骨髓腔内注射装置操作完整讲解程序课件

IntraosseousVascularAccess

骨髓腔内血管通路

.1IntraosseousVascularAccess

骨.2.2TheSystem

系统介绍.3TheSystem

系统介绍.3EZ-IOTrainingMaterialsEZ-IO培训材料

PowerPoint™PresentationsPPT展示Withcomprehensivenoteslocatedbehindeachslide每张幻灯片后附有注释EZ-IOStarCastPresentationsEZ-IO远程医疗展示QuickReferenceCard快速参考卡Insertion&RemovalPoster插入和移除海报TrainingMannequins用于培训的人体模型TrainingDriver&NeedleSets

训练驱动器和套针CompleteWebSite完整的网页ClinicalSupportHotline临床支持热线.4EZ-IOTrainingMaterialsEZ-TheEZ-IOPowerDriver

（

骨髓腔内注射装置驱动器）Designedfor1000humaninsertions可使用1000人次Sealedcap密封盖LithiumBatteries锂电池.5TheEZ-IOPowerDriver

（骨髓腔内注Needlesetpackaging

套针装置包装.6Needlesetpackaging

套针装置包装.6EZ-IOPD15mmNeedleSet小儿型15毫米针EZ-IOAD25mmNeedleSet成人型25毫米针EZ-IOLD45mmNeedleSet加长45毫米套针LengthandcoloraretheonlydifferencesbetweentheseNeedleSets不同型号的套针颜色不同5mmmark5毫米标志.7EZ-IOPD15mmNeedleSetCatheter&Stylet

TheEZ-IONeedleSetEZ-IO套针

NeedleSetSafetyCap套针安全帽Catheter&CatheterHub导管及导管外套Stylet探针StyletHub探针外套MetalDisc金属垫EZ-IONeedleSet(safetycapremoved安全帽移除)EZ-IONeedleSet(“X-RayView”withsafetycapX片视野下的安全帽)Specializedtip特殊针尖MRI禁止做磁共振检查.8Catheter&StyletTheEZ-IONSealedSterileCartridge密封无菌针筒Note:“lotcodeandexpiration”movedtocartridgebarrel注意：代码和有效期OpenCartridge打开针筒Note:NeedleSet’spositionNote:torn(andlifted)safetyseal注意：撕开安全封条OpenCartridge打开针筒Note:torn(andlifted)safetyseal注意：揭下安全封条OpenCartridge打开针筒Note:exposed“singleuseonly”sticker注意：查看“一次性使用”标志Styletin“Shuttle”保留探针在筒内Note:REMOVEDsafetyseal撕下安全封条Styletin“Shuttle”盖上针筒Note:REMOVEDsafetyseal.9SealedSterileCartridge密封无菌针筒LengthandcoloraretheonlydifferencesbetweenEZ-IONeedleSets不同型号的套装颜色不同5mmmark5毫米标志15mmPD25mmAD45mmLDEZ-IOLDNeedleSetTraywithSharpsProtectors锐器保护装置的针盒.10LengthandcoloraretheonlyPutthemwheretheybelong!废物处理Styletsbelonginapprovedsharpscontainers探针放入特定的锐器盒

内EZ-IOLDSharpsprotector锐器保护装置EZ-IOPD&ADShuttles套针盒.11Putthemwheretheybelong!StyConsiderthesepointsBEFOREEVERYEZ-IOinsertion:操作前注意事项：Didyou“hear”apopwhenthecartridgewasopened?

打开时是否有砰砰声？2DidtheDrivereasilyattachtotheNeedleSet(WiththeNeedleSetremaininginthecartridge)

是否有套针不能从针筒中取出的情况？3DidyouREMOVEtheNeedleSetSafetyCapfromtheNeedleSet?

能否打开套针安全帽？DidyouCONFIRMthe5mmmark?

