This was a problem in the "old Days" when we used Jam-Shidi
needles.  They produced an oblong hole which made the insertion site leak.

Thanks,

Victor R. Hernandez, EMT-P
Emergency Training & Consultations
Truckee CA


-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Milton Tenenbein
Sent: Thursday, July 09, 2009 11:11 AM
To: [log in to unmask]
Subject: Re: Powered Intra-osseous access devices

Some posts have referred to IO drills and others have referred to a gun.

 

The original post (by Fran Nadel) referred to the EZ IO which is a drill
based system (requires a separate drill).

 

The other relatively new device is the B.I.GTM (for bone injection gun).

It is a self-contained spring powered unit.

 

I have evaluated both devices.

Both are relatively easy to use and have high success rates.

 

I chose the BIG because no power source and no auxiliary equipment (a
drill) are required.

It is supported by ample training videos found in the company's web site
(waismed.com) and even on YouTube.

Training equipment is also available.

Our EMS has adopted the BIG as well.

 

(For those who may be wondering - I do not have a financial interest in
the company).

 

Milton Tenenbein

Children's Hospital, Winnipeg

 

 

 

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Peter Antevy
Sent: Tuesday, July 07, 2009 3:59 PM
To: [log in to unmask]
Subject: Re: Powered Intra-osseous access devices

 

I too echo the prior comments regarding the ease of use of the gun,  

however there is a downside.

In the past month EMS has transported two children with simple febrile  

seizures to the ED with an IO in place.

Of course on arrival the kids were awake and alert and sent home  

shortly thereafter.

Sometimes when something is that easy it tends to get overused.  We  

need to continue to educate our EMS colleagues on appropriate use of  

an IO, EZ or otherwise.

 

Peter Antevy

Pediatric Emergency Medicine

Joe DiMaggio Children's Hospital

Hollywood, Florida

 

On Jul 7, 2009, at 3:34 PM, Lennarz, William :LPH Dir. ES wrote:

 

> I was a skeptic, thinking the EZ IO was another gizmo that brought  

> no value added to patient but generated profit for a private  

> company.  When they were initially introduced to us there was little  

> or no published evidence base for their use.

> 

> However, having used a number of them myself (in infants, children  

> and one elderly adult), and seen others who do not have great  

> experience w. placing the "old fashioned" Jamshidi's (?sp) place  

> them, they seem simple, controlled, consistent and successful on  

> first attempt nearly every time.  I have used them in a couple  

> "slightly" awake patients, after lidocaine to the periosteum, and  

> they have been very useful in that setting as well as arrest.

> 

> We now teach EZ IO use in our APLS course.  When using this  

> technique in an infant, be sure to stabilize the needle when  

> disconnecting the "gun/driver", since in small thin bones it may  

> pull the needle out.  We use raw eggs in APLS to practice this  

> techniques on neonates and infants.

> 

> Our department now stocks them in every peds code cart, and as our  

> primary IO device.

> 

> Billy Lennarz

> William M Lennarz, MD, FAAP, FAAEM

> 

> Director, Pediatric Emergency Services, Legacy Health System and  

> Legacy Emanuel Children's Hospital

> Emanuel Hospital Room 3067

> 2801 N Gantenbein

> Portland, OR 97227

> phone 503.413.2844

> fax 503.413.4216

> cell 804.307.9328

> 

> 

> 

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> privileged, confidential and may contain medical information  

> intended for an established health care provider of the named  

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> 

> -----Original Message-----

> From: Pediatric Emergency Medicine Discussion List

> [mailto:[log in to unmask]]On Behalf Of Fran Nadel

> Sent: Tuesday, July 07, 2009 8:18 AM

> To: [log in to unmask]

> Subject: Re: Powered Intra-osseous access devices

> 

> 

> We are considering adopting such devices and are interested in  

> hearng about your hospital's experience with powered IO access  

> devices like the EZ IO in children and teens--if you are using them,  

> how do you feel they compare to the manually placed IOs in ease/  

> success/complications/pain? Are they deployed throughout the  

> hospital (code teams, ICUs, EDs, etc) or just at one site? Approx.  

> how long have you had it and how many times has it been used? Do you  

> use them exclusively or have both available? Were there any issues  

> in training or maintenance of the equipment--did they mysteriously  

> disappear? Thanks for your response.

> 

> Frances M. Nadel, MD, MSCE

> Children's Hospital of Philadelphia

> Division of Emergency Medicine

> 34th & Civic Center Blvd.

> Phila, PA 19140

> [log in to unmask]

> Office: 215 590 1292

> Fax: 215 590 4454

> 

> For more information, send mail to [log in to unmask] with  

> the message: info PED-EM-L

> The URL for the PED-EM-L Web Page is:

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> 

> For more information, send mail to [log in to unmask] with  

> the message: info PED-EM-L

> The URL for the PED-EM-L Web Page is:

>                 http://listserv.brown.edu/ped-em-l.html

 

For more information, send mail to [log in to unmask] with the
message: info PED-EM-L

The URL for the PED-EM-L Web Page is:

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For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html