Healthcare and Medicine Reference
Figure 12.8 FAST1™ intraosseous infusion system.
Figure 12.6 Manual needle insertion.
multiple needle design prevents the operator from accidentally
penetrating through the sternum. Estimated time for insertion is
Step-by-step guide: FAST-1 device
Locate and swab insertion site.
Align target patch with sternal notch (Figure 12.9a).
Holding device perpendicular to the surface of the manu-
brium place introducer needle cluster into target area
Increase pressure on device until the device releases.
Lift introducer device off inserted infusion tube.
Attach extension set and fl ush before use (Figure 12.9d).
Attach protective dome (Figure 12.9e).
The sternal infusion tube should be removed within 24 hours.
Insertion failures are mostly due to improper insertion technique
(i.e. not inserting perpendicular to manubrium) or patient obesity.
Figure 12.7 EZ-IO™ manual sternal needle.
Bone injection gun (BIG™)
The BIG™ is a light-weight, self-contained device that comes in
both adult and paediatric models (Figure 12.10). It is licensed
for use on the distal and proximal tibia and the humerus. When
correctly triggered a powerful spring fi res the needle a preset
distance into the medullary space. The appropriate insertion
depth is selected by the operator. Estimated time for insertion is
the infusion line. Syringing also allows accurate fl uid titration in
Manual sternal needle
A manual adult sternal intraosseous set (EZ-IO™ Sternal
Intraosseous Set) is currently being trialled by the UK military. The
device has a collar to limit the depth of needle penetration through
the sternum. It requires a small skin incision for insertion in order
to accommodate the collar. An adhesive needle stabiliser aids stabil-
ity following insertion. Estimated insertion time is 30 seconds. See
Step-by-step guide: bone injection gun (Figure 12.11)
Set correct insertion depth.
Locate and clean insertion site.
Hold the barrel of the device (arrowed) fi rmly against insertion
Impact-driven intraosseous needles
FAST1™ intraosseous infusion system
The FAST1™ (Pyng Medical) is a disposable hand-held device that
uses an internal spring mechanism to access the sternal medul-
lary space (Figure 12.8). It can only be used on the adult sternum
and utilises a target patch to indicate the insertion point on the
manubrium. As pressure is applied to the device a central penetrat-
ing needle is fi red precisely into the sternal medullary space. The
point at 90º to the bone surface.
Squeeze and pull out red safety latch.
Apply pressure with the free hand to top of device to fi re the
Slowly remove the device from the inserted needle.
Remove the needle trocar.
Attach extension set and fl ush before use.
Support and protect insertion site.