能否有5毫米标志？ImportantEZ-IOusageconsiderations使用EZ-IO的主要注意事项Notethata“loneStylet”sitsdeeperthanacompleteNeedleSet探针要比整个套针在针筒内的位置更深NeedleSet.12ConsiderthesepointsBEFOREEPrecisecylindricalholecreatedbyEZ-IOinsertion

由EZ-IO制作的精确的圆柱孔.13Precisecylindricalholecreat

TheEZ-IOInfusionSolutionEZ-IO输液装置EZ-IOAD&PDNeedleSetsTrainingNeedleSets练习套针EZ-IOStorageCases&CradleEZ-IO箱和支架

EZ-IODriver驱动器EZ-Connect连接TrainingDriver训练驱动器Wristband腕带.14TheEZ-IOInfusionSolutionGeneralIOAnatomy

常规骨髓通路解剖.15GeneralIOAnatomy

常规骨髓通路解剖.15Anatomy

ofintraosseousaccess骨髓通路解剖Thousandsofsmallveinsleadfromthemedullaryspacetothecentralcirculation数以千计的小静脉将骨髓腔与中心静脉相连通.16Anatomyofintraosseousaccess.17.17Intraosseoususageandpain

骨髓通路的使用和疼痛.18Intraosseoususageandpain

骨髓AdultIOAnatomy

成人骨髓通路解剖.19AdultIOAnatomy

成人骨髓通路解剖.19ProximalTibialAnatomy

近端胫骨解剖.20ProximalTibialAnatomy

近端胫骨解剖Patella膝盖骨

AdultRightLeg成人右腿

Tuberosity结节InsertionSite插入位点EZ-IOInsertedEZ-IO插入StyletRemoved导管管芯去除Notecatheterlocationidentifyingstructuresandtissuethickness注意导管：位置、识别结构和组织厚度Adultfemalecadaver–rightproximaltibia成年女性尸体右胫骨近端.21Patella膝盖骨AdultRightLeg成人右腿TNotethedistancefromtheproximalaspectofthetibiatothemiddleofthetuberosity注意：丛胫骨近端到结节中心的距离Notetheaverageskinthicknessattheinsertionsite注意：插入点处平均皮肤厚度Adultfemalecadaver–rightproximaltibia.22NotethedistancefromtheproDistalTibialAnatomy远端胫骨解剖.23DistalTibialAnatomy远端胫骨解剖.2

TheanklejointiscomprisedoftheTibia,TalusandFibula

踝关节由胫骨，距骨和腓骨组成.24TheanklejointiscomprisedAcloserlookattheanatomy近距离观看解剖结构Posterior后面Anterior前面.25AcloserlookattheanatomyPoPosteriorAnteriorDistalTibia远端胫骨Calcaneous跟骨Talus距骨Adultfemalecadaver–leftdistaltibia.26PosteriorAnteriorDistalTibia远PosteriorAnteriorDistalTibia远端胫骨Adultfemalecadaver–leftdistaltibia.27PosteriorAnteriorDistalTibiaAPosteriorAnteriorDistalTibia远端胫骨Adultfemalecadaver–leftdistaltibia.28PosteriorAnteriorDistalTibia远PosteriorAnteriorDistalTibia远端胫骨Saphenousvein隐静脉Tendons肌腱MedialMalleolus内踝Adultfemalecadaver–leftdistaltibia.29PosteriorAnteriorDistalTibia远ProximalHumeralAnatomy近端肱骨结构.30ProximalHumeralAnatomy.30Insertionsite插入点Insertionsite插入点.31Insertionsite插入点InsertionsitLandmarkingthegreatertubercleinsertionsite标记较大的结节插入点.32LandmarkingthegreatertuberProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.33ProximalHumerusSite近端肱骨点AduProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.34ProximalHumerusSite近端肱骨点AduThegreatertubercleinsertionsite较大的插入点结节Noteindexfingerintheintertuberculargroove注意：食指所指位置为结节间沟

Needlesetshouldneverenterorbemedialtotheintertuberculargroove!穿刺针不应该进入或接近结节间沟ProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.35ThegreatertubercleinsertionNotethatarmisadductedwiththeelbowposteriorlyplaced!注意：上臂随肘部内收TheProximalHumerusinsertionsiteisfound“slightlyanteriortothearmslateralmidline”发现肱骨近端插入点位于“上臂侧面的中线稍靠前一点”RightarmAdultmale成年男性右上肢.36NotethatarmisadductedwithTheProximalHumerusinsertionsiteNotethatarmisadductedwiththeelbowposteriorlyplaced!

注意：上臂随肘部内收Notethattheinsertionsiteisfoundanteriortothearmslateralmidline!

