How the NIO Works

The NIO is a simple, automatic intraosseous device ready to use for safe, quick, and easy vascular access.

  1. Open the pack and remove the NIO.
  2. Locate and disinfect injection site.
  3. Place device approx. 2cm medially and 1cm proximally from tibial tuberosityAlternate site: humeral head. See videos for detail.
  4. Unlock the NIO by rotating the cap 90 degrees in either direction.
  5. Place dominant hand over cap, and press device against patient. While pressing down on the device with palm, pull trigger wings upwards with fingers.
  6. Gently pull the NIO up in a rotating motion while holding the needle stabilizer against the insertion site.
  7. Continue holding the needle stabilizer in place and pull up the stylet to remove.

Complete Instructions for Use

  1. Open the pack and take out the NIO. Make sure that the NIO is free of all packaging parts.
  2. Select one of the following injection sites:
    1. Primary site for Intraosseous injection: Proximal tibia
      Approximately 1 inch or 2 cm medially and 1/2 inch or 1 cm proximally to the tibial tuberosity.
    2. Secondary site for Intraosseous injection: Humeral Head
      Adduct the patient’s hand and locate the greater tubercle next to the head of the humerus.
      NOTE: To prevent accidental removal of the device, following the procedure immobilize the patient arm.
  3. Disinfect the skin on the injection site by following institutional protocols. Note that this is a two-handed procedure. Place your non-dominant hand on the textured dots located on the lower part of the NIO and position the NIO at a 90 degrees angle to the skin at the injection site. The non-dominant hand should maintain this position throughout this procedure.
  4. Unlock the NIO by rotating the cap 90 degrees in either direction.
  5. Place the palm of your dominant hand over the cap. Press the device against the patient’s skin and maintain downward pressure. While pressing down on the device, pull the trigger wings upwards. This action will activate the device.
  6. Gently pull the NIO up in a rotary motion while holding the base of the needle stabilizer against the insertion site.
  7. While holding the needle stabilizer and cannula in place, remove the stylet by pulling it up (use a twisting motion of the stylet if necessary). The keyhole notch on the distal end of the NIO can be used to assist in removing the stylet from the cannula. Place stylet into an appropriate biohazard container.
  8. Connect a syringe and confirm secure fitting. If desired, aspirate bone marrow. Always confirm successful needle placement by flushing with up to 20 cc of fluid or per your protocol. It is recommended to use the NIO Fixation sticker to affix the NIO stabilizer. (A). Connect any standard system for infusion (B). Cover the insertion site with a sterile, occlusive dressing.
  9. Removal instruction: Remove the cannula and needle stabilizer by twisting and pulling vertically. Dispose of the removed components in the appropriate biohazard container. Cover the insertion site with a sterile, occlusive, wound dressing.
Download foldable IFU printout sheet

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