News: Medic demonstrates bone-injection procedure on roommate
Story by Staff Sgt. Ryan Matson
LAGHMAN PROVINCE, Afghanistan – It’s nice to be able to trust your roommate.
U.S. Army Cpl. Eric Palmer trusts 19-year-old U.S. Army Spc. Justin Day, so much he allowed him to drive a needle through his shinbone and pump liquids into it.
“We’re roommates; met about a year ago and have been through a lot of medical training together,” Palmer said. “I had complete faith in him doing this. We talked to the colonel and he blessed off on it; he thought it would be a good class we could all learn from.”
The two combat medics with Headquarters and Headquarters Company, 1st Battalion, 133rd Infantry Regiment, 2nd Brigade Combat Team, 34th Infantry Division, demonstrated an injection of intravenous liquids into the bone of a live patient using a bone injection gun in the aid station at Forward Operating Base Mehtar Lam March 10.
“It was a class on interosseous infusion,” explained Palmer, who is an iron worker in his hometown of Fairfield, Iowa. “If we have a patient in a scenario where we’re unable to get IV access on them to run fluids into them and they’ve had a lot of blood loss, we can also run fluids through the bone. The bone marrow will accept the fluid in the same way a vein would.”
The medics said the procedure could be used on a Soldier involved in an improvised explosive device explosion who is missing limbs or for heavier people whose veins are not easily accessible. If time was of the essence and the medics could not administer IV fluids, the medics said the interosseous infusion would be the next best option.
“For ... medics, the more tools we have in our toolbox at our disposal to use increases our chances for keeping battlefield casualties alive,” Palmer said. “The better trained we are on using these devices on people, the better we can save lives.”
Palmer and Day said they have had training on the process, but there was one big difference during this demonstration.
“We had never done training on this on live tissue,” said Day, a Davenport, Iowa, native. “It was kind of a big deal ... to inject the fluids into the bone, you have to actually fracture the bone with the (bone injection gun).”
Day explained the process.
“You inject a 15-gauge tropic needle into the bone,” he said. “The BIG has a heavy spring which shoots the needle into the bone causing a small fracture. There is a metal catheter around the needle. The needle and the catheter are injected together and then the catheter is pulled out. An extension set for a standard IV is connected, and the fluids are administered inside the bone.”
Day injected the needle into a plate of bone known as the tibia plateau by Palmer’s shin. The medics said placement of the injection is key because there are arteries inside bones as well as tendons and other things that could be damaged. The Saline fluids are pushed into a cavity inside the bone through a syringe, which is where the pain occurs for the patient, because it breaks apart the marrow.
Palmer, a former wrestler, said he has a pretty high threshold for pain and said when the BIG fractured his bone, it was not painful at all. However, when the liquid was injected into the bone in his leg, he said the level of pain was a 13 on a scale of 1-to-10.
“It did hurt; it’s an ungodly pain,” Palmer said. “It felt like the bone in my leg expanded to the size of a tanker truck.”
The medics administered a small dose of morphine to Palmer, who felt nauseous from the pain. They said in a real-life situation, the patient would be unconscious or medicated prior to the fluid administration or would probably be in so much pain from existing injuries that the bone injection would be an afterthought.
Day, a medic for the scout platoon, said he was not nervous about the procedure because he was confident he could perform the injection correctly. What made him nervous, he said, was the large collaboration of people who watched the process.
“Here I am, a little (specialist), telling our sergeant major and colonel and all these people how this procedure is done,” Day said.
Day said he did a lot of research on the device and others like it, such as another emergency bone injector, which is driven into a patient’s sternum, prior to using the BIG on his roommate.
“The only reason I didn’t let him do the injection into my sternum is because I have a tattoo there I didn’t want to get messed up,” Palmer said.
One thing was clear from the demonstration: if these medics ever need to apply this emergency procedure in a combat situation, they proved they could do it.
“The only way to find out if something works is to use it,” Day said.