注意：插入点位于上臂外侧中线之前LeftarmMannequin人体模型左上臂Anterior前面Posterior后面.37TheProximalHumerusinsertionProximalHumerus肱骨近端ProximalTibia胫骨近端DistalTibia胫骨远端Fractures骨折B.Multipleoptions?Multipleoptions多处选择DistalTibia胫骨远端ProximalTibia胫骨近端Multipleconcerns?多处关注？ProximalHumerus肱骨近端Thisslideillustratesimmediaterealworldsolutionstocomplexpatientencounters

.38ProximalHumerusProximalTibiaPediatricAnatomy

小儿解剖.39PediatricAnatomy

小儿解剖.39PediatricAnatomicalOverview.40PediatricAnatomicalOverview.ClearlyvisibletibialgrowthplateTibiaInsertionsite

ThepediatricgrowthplateGrowthPlateLeftLegRightLeg.41ClearlyvisibleTibiaInsertionSkinSubcutaneousFatIntraosseousCatheterTibiaFibulaPost.CompartmentAnt.CompartmentLat.Compartment

AnatomyFemaleneonatecadaver–Leftproximaltibia.42SkinSubcutaneousFatIntraosseElevenyearoldproximaltibia

insertionsitecrosssectionInsertionsiteTibiaFibulaLeftleg.43Elevenyearoldproximaltibia11mmMusclesSkinAdiposeCompactboneCancellousbone17.9kgMale,LeftArmProximalHumerusSelectNeedleSetbasedonsizeandweight.4411mmMusclesSkinAdiposeCompact3.1kgfemale,LeftLeg/1.5cmproximaltothepatella–proximalviewVentralDorsal

SitenotFDAclearedDistalFemur.453.1kgfemale,LeftLeg/1.5AnteriorPosteriorMedialLateralSkinAdiposeMuscleCompactboneCancellousbone3.1kgfemale,LeftLeg/1.5cmproximaltothepatella–proximalviewPrimarymusclegroupsinvolvedwithdistalfemurintraosseousinsertionincludethe:RectusFemorisVastusIntermediusVastusLateralisDistalFemurSitenotFDAcleared.46AnteriorPosteriorMedialLateralDistalFemurProximalTibiaDistalTibiaInfantIOsitecomparative

3.1Kgfemale,leftlegSitenotFDAclearedNote:Compactbonedensity,overallsizeoftargetbone,adjacentmusclestructuresandthecathetertobonerelationship.47DistalFemurProximalTibiaDistDistalFemurProximalTibiaDistalTibiaToddlerIOsitecomparative17.9kgMaleNote:Compactbonedensity,overallsizeoftargetbone,adjacentmusclestructuresandthecathetertobonerelationshipSitenotFDAclearedProximalHumerus.48DistalFemurProximalTibiaDistProximalHumerusProximalHumerusProximalTibiaProximalTibiaDistalTibiaDistalTibiaDistalFemurDistalFemurIntraosseousaccesssitesforthepediatricpatientNotFDAclearedNotFDAclearedExperience&anatomysuggestthatthissiteismostsuitableforpatients5yearsofageandolderExperience&anatomysuggestthatthissiteissuitablemostforpatients5yearsofageandolder.49ProximalHumerusProximalHumerIndicationsforEZ-IOAccess

EZ-IO使用适应症

1.Alteredlevelofconsciousness意识改变2.Respiratorycompromise呼吸窘迫3.Hemodynamicinstability血流动力学不稳定Togainintraosseousaccessinemergencies.50IndicationsforEZ-IOAccess

PreparingtheEZ-IOforuse使用EZ-IO准备.51PreparingtheEZ-IOforuse.51ContraindicationsforEZ-IOAccess

EZ-IO使用的禁忌症Fracture(targetedbone)骨折（目标骨骨折）Previousorthopedicproceduresnearinsertionsite（ProstheticLimborjoint）

穿刺点附近做过整形术（假肢或人工关节）IOwithinpast24hours(targetedbone)在过去24小时内做过骨髓通路术（目标骨）Infectionattheinsertionsite穿刺部位有感染Inabilitytolocatelandmarksorexcessivetissue

操作者不能定位或由于组织过多无法定位.52ContraindicationsforEZ-IOAcObserveBodySubstanceIsolationPrecautions.53ObserveBodySubstanceIsolatiRetrieveEZ-IOdriverandcartridge.Opencartridge&attachdrivertoneedleset

