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Intraosseous route – The F.A.S.T.1-System… März 3, 2007

Posted by JamL in Products & Technology, Science & Medicine.

The ERC guidelines of 2005 recommend considering the intraosseous application route in situations where intravenous access is difficult or simply impossible. As I am just about to finish my work on a new lecture for the ERC Advanced Life Support Courses here in Vienna, I have been confronted with different systems aiming at accomplishing a pathway to the cardiovascular system in an acceptable time. One of these devices, the „First Access for Shock & Trauma“ (F.A.S.T.1) device, is an intraosseous access device which can be applied to the manubrium sterni very easily, ensuring a quick pathway to the cardiovascular system.

I myself had the opportunity of trying the system in the course of the last ERC Congress in Stavanger (Norway), and I was very surprised at how easy it is to handle. There are only a few steps that need to be done and since the manubrium is a structure which can be found easily, the risk of dislocation is small. The IO sternal device is designed for insertion into the adult manubrium on the midline 1.6 cm below the sternal notch. For this purpose, there is an enclosed patch, which has a hole showing the operator where to place the device. After pushing it into the bone, an infusion can be attached.

The first studies with paramedics have already been conducted (check out the link below for the abstract of one of the studies) and had a fantastic outcome. Different studies show that the intraosseous route for drug delivery achieves effective plasma concentrations more reliably than the outdated concept of applying medication through the tracheal tube. With the new recommendation in the guidelines there is no doubt that the number of different products will rise since the demand will be rising as well. Today, however, the devices are still very expensive and an acceptable price is the basic requirement for this measure to become widely accepted.

Did you ever use the F.A.S.T.1-System? What were your experiences?

Study sighted in PubMed: „The paramedic evaluation of adult Intraosseous Infusion System“



1. dr. michael deutinger - März 24, 2007

a pleasure to be the first to write a commentary!
after 4 successful insertions i am convinced of the utility of this system. it´s easy to learn and difficult to forget. it´s definitely fast!
i´ve seen quick action of drugs, comparable with central venous application.
good compatibility with basic life support.
problems, that i´ve seen so far: bleeding from the insertion-site and dislocation of the patch afterwards – with no effect on the catheter-position. problems with removal – you don´t feel any resistance and don´t know, when the tip of the catheter is „really“ fixed on the remover. at last, it always worked.

you won´t need it very often, but it´s a good feeling to have it in pocket.

greetings, michael

2. locomino - März 24, 2007

Thanks for stopping by and telling us your experiences! It is not easy to find field reports on that topic! Cheers, Ben

3. Andrew Karrer - Mai 4, 2007

I’ve used the FAST 1 many times in the pre-hospital cardiac arrest setting. After establishing that peripheral IV access is not an option, the sternal IO is a fantastic tool to have at your side. Easy to learn and to mark your anatomical site location, and works very easily in the field. Only drawback I’ve noticed in the field is not very useful for large patients with thick subcutaneous fat and tissue, otherwise I highly recommend its use.

Stay safe,

Andrew Karrer
Oregon, USA

4. locomino - Mai 4, 2007

Thats what we hear all the time! Thanks for your comment and take care!

5. Rod Reed - Februar 8, 2008

Im a Navy Corpsman (combat medic for the marines) and when extremity veins are difficult to access I found this to be a lot easier/safer then a jugstick.

6. Jason Brown - Mai 14, 2009

This tool is being used as one of the standard skills of a combat medic in the army currently……I truly like the ease of site ID and insertion. another phenomenal invention and improvement in the developement of prehospital care!

7. Hamdija - März 13, 2010

Bitte können Sie mir sagen, wie viel FAST1AM

8. Woody - April 9, 2011

Hey! I’m a Combat medic for the army.
We got bored in our aid station today and i volunteered to receive the fast one. It kind of hurt during the flush, but other than that, I would never feel bad about doing it to anyone. It was one of the newer ones that requires no removal tool and taking it out produced almost no sensation of pain. Definitely an extremely easy-to-use device.

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