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Tue Feb 20 07:13:47 GMT 2007

Hi all,

I'm fine thank you Pret.

I know that there was a discussion some time ago about Intra Osseous 
Injections/Infusions. In my old age, I have forgotten what was said! 
Please enlighten me.

There seems to be a trend of using IO for medical conditions, especially 
cardiac arrest in the pre- hospital environment.

Names that I have heard are Bone Injector Gun and most recently FAST 1, 
where the device is placed in the sternum.

Question is, how useful are these devices in pre-hospital trauma care 
where fluid restriction should be the name of the game. Rather 
concentrate on Basic ABC, Advanced AB etc., get a line if you can, but 
run it slowly. In the area I work, we have some of the deepest gold 
mines in the world. I have worked underground as a paramedic retrieving 
patients from them. It is not unusual for 1 - 2 hours to have passed 
before you arrive at the patient and 3 - 4 hours before he is in 
hospital. The miners are extremely fit, having to work in environments 
where the temp is 30+ degrees celcius with humidities of 70+%. 
Fortunately due to this, with their injuries, they are able to 
compensate extremely well. You just have to remember that their pulse 
rate of 80 bpm is a tachy, twice their normal pulse of around 40. 
Obviously, fluid restriction with such long transit times is applicable. 
The cost of these devices in this country in prohibitive, for a single 
use item that expires in about 2 years.

The FAST 1 is only for use in adults.

MAST: still being taught to our emergency care practitioners!! Can any 
one give some pointers to studies showing that this device is not 
suitable at all. I use to swear by it in the early days, now I swear at 
it, but need the back up of scientific data.

Regards,

Ian Philbrick
ALS Paramedic
Klerksdorp
South Africa
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