取出驱动器和针筒，打开针筒并将驱动器与套针相接.54RetrieveEZ-IOdriverandcartAdultSiteSelection

成人穿刺点的选择.55AdultSiteSelection

成人穿刺点的选择.Confirmandcleaninsertionsite

确定并清洁穿刺点.56ConfirmandcleaninsertionsiIdentifytheinsertionsite

确定穿刺点.57Identifytheinsertionsite

确定Confirmandcleaninsertionsite确定并清洁穿刺点.58ConfirmandcleaninsertionsiIdentifytheProximalHumerusinsertionsite确定肱骨近端穿刺点Elbowshouldremainadductedandposteriorlylocated肘部内收并位于后方orientthearmtothisposition保持上肢这种姿势

Placethehandovertheumbilicusforhumeralpositioningandsafety手高于脐利于定位肱骨和安全.59IdentifytheProximalHumerusPreferredinsertionsiteidentificationmethod

首选的穿刺点确定程序

Placethepatientinasupinepositionwiththearmcorrectlyoriented置患者仰卧位，

并调整上肢为正确姿势.60PreferredinsertionsiteidentConfirmandcleaninsertionsite确定并清洁穿刺点.61ConfirmandcleaninsertionsiPediatricSiteSelection.62PediatricSiteSelection.62Ifthepatient“fits”ontheBroselow™TapeTHINKPINK*andconsidertheEZ-IOPD=*ObeseorlargepediatricpatientsmayrequiretheEZ-IOADneedleSetFemurnotFDAcleared.63Ifthepatient“fits”ontheBTheTibialTuberositycanbedifficultorimpossibletopalpateonyoungerpatientsIftheTibialTuberosityCANNOT

bepalpatedtheinsertionsiteistwofingerwidthsbelowthePatella(andthen)medialalongtheflataspectoftheTibiaIdentifyingthepediatricEZ-IOinsertionsite.64TheTibialTuberositycanbedAspatientsmaturetheTibialTuberositybecomeseasiertoidentifyIftheTibialTuberosityCANbepalpatedtheinsertionsiteisonefingerwidthbelowtheTuberosity(andthen)medialalongtheflataspectoftheTibiaIdentifyingthepediatricEZ-IOinsertionsite.65AspatientsmaturetheTibialConfirmandcleaninsertionsite.66ConfirmandcleaninsertionsiConfirmandcleaninsertionsite.67ConfirmandcleaninsertionsiConfirmandcleaninsertionsite.68ConfirmandcleaninsertionsiInsertion&Infusion

穿刺及输液.69Insertion&Infusion

穿刺及输液.6Removeneedlesetsafetycap

取下套针安全帽ROTATESAFETYCAPCLOCKWISETOREMOVE顺时针旋转取下安全冒.70Removeneedlesetsafetycap

取StabilizeExtremity

固定手足Guardagainstunexpectedpatientmovement防止患者活动.71StabilizeExtremity固定手足GuardInsertADneedlesetintoappropriatesiteDon’tforcetheneedlesetintoposition-“allowthedrivertodothework”PositiontheEZ-IODriverata90degreeangletotheboneRemember“EZdoesit”40kgandgreaterusageLightlyholdingtheEZ-IOdriverwillimproveusage.72InsertADneedlesetintoapprInsertPDneedlesetintoappropriatesiteSelectthecorrectneedlesetbasedonpatientsize,weight&5mmmark

PositiontheEZ-IODriverata90degreeangletothebone3-39kgusageLightlyholdingtheEZ-IOdriverwillimproveusageNotFDAcleared.73InsertPDneedlesetintoapprInsertEZ-IO

NeedleSet-ata90degreeangle

totheboneTHENcheckthe5mmmark

垂直穿刺然后查看5毫米标记Checkthe5mmmark!检查5毫米标记.74InsertEZ-IONeedleSet-at25mmNeedleSet25毫米长的套针5mmmark5毫米标记处needlesetpendingFDAclearanceNotethatthe5mmmarkisNOTvisibleabovetheskin

5毫米标记线未在皮肤之上，不能看见AdiposeormuscletissuethicknessshouldbeconsideredpriortoEZ-IOinsertion穿刺之前，应该被考虑到脂肪或肌肉组织的厚度45mmNeedleSet45毫米长套针5mmmark5毫米标记处NeedleSethasnotbeenFDAcleared不合格套针.7525mmNeedleSet5mmmarkneedleCompleteInsertion完成穿刺Intheunlikelyeventofadriverfailureconsidermanualinsertion驱动器穿刺失败考虑手工完成是不太可能的事情.76CompleteInsertion完成穿刺IntheuImportantneedlesetinsertiontip重要的套针穿刺提示

