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Old 07-13-2004, 07:37   #1
Sacamuelas
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IntraOsseous infusion kit

This system is currently being issued as standard items in the following US Army Medic kits:
  • The Combat Medics Bag (Military Code 2246)
  • The Field Hospital Surgical Instrument and Medical Equipment Supply Set (Code 3246)
  • The Ground Ambulance Medical Kits (Code 2256)

Procurement will be made utilizing Pyng Medical Corporation's assigned military stocking number N.S.N. 6515-01-453-0960.


F.A.S.T.1 can be used to provide drugs for medical emergency, or volume fluid resuscitation for treatment of haemorrhagic shock. Typical flow rates for normal saline are 30ml/min under gravity feed and 125ml/min with a pressurized bag or syringe-stopcock manual pump.

***TIP: In the field, if you don't have an IV pump available(likely) or don't have a spare indig. soldier or Teammate to manually compress the IV solution bag, then you can use a BP cuff which can be inflated around the IV bag to compresses and directly infuse solution at a faster rate.

A 250ml bag of Hypertonic Saline Dextan (HSD), equivalent to nearly 2 litres of normal saline, can be infused using a syringe- stopcock pump in only 2.5 minutes.
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Last edited by Sacamuelas; 07-13-2004 at 12:14.
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Old 07-13-2004, 07:42   #2
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Parts of the kit:
A: INTRODUCER, with depth control
B: INFUSION TUBE
C: PROTECTOR DOME
D: TARGET/STRAIN - RELIEF PATCH
E: REMOVER
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Old 07-13-2004, 07:56   #3
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Placement procedure:

Watch the video on placement:
CLICK ME... then click the link "here" at the very top right of the page for video

Here is a link to common errors when obtaining access and the "how to" to prevent them cfrom occuring. Troubleshooting the procedure to gain access- CLICK ME

Edited to fix link to video...

Last edited by Sacamuelas; 07-13-2004 at 08:18.
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Old 07-13-2004, 08:03   #4
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Removal instructions:
  1. Dome removal: Dome removal video
  2. Disconnect Infusion Tube
  3. Remove Infusion Tube:
    Warning: Do NOT pull on the Infusion Tube to remove it.
    a. Open the Remover Package while maintaining aseptic technique
    b. Remove the tubing protecting the Remover tip.
    c. Insert Remover into Infusion Tube while holding the Infusion Tube straight out (90°) from the patient.
    d. Advance the Remover, and turn it clockwise until it stops. This will engage the threads in the proximal tip of the Infusion Tube.
    e. Use one hand to press down lightly on Target Patch, and the other to pull the Remover straight out to dislodge the Infusion Tube. Hold the Remover by the T-shaped knob. Do NOT hold the luer or tubing. If the Remover disengages from the Infusion Tube without removing it, re-attempt.

    Note: Make sure that you pull the Remover in the direction perpendicular to the Infusion site to avoid bending of the Remover tip.
  4. Remove Target Patch
  5. Dress the Infusion Site
    A. Apply pressure to the infusion site.
    B. Reassess to check bleeding from site.
    C. Dress the infusion site using aseptic technique.
    D. Dispose of the Remover and Infusion Tube

Link to Troubleshooting removal procedure

Last edited by Sacamuelas; 07-13-2004 at 08:18.
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Old 07-26-2004, 03:04   #5
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Ooo...

I love the FAST-1. Typical response from joe when giving a class on the kit carried by the medics:

"You aren't coming anywhere near me with that, Doc!"
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Old 07-27-2004, 07:12   #6
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about 4 years ago I was approached by one of the companies making this thing....how would I like to puncture sternums with it was the question, the answer was why? There are so many available veins in the human body, even patients that are in class 3 or 4 shock {spend a day with me or Doc-T and we'll show you how to access veins you have never seen, touched,i.e., deep basilic in the upper arm, Internal jugular, femoral all with a 5cm angiocath}....I can even pour NSS down an ETT if needed.
The original argument for these souped up ear piercers was the typical medic may not have the equipment, skill to find adequate venous access and in a true emergency, could use the intraosseous route. The studies showed a few harpoonings of the heart, a bicortical puncture (went through inner and outer parts of bone, thereby resuscitation the mediastinum (area around the heart)) and now that we actively practice hypotensive resuscitations, what is the real role for these instruments of potential disaster????????
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(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

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Old 07-27-2004, 07:17   #7
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I just watched the video on the FAST1....newer system than the one I tried (like the peds kit....all manual placement if the needle.....okay, so this one looks foolproof and you know what that means..............)
This is a different animal than the one I used, less potential for incorrect placement, deeper puncture, etc. I stand corrected except for this really should be the LAST resort.
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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