Fast1 Sternal IO

Protocol

Download FAST1 Protocol (pdf)

Protocol: FAST1^® Intraosseous Infusion System. A depth-controlled device for rapid sternal intraosseous infusion.

Use: Adults and Adolescents 12+ years of age.

Outcomes:

1. Quickly and safely establish vascular access when IV is difficult or impossible.
2. Sternal site delivers drugs to the heart faster than peripheral sites and in greater concentrations.
3. Achieve consistent and proper placement of the infusion tube 6 mm into the manubrium utilizing the device’s patented depth-control.
4. Bridge to a central line – patient may be stabilized quickly and a central line inserted under sterile, non-emergency conditions to decrease the risk of infection and other adverse events.
5. Success rates for insertion over 95%.

Content:

1. Indications for Use – Used in emergency resuscitation situations when attempts to gain IV access have failed or when critical medications need to be administered immediately.
2. Insertion – The FAST1^® can be inserted by any healthcare provider who has been appropriately trained. All necessary tools are included in the small, sterile package.
   1. Expose the sternum and clean the site. Maintain aseptic technique. Note: local anesthetic should be used if the patient is alert.
   2. Remove the top half of the “Target Patch” backing and locate the sternal notch with your index finger.
   3. Align patch notch with patient’s sternal notch ensuring that the hole in the patch (“Target Zone”) is over the patient’s midline.
   4. Remove the bottom half of the patch backing and press it down firmly.
   5. Remove the sharps cap from the device and place the cluster of needles in the “Target Zone” holding the device perpendicular to the skin at the insertion site.
   6. Press down, with hand and elbow in line, using firm, increasing pressure until a distinct release is heard and felt. It is important that the device remain perpendicular to the skin.
   7. After release, pull straight back on the device (along the same line as for insertion), thus exposing the infusion tube.
   8. Push the used device on the foam-filled, orange sharps plug. The used device is disposed of as contaminated sharps to eliminate risk of cross-contamination.
   9. Attach the connector tube to the infusion tube luer and to the IV line and begin infusing.
   10. Place protective dome over patch and press down to engage Velcro fastening.
   11. To remove – Disconnect the IV line from the luer fitting and grasp the infusion tube between the luer and the patient using your fingers or forceps.
   12. Pull firmly on the infusion tube to remove.
   13. Remove target patch and dispose of infusion tube and target patch using appropriate techniques.

Considerations:

1. There are no absolute contraindications for use, however severely compromised skin from trauma, infection or burns over the infusion site may interfere with use.
2. Check for fracture of the sternum or vascular injury that may compromise the integrity of the manubrium or its vascularization.
3. Check for midline sternotomy scars as the device may be less effective in patients with a previous midline sternotomy.