Userinducedrecoilmayleadtoneedlesetdislodgementorextravasation操作者不能控制反冲力可能导致套针移位或脱出

STOP

WHENYOUFEELTHEPOP当有“砰砰”的感觉时停止穿刺反冲力!保持平衡Allowdrivertodothework!DONOTEXCESSIVEFORCEGentlyGUIDEneedlesetintoposition让驱动器去工作勿给予过多的人工力量轻柔的引导套针进入位置Caution!Recoil!3-39kgusage40kgandgreaterusage.77ImportantneedlesetinsertioRemoveDriverfromneedleset

把驱动器丛套针上取下StabilizeNeedleSetwhiledisconnectingDriver分离驱动器时固定牢固套针.78RemoveDriverfromneedleset

Removestyletfromcatheter从套管内取下探针Neverattempttoreplacethestyletonceremovedfromthecatheter.79Removestyletfromcatheter从Confirmcatheterplacement确定导管位置Confirmplacementbynoting通过以下提示确定位置Bloodatthestylettip探针针尖有血Firmlyseatedcatheter导管固定牢固Bloodinthecatheterhub导管外套处有血Aspirationofblood有血溢出Fluidsflowwithoutdifficulty液体流入顺利Pharmacologiceffects药物发挥作用Monitortheinsertionsiteanddistalextremityforsignsofextravasation观察穿刺点及远端肢体，防止外渗.80Confirmcatheterplacement确定导管Putthemwheretheybelong!Styletsbelonginapprovedsharpscontainers探针放于特定的锐气盒内

NEWEZ-IOLDSharpsprotector新式锐器保护装置EZ-IOPD&ADShuttles.81Putthemwheretheybelong!StyConsiderplacingstabilizeroncatheter安装导管固定装置CentrallylocateCathetertotheeyeoftheStabilizer固定导管于固定装置中心的孔内

2121.82ConsiderplacingstabilizeronRemovestabilizer’sadhesivebacking撕掉固定装置的粘合底布Securedadhesivepreventslateralmovement粘合剂可有效避免套针横向移动Graspstabilizerandgentlypulltabs固定好固定装置并轻拉底布.83Removestabilizer’sadhesivebLidocaineconsiderationsandadministration

利多卡因的应用及注意事项2%(preservativefree)Lidocaine-givenintraosseously(IO)-hasbeenshowntooffereffectivelocalanesthesiainmostalertpatients2%利多卡因局麻用于较敏感患者IOinfiltrationforalertpatients:ConsiderprimingtheEZ-Connect®with2%LidocaineAdultdosage20–40mgIO成人剂量20–40mgPediatricdosage0.5mg/kgIO小儿剂量0.5mg/kgInfuseLidocaineslowly(over30seconds)缓慢推注大于30秒Allow1minuteforanestheticeffect一分钟后见效Repeatasneededtoreachtherapeuticlevel

有必要时可重复使用DONOTexceed3mg/kg不能超过3mg/kgSomepatientsmayrequirerepeatedadministrationtoachievedesiredeffect*Seenotesattachedtoslideforbibliographyanddetailedexplanation.84LidocaineconsiderationsandaNoFlush=NoFlowSyringeFLUSHcatheterSyringeFLUSHcatheterwith10mlofasterilesolutionAlertpatientsmayrequire2%preservativefreeLidocaineIntraosseouslyPRIORtoflushSomepatientsmayrequiremultiplesyringeflushes.85NoFlush=NoFlowSyringeFLUSAvoidrockingtheEZ-IOcatheterduringusageUsetheEZ-Connectsuppliedwiththeneedleset.86AvoidrockingtheEZ-IOcathetBegininfusionwithpressureApressurebag,infusionpumporsyringewillimprovetheflowrates3-39kgusageRegulatefluiddeliveryforALLpediatricpatients40kgandgreaterusage.87BegininfusionwithpressureARemoval.88Removal.88#1.RemoveEZ-Connect#2.LiftAdhesiveDressing

