Wings Air Rescue & PYNG's FAST-1
I wonder how many these folks have used to date?
msha.com
ADULT STERNAL INTRAOSSEOUS
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The F.A.S.T 1 intraosseous infusion system is a specialized medical procedure. It is recommended that the F .A.S. T 1 only be used by trained medical professionals who have received formal training and instruction of its safe and effective uses.
The F.A.S.T. 1 intraosseous infusion system may be utilized on adult patients as an alternate method to achieve vascular access. The F.A.S.T. 1 should not be used on pediatric patients, patients with abnormal sternal anatomy including previous sternotomy, severe osteoporosis or other bone softening condition, or an extremely small adult patient. It is also not recommended to use on patients with burns or infections of the skin at the target site. There are no known contraindications for the use of the F .A.S. T. 1 sternal intraosseous infusion system .
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PROCEDURE:
Prepare the insertion site using aseptic technique. The insertion site is located over the manubrium. The iodine and alcohol swabs included in the F.A.S.T. 1 package should be used to clean the site; it should be left for at least 15 seconds to dry.
If the patient is conscious and alert, administer a local anesthetic. Placement of the Patch will serve as a targeting aid.
Remove the top half of the backing, labeled "1", from the Target/strain-Relief Patch. Place an index finger in the patient's sternal notch, perpendicular to the manubrium surface, to align the indicator notch in the Patch with the patient's sternal notch.
Place the Target Zone (the circular hole in the Patch) over the patient's midline. The locating finger must be held perpendicular to the manubrium.
Secure the top half of the Patch to the body by pressing firmly downward on the Patch, engaging the adhesive. Verify location. Removing the bottom half of backing, labeled "2", and press Patch to skin.
Verify that the indicator notch on the Patch matches the patient's sternal notch, and that the Target Zone is over the patient's midline. If there is error greater than 1 cm, the Patch should be removed and discarded, and a new Patch placed. Note: It may be possible to move and hold the patient's skin so that the Patch is correctly positioned for insertion.
Remove the Sharps Cap from the Introducer.
Place the bone probe cluster in the Target Zone, with the vertical axis of the Introducer perpendicular to the skin. It is vital that the Introducer is perpendicular to the skin and manubrium surface at the insertion site. The chest is often rounded; care must be taken to ensure the device is perpendicular to the skin, not to the surface on which the patient rests. Ensure that the entire bone probe cluster is within the Target Zone.
Press the Introducer into the Target Zone with firm and increasing force, until a distinct release of the Introducer handle is heard and felt. In some patients considerable force may be needed to release the Introducer. After the release, pull straight back to remove the Introducer, exposing the Infusion Tube. The stylet support sleeves will fall away.
Locate the orange Sharps Plug. Place it on a flat surface with foam facing up. Keeping both hands behind the needles, push the bone probe cluster straight into the foam. After the Sharps Plug has been engaged and the sharps are safely covered, re-attach the clear Cap to the Introducer. The Cap will fit securely over the Plug. This completes the dual Sharps protection. Dispose of the Introducer using contaminated sharps protocols.
Attach the right-angle Female Connector of the Patch to the Infusion Tube.
Verify that correct placement has occurred by attaching the enclosed syringe to the straight Female Connector and withdrawing marrow into the Infusion Tube.
Attach the straight Female Connector on the Patch to a purged source of fluid or drugs. Fluid can now flow to the site and into the bloodstream.
Place the Protector Dome over the Patch and press down firmly to engage the Velcro fastening.
Attach the UNOPENED Remover package to the patient. This package must be transported with the patient. The Remover will be needed later to remove the Infusion Tube from the patient when intraosseous access is no longer required.
REMOVAL PROCEDURE:
Remove the Protector Dome from the Target/strain-Relief Patch.
Disconnect the Infusion Tube from the Female Connector on the Patch.
Maintaining aseptic technique, open the Remover package.
Note: If the Remover has been misplaced, obtain a replacement Remover. Alternatively, the Infusion Tube may be removed using a minor surgical procedure performed by a qualified health provider. Through a small incision, grip the stainless steel portal with hemostats and pull straight back. This can be performed whenever the decision to discontinue infusion is made.
Remove the tubing protecting the threaded tip, and insert the Remover into the Infusion Tube. The Infusion Tube should be held straight out from the patient; this will ease insertion and prevent the Remover stylet from being pushed through the side of the infusion tubing.
Advance the Remover to engage the threads in the proximal tip of the Infusion Tube. Turn the Remover clockwise until it stops.
Pull straight out on the Remover to remove the Infusion Tube.
Note: If the Remover disengages from the infusion Tube Without removing it, return to Step 5 and re-attempt; it is likely that the threads were not completely engaged. If the threads cannot be engaged, the Infusion Tube must be removed by surgical procedures, as described above.
Remove the Target/ Strain-Relief Patch.
Apply pressure after removing the Patch, and treat the site using aseptic technique.
Dispose of the Remover and Infusion Tube using contaminated sharps protocols. Dispose of the rest of the F.A.S.T. 1 System.
APPROVED BY: ____________________________ DATE:____________________
Mark J. Wilkinson, M.D. - Medical Director, Wings Air Rescue |
