FASTx (next gen FAST 1 for IO)

[Iraq Ninja]

Those of you who have used FAST 1 may be interested in their new version. It is still pending the FDA, but appears to be a bit faster.

http://www.pyngmedical.com/fastx/images/fastx_home.jpg

Here is a video of two Blackwater medics demonstrating the older version.

http://www.youtube.com/watch?v=lPsK-7e0mek&feature=PlayList&p=136D31428BEB644C&index=57

[Vash1023]

ouch

thats video sucks. lol

[Iraq Ninja]

FAST is a good piece of kit, IF you are trained up on it. It is not something you get and throw in your med pouch.

We only use it after two failed attempts at IV access.

[Danny Boy]

Those things are bad ass. Thanks for the heads up.

We were made very familiar with those in Whiskey. The one problem with them being the potential for infection inside the bone tissue, but chances are you've got bigger problems if someones using them on you. We're told to treat them as our buddy and not be afraid to use them.

One of the Officers snapped a pic of a medic trying to put one in the lower sternum rather than the sternal notch..... d'oh. Please get properly trained if you get one.

The flush is apparently the worst part as far as pain goes. The one criticism of that vid is that he really didn't flush hard enough, or at least not as hard as we were taught to do it. But hey, it's not my chest and my pain.

[NinjaMedic]

The FAST is a good system but I prefer the EZ-IO as it is a bit more versatile and just as fast in my opinion. Always excited to see more options on the market though!

We often use them first line in critical pt's and with a little lidocaine even conscious pt's are a lot more tolerant of it.

Also while they rightfully claim that it is an extremely fast route to get medications to the heart it is not realisitically any faster than any other IO access site.

[brit]

the EZ-IO was developed by a local MD who is also one of the medical directors for a local EMS service. I've had the chance to practice with one, and I must say, its awesome!

I've been told that the medication administration is more painful than the drill entering the bone.

[lexmedic157]

I've drilled EZ-IO on countless patients unresponsive and alert. For my conscious patients most didn't complain much about the drilling (just the sound, and the idea of it), but the infusion was serious pain (tons of nerve endings in the marrow space). 20mg of 2% lidocaine does the trick. Only thing I wish was different was the price for the replacements.

[Iraq Ninja]

NM,

The reason I was told we don't get the EZ-IO is because it is not ideal for our environment. First of all, it is battery powered. Also, trauma incidents here typically involve amputations or severe trauma to the extremities. The sternum/manubrium are generally well protected due to the body armor.

The problem I see with FAST is that people fail to get the proper angle on the manubrium, and when it doesn't activate, they press harder and harder.

BTW, we are limited to NS and our normal time lines to definitive care can be from 20 minutes to 1 hour.

[lexmedic157]

I could see the problem with the batteries, but I've also heard that soldiers in Iraq use them without the driver in the traditional Jamshidi method. I too have had poor results with FAST devices. Had the angle line up great and easy to activate only to shatter the manubrium.

I do like the EZIO for the use on all sorts of patients. Remember the days we had to use Jelcos for all our trauma/coded patients? We've come a long way!

[MIKE G]

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[Iraq Ninja]

but also have one of the original SOF insertion devices (do they even still make those?).

If that is the manually inserted version, I think Chinook still sells them. I must admit I am interested in it, but we have liability issues. FAST is our issued kit, and if we use something else we are not certified on it may cause issues with our Head Shed. Price is always a factor in contracting. Worse case situation is that you could save someone's life, but loose your job if you could not show you were qualified to use it.

[MIKE G]

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[Iraq Ninja]

Hmm, I guess I should look up the local 18D here on the FOB.

BTW, if you want to make a training FAST, just drill a hole in the top of the handle and use a screwdriver to push it down to reset. A bit more realistic compared the the velcro verson in the Pyng training kit. Obviously there is the sharps concern with such a modification.

[NinjaMedic]

Definitely stick with what you are issued. And I agree that the FAST is a great tool for use on healthy adults wearing body armor the real limitations show up on the civilian side.

[Gutshot John]

Neat piece of kit but OUUUCCCHHH!!!:eek:

My experience with I/O needles is exclusively pediatric.

Why did they choose the sternum rather than say a shin bone?

[Iraq Ninja]

I suspect that a sternal IO is a bit faster than one put in at the tibia. Not sure how important this is for fluid resus, but probably more important for drugs.

[Gutshot John]

I suspect that a sternal IO is a bit faster than one put in at the tibia. Not sure how important this is for fluid resus, but probably more important for drugs.

So essentially the sternum is proximal to the vitals so drugs get there faster?

[Danny Boy]

Why did they choose the sternum rather than say a shin bone?

Extremities get blown off but are survivable. Chances are if you've been in a blast and are alive then you have your sternum, but maybe not your arms and legs.

[lexmedic157]

I dunno, proximal humerus is pretty quick to central circulation. Fast enough to give adenosine. I watched a fluoroscope with a patient getting contrast through a prox humerus and the drug got to heart in less than a sec.

[lexmedic157]

Sternal is pretty convenient for healthy soldiers especially with extremity trauma. Another toy in the bag I guess.

[Gutshot John]

6th Edition Military PHTLS says the I/O route is preferable as it's cleaner and faster, with less need for sterile technique on the battlefield. It makes mention of several products including the FAST-1 that can deliver I/O access on various parts of the body.

The sternum was chosen for the FAST apparently since the landmarks are more readily apparent and that the I/O site is less exposed than it would be on a limb.

[MIKE G]

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[airwayguru]

I have trained with the FAST System I love it. I have seen it used once on a patient in Central America on a medical missions trip (should been there a few minutes sooner). We are planning to carry them as a 3rd IV access protocol. Waiting to get the funds and/or donation to get a few units.

[MIKE G]

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[Iraq Ninja]

Nice. If I remember correctly, those are not approved for CONUS by the FDA. Any idea where I may be able to get one?

I am seriously considering the EZ IO to supplement my FAST. I like having other options available. FAST is a one location device, and blunt trauma to the sternum may rule it out. I will have to find a qualified instructor for certification to cover my ass.

[Iraq Ninja]

Turns out Chinook sells them:

http://www.chinookmed.com/cgi-bin/item/05300MD/s-iv_io/-EZ-IO-Manual-Driver-Intraosseous-Device-and-Needle

http://www.chinookmed.com/mas_assets/full/05300MD.jpg

[MIKE G]

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