EZ-Stabilizerremoval

.89#1.RemoveEZ-Connect#2.LifEZ-IORemovalMaintaina90degreeangleMaintain90degreeangle.90EZ-IORemovalMaintaina90degEZ-IORemovalMaintaina90degreeangleContinuouslyrotatesyringeclockwiseContinuouslyrotatethesyringeclockwise.91EZ-IORemovalMaintaina90degEZ-IORemovalMaintaina90degreeangleContinuouslyrotatethesyringeclockwiseGentlybackcatheteroutGentlebackcatheteroutofpatient.92EZ-IORemovalMaintaina90degOncecatheterhasbeenremoved–dresssiteandmonitorpatient.93OncecatheterhasbeenremovedPossibleComplicationsIfbreakageoccursGrasptheexposedcatheterwithahemostat–rotateandpullRocking,BendingorinadvertentlyStrikingthecathetermaycauseittobreak24houremergencysupport1.800.680.4911.94PossibleComplicationsIfbreakPossibleComplicationsIfbreakageoccursGrasptheexposedcatheterwithhemostats–rotateandpullRocking,BendingorinadvertentlyStrikingthecathetermaycauseittobreak24houremergencysupport1.800.680.4911.95PossibleComplicationsIfbreakQuickReferenceCard&UnitPoster快速参考卡片和装置视图.96QuickReferenceCard&UnitPo.97.97Aroundtheworld-24hoursaday-7daysaweek无处不在，五十不在

.98Aroundtheworld-24hoursaQuestions?

有提问吗？

.99Questions?

有提问吗？.99IntraosseousVascularAccess

骨髓腔内血管通路

.100IntraosseousVascularAccess

骨.101.2TheSystem

系统介绍.102TheSystem

系统介绍.3EZ-IOTrainingMaterialsEZ-IO培训材料

PowerPoint™PresentationsPPT展示Withcomprehensivenoteslocatedbehindeachslide每张幻灯片后附有注释EZ-IOStarCastPresentationsEZ-IO远程医疗展示QuickReferenceCard快速参考卡Insertion&RemovalPoster插入和移除海报TrainingMannequins用于培训的人体模型TrainingDriver&NeedleSets

训练驱动器和套针CompleteWebSite完整的网页ClinicalSupportHotline临床支持热线.103EZ-IOTrainingMaterialsEZ-TheEZ-IOPowerDriver

（

骨髓腔内注射装置驱动器）Designedfor1000humaninsertions可使用1000人次Sealedcap密封盖LithiumBatteries锂电池.104TheEZ-IOPowerDriver

（骨髓腔内注Needlesetpackaging

套针装置包装.105Needlesetpackaging

套针装置包装.6EZ-IOPD15mmNeedleSet小儿型15毫米针EZ-IOAD25mmNeedleSet成人型25毫米针EZ-IOLD45mmNeedleSet加长45毫米套针LengthandcoloraretheonlydifferencesbetweentheseNeedleSets不同型号的套针颜色不同5mmmark5毫米标志.106EZ-IOPD15mmNeedleSetCatheter&Stylet

TheEZ-IONeedleSetEZ-IO套针

NeedleSetSafetyCap套针安全帽Catheter&CatheterHub导管及导管外套Stylet探针StyletHub探针外套MetalDisc金属垫EZ-IONeedleSet(safetycapremoved安全帽移除)EZ-IONeedleSet(“X-RayView”withsafetycapX片视野下的安全帽)Specializedtip特殊针尖MRI禁止做磁共振检查.107Catheter&StyletTheEZ-IONSealedSterileCartridge密封无菌针筒Note:“lotcodeandexpiration”movedtocartridgebarrel注意：代码和有效期OpenCartridge打开针筒Note:NeedleSet’spositionNote:torn(andlifted)safetyseal注意：撕开安全封条OpenCartridge打开针筒Note:torn(andlifted)safetyseal注意：揭下安全封条OpenCartridge打开针筒Note:exposed“singleuseonly”sticker注意：查看“一次性使用”标志Styletin“Shuttle”保留探针在筒内Note:REMOVEDsafetyseal撕下安全封条Styletin“Shuttle”盖上针筒Note:REMOVEDsafetyseal.108SealedSterileCartridge密封无菌针筒LengthandcoloraretheonlydifferencesbetweenEZ-IONeedleSets不同型号的套装颜色不同5mmmark5毫米标志15mmPD25mmAD45mmLDEZ-IOLDNeedleSetTraywithSharpsProtectors锐器保护装置的针盒.109LengthandcoloraretheonlyPutthemwheretheybelong!废物处理Styletsbelonginapprovedsharpscontainers探针放入特定的锐器盒

内EZ-IOLDSharpsprotector锐器保护装置EZ-IOPD&ADShuttles套针盒.110Putthemwheretheybelong!StyConsiderthesepointsBEFOREEVERYEZ-IOinsertion:操作前注意事项：Didyou“hear”apopwhenthecartridgewasopened?

