Fast1 training ppt 2006 - mil - compress

1Copyright 2006 - Pyng Medical Corp.

FAST1 Sternal FAST1 Sternal Intraosseous Device Intraosseous Device

InsertionInsertion


INDICATIONSINDICATIONS

• Inadequate peripheral vasculatureInadequate peripheral vasculature• Failed peripheral IV attemptsFailed peripheral IV attempts• Rapid central vasculature accessRapid central vasculature access


TYPICAL PROTOCOL PRECAUTIONSTYPICAL PROTOCOL PRECAUTIONS

FAST1 NOT RECOMMENDED IFFAST1 NOT RECOMMENDED IF::

• Patient is of small stature:Patient is of small stature:– 40-50 Kg. minimum recommended size40-50 Kg. minimum recommended size

• Fractured manubrium/sternum – flailFractured manubrium/sternum – flail• Significant tissue damage at siteSignificant tissue damage at site


IV FLOW CAPABILITIESIV FLOW CAPABILITIES

• 15-80 ml/min by gravity15-80 ml/min by gravity• 125 ml/min pressure infusion125 ml/min pressure infusion• Roughly equivalent to 18g IVRoughly equivalent to 18g IV


Administering BloodAdministering Blood

• Blood is 4 X more viscous than NSSBlood is 4 X more viscous than NSS• Result is 1/4 normal rate of flow when Result is 1/4 normal rate of flow when

administering blood using gravityadministering blood using gravity• FAST1 system can tolerate increased FAST1 system can tolerate increased

pressurespressures• Solution? Solution? USE PRESSURE INFUSIONUSE PRESSURE INFUSION


Understanding Understanding PerpendicularPerpendicular

• FAST1 introducer must be perpendicular FAST1 introducer must be perpendicular to the surface of the manubriumto the surface of the manubrium

• 10 circumferential needles penetrate to 10 circumferential needles penetrate to the bony surface of the manubrium and the bony surface of the manubrium and assure uniform, level approachassure uniform, level approach

• Central trocar goes 6 mm beyond Central trocar goes 6 mm beyond circumferential needles and prevents circumferential needles and prevents over-penetrationover-penetration

• Rich vasculature drains manubrium… Rich vasculature drains manubrium… FAST1 is equivalent to a central lineFAST1 is equivalent to a central line



• Manubrium is Manubrium is upper aspect of upper aspect of sternal structuresternal structure

• Articulates with Articulates with body of sternum body of sternum at the Angle of at the Angle of LouisLouis



• Note that there Note that there are three planes are three planes relative to the relative to the patientpatient– Surface of groundSurface of ground– Surface of body Surface of body

of the sternumof the sternum– Surface of the Surface of the

manubriummanubrium



• Manubrium Manubrium surface angle is surface angle is your point of your point of focusfocus

• Perpendicular Perpendicular means at right means at right angles to the angles to the surface of the surface of the manubriummanubrium


INSERTIONINSERTION

• Prepare IV setPrepare IV set• BSI precautionsBSI precautions

– Gloves minimumGloves minimum

• Prepare site Prepare site using aseptic using aseptic techniquetechnique


INSERTIONINSERTION

• Finger at Finger at suprasternal suprasternal notchnotch

• Patch Patch indentation indentation abuts fingerabuts finger

• Place patchPlace patch• Make sure patch Make sure patch

is midlineis midline


INSERTIONINSERTION

• Place introducer Place introducer needle cluster in needle cluster in hole on target hole on target patchpatch

• Assure firm gripAssure firm grip• Keep introducer Keep introducer

device device perpendicular to perpendicular to the surface of the the surface of the manubriummanubrium

• Place introducer Place introducer needle cluster in needle cluster in hole on target hole on target patchpatch

• Assure firm gripAssure firm grip• Keep introducer Keep introducer

device device perpendicular to perpendicular to the surface of the the surface of the manubriummanubrium


INSERTIONINSERTION

• Insert using Insert using increasing pressure increasing pressure till device releases…till device releases…avoid “poking” or avoid “poking” or “punching” action “punching” action when insertingwhen inserting

• PERPENDICULAR PERPENDICULAR ALIGNMENT TO THE ALIGNMENT TO THE MANUBRIUM MANUBRIUM THROUGHOUTTHROUGHOUT

• Insert using Insert using increasing pressure increasing pressure till device releases…till device releases…avoid “poking” or avoid “poking” or “punching” action “punching” action when insertingwhen inserting

• PERPENDICULAR PERPENDICULAR ALIGNMENT TO THE ALIGNMENT TO THE MANUBRIUM MANUBRIUM THROUGHOUTTHROUGHOUT


INSERTIONINSERTION

• Following device Following device release, Remove release, Remove introducer by introducer by PULLING PULLING STRAIGHT BACKSTRAIGHT BACK

• Use orange Use orange sharps cap to sharps cap to cover exposed cover exposed needlesneedles

• Following device Following device release, Remove release, Remove introducer by introducer by PULLING PULLING STRAIGHT BACKSTRAIGHT BACK

• Use orange Use orange sharps cap to sharps cap to cover exposed cover exposed needlesneedles


INSERTIONINSERTION

• Connect infusion Connect infusion catheter to tube catheter to tube on the target on the target patchpatch

• Connect infusion Connect infusion catheter to tube catheter to tube on the target on the target patchpatch


INSERTIONINSERTION

• Remove white cap Remove white cap from Luer fittingfrom Luer fitting

• Connect IV lineConnect IV line• Flush line using Flush line using

either syringe or either syringe or by bolus from IV by bolus from IV bagbag

• Remove white cap Remove white cap from Luer fittingfrom Luer fitting

• Connect IV lineConnect IV line• Flush line using Flush line using

either syringe or either syringe or by bolus from IV by bolus from IV bagbag


INSERTIONINSERTION

• Cover site with Cover site with protective protective dome…leave dome…leave removal device removal device attachedattached


INSERTIONINSERTION

• Open IV and Open IV and assure good flow assure good flow or in cardiac or in cardiac arrest, inject arrest, inject epinephrine epinephrine directly into Luer directly into Luer fittingfitting

• Observe for Observe for infiltration or no infiltration or no flowflow


INSERTIONINSERTION

• Problems:Problems:– InfiltrationInfiltration

•Usually due to insertion not Usually due to insertion not perpendicular to manubriumperpendicular to manubrium

– Inadequate flow or no flowInadequate flow or no flow• Infusion tube occludedInfusion tube occluded

– Repeat flushRepeat flush

• Infusion catheter inserted at other Infusion catheter inserted at other than a perpendicular angle to the than a perpendicular angle to the manubrium surfacemanubrium surface

Fast1 training ppt 2006 - mil - compress

Education

Transcript of Fast1 training ppt 2006 - mil - compress