打开时是否有砰砰声？2DidtheDrivereasilyattachtotheNeedleSet(WiththeNeedleSetremaininginthecartridge)

是否有套针不能从针筒中取出的情况？3DidyouREMOVEtheNeedleSetSafetyCapfromtheNeedleSet?

能否打开套针安全帽？DidyouCONFIRMthe5mmmark?

能否有5毫米标志？ImportantEZ-IOusageconsiderations使用EZ-IO的主要注意事项Notethata“loneStylet”sitsdeeperthanacompleteNeedleSet探针要比整个套针在针筒内的位置更深NeedleSet.111ConsiderthesepointsBEFOREEPrecisecylindricalholecreatedbyEZ-IOinsertion

由EZ-IO制作的精确的圆柱孔.112Precisecylindricalholecreat

TheEZ-IOInfusionSolutionEZ-IO输液装置EZ-IOAD&PDNeedleSetsTrainingNeedleSets练习套针EZ-IOStorageCases&CradleEZ-IO箱和支架

EZ-IODriver驱动器EZ-Connect连接TrainingDriver训练驱动器Wristband腕带.113TheEZ-IOInfusionSolutionGeneralIOAnatomy

常规骨髓通路解剖.114GeneralIOAnatomy

常规骨髓通路解剖.15Anatomy

ofintraosseousaccess骨髓通路解剖Thousandsofsmallveinsleadfromthemedullaryspacetothecentralcirculation数以千计的小静脉将骨髓腔与中心静脉相连通.115Anatomyofintraosseousaccess.116.17Intraosseoususageandpain

骨髓通路的使用和疼痛.117Intraosseoususageandpain

骨髓AdultIOAnatomy

成人骨髓通路解剖.118AdultIOAnatomy

成人骨髓通路解剖.19ProximalTibialAnatomy

近端胫骨解剖.119ProximalTibialAnatomy

近端胫骨解剖Patella膝盖骨

AdultRightLeg成人右腿

Tuberosity结节InsertionSite插入位点EZ-IOInsertedEZ-IO插入StyletRemoved导管管芯去除Notecatheterlocationidentifyingstructuresandtissuethickness注意导管：位置、识别结构和组织厚度Adultfemalecadaver–rightproximaltibia成年女性尸体右胫骨近端.120Patella膝盖骨AdultRightLeg成人右腿TNotethedistancefromtheproximalaspectofthetibiatothemiddleofthetuberosity注意：丛胫骨近端到结节中心的距离Notetheaverageskinthicknessattheinsertionsite注意：插入点处平均皮肤厚度Adultfemalecadaver–rightproximaltibia.121NotethedistancefromtheproDistalTibialAnatomy远端胫骨解剖.122DistalTibialAnatomy远端胫骨解剖.2

TheanklejointiscomprisedoftheTibia,TalusandFibula

踝关节由胫骨，距骨和腓骨组成.123TheanklejointiscomprisedAcloserlookattheanatomy近距离观看解剖结构Posterior后面Anterior前面.124AcloserlookattheanatomyPoPosteriorAnteriorDistalTibia远端胫骨Calcaneous跟骨Talus距骨Adultfemalecadaver–leftdistaltibia.125PosteriorAnteriorDistalTibia远PosteriorAnteriorDistalTibia远端胫骨Adultfemalecadaver–leftdistaltibia.126PosteriorAnteriorDistalTibiaAPosteriorAnteriorDistalTibia远端胫骨Adultfemalecadaver–leftdistaltibia.127PosteriorAnteriorDistalTibia远PosteriorAnteriorDistalTibia远端胫骨Saphenousvein隐静脉Tendons肌腱MedialMalleolus内踝Adultfemalecadaver–leftdistaltibia.128PosteriorAnteriorDistalTibia远ProximalHumeralAnatomy近端肱骨结构.129ProximalHumeralAnatomy.30Insertionsite插入点Insertionsite插入点.130Insertionsite插入点InsertionsitLandmarkingthegreatertubercleinsertionsite标记较大的结节插入点.131LandmarkingthegreatertuberProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.132ProximalHumerusSite近端肱骨点AduProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.133ProximalHumerusSite近端肱骨点AduThegreatertubercleinsertionsite较大的插入点结节Noteindexfingerintheintertuberculargroove注意：食指所指位置为结节间沟

Needlesetshouldneverenterorbemedialtotheintertuberculargroove!穿刺针不应该进入或接近结节间沟ProximalHumerusSite近端肱骨点Adultmalecadaver–rightproximalhumerus.134ThegreatertubercleinsertionNotethatarmisadductedwiththeelbowposteriorlyplaced!注意：上臂随肘部内收TheProximalHumerusinsertionsiteisfound“slightlyanteriortothearmslateralmidline”发现肱骨近端插入点位于“上臂侧面的中线稍靠前一点”RightarmAdultmale成年男性右上肢.135NotethatarmisadductedwithTheProximalHumerusinsertionsiteNotethatarmisadductedwiththeelbowposteriorlyplaced!

注意：上臂随肘部内收Notethattheinsertionsiteisfoundanteriortothearmslateralmidline!

注意：插入点位于上臂外侧中线之前LeftarmMannequin人体模型左上臂Anterior前面Posterior后面.136TheProximalHumerusinsertionProximalHumerus肱骨近端ProximalTibia胫骨近端DistalTibia胫骨远端Fractures骨折B.Multipleoptions?Multipleoptions多处选择DistalTibia胫骨远端ProximalTibia胫骨近端Multipleconcerns?多处关注？ProximalHumerus肱骨近端Thisslideillustratesimmediaterealworldsolutionstocomplexpatientencounters

.137ProximalHumerusProximalTibiaPediatricAnatomy

小儿解剖.138PediatricAnatomy

小儿解剖.39PediatricAnatomicalOverview.139PediatricAnatomicalOverview.ClearlyvisibletibialgrowthplateTibiaInsertionsite

ThepediatricgrowthplateGrowthPlateLeftLegRightLeg.140ClearlyvisibleTibiaInsertionSkinSubcutaneousFatIntraosseousCatheterTibiaFibulaPost.CompartmentAnt.CompartmentLat.Compartment

AnatomyFemaleneonatecadaver–Leftproximaltibia.141SkinSubcutaneousFatIntraosseElevenyearoldproximaltibia

insertionsitecrosssectionInsertionsiteTibiaFibulaLeftleg.142Elevenyearoldproximaltibia11mmMusclesSkinAdiposeCompactboneCancellousbone17.9kgMale,LeftArmProximalHumerusSelectNeedleSetbasedonsizeandweight.14311mmMusclesSkinAdiposeCompact3.1kgfemale,LeftLeg/1.5cmproximaltothepatella–proximalviewVentralDorsal

SitenotFDAclearedDistalFemur.1443.1kgfemale,LeftLeg/1.5AnteriorPosteriorMedialLateralSkinAdiposeMuscleCompactboneCancellousbone3.1kgfemale,LeftLeg/1.5cmproximaltothepatella–proximalviewPrimarymusclegroupsinvolvedwithdistalfemurintraosseousinsertionincludethe:RectusFemorisVastusIntermediusVastusLateralisDistalFemurSitenotFDAcleared.145AnteriorPosteriorMedialLateralDistalFemurProximalTibiaDistalTibiaInfantIOsitecomparative

3.1Kgfemale,leftlegSitenotFDAclearedNote:Compactbonedensity,overallsizeoftargetbone,adjacentmusclestructuresandthecathetertobonerelationship.146DistalFemurProximalTibiaDistDistalFemurProximalTibiaDistalTibiaToddlerIOsitecomparative17.9kgMaleNote:Compactbonedensity,overallsizeoftargetbone,adjacentmusclestructuresandthecathetertobonerelationshipSitenotFDAclearedProximalHumerus.147DistalFemurProximalTibiaDistProximalHumerusProximalHumerusProximalTibiaProximalTibiaDistalTibiaDistalTibiaDistalFemurDistalFemurIntraosseousaccesssitesforthepediatricpatientNotFDAclearedNotFDAclearedExperience&anatomysuggestthatthissiteismostsuitableforpatients5yearsofageandolderExperience&anatomysuggestthatthissiteissuitablemostforpatients5yearsofageandolder.148ProximalHum