Patent Publication Number: US-2023157725-A1

Title: Powered driver actuated by force on driveshaft and related kits, components, and methods

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation application of U.S. patent application Ser. No. 16/875,338 filed May 15, 2020, which is a continuation application of U.S. patent application Ser. No. 16/135,161 filed Sep. 19, 2018, now U.S. Pat. No. 10,653,448, which is a continuation application of U.S. patent application Ser. No. 14/624,219 filed Feb. 17, 2015, now U.S. Pat. No. 10,092,320, which claims priority from U.S. Provisional Patent Application No. 61/940,741 filed Feb. 17, 2014 and U.S. Provisional Patent Application No. 61/945,325 filed Feb. 27, 2014, the entire contents of which are incorporated herein by reference. 
    
    
     FIELD OF INVENTION 
     The present invention is generally related to powered drivers and more particularly, but not by way of limitation, to powered drivers actuated by a force on a driveshaft (e.g., for inserting an intraosseous device into a patient&#39;s bone). 
     BACKGROUND 
     Examples of powered drivers for inserting an intraosseous device are disclosed in U.S. patent application Ser. No. 12/025,580, which is published as Pub. No. US 2008/0221580. 
     SUMMARY 
     Embodiments of the present drivers and kits can be configured to assist a user with inserting an intraosseous (IO) device into a patient&#39;s bone. 
     Some embodiments of the present apparatuses or drivers comprise: a housing having a distal end and a proximal end; a motor disposed in the housing; a driveshaft extending outward from the distal end of the housing in a direction away from the proximal end; a gearbox coupled to the motor and to the driveshaft such that activation of the motor will cause rotation of the driveshaft; and a battery configured to power the motor; where the gearbox is slidably disposed in the housing and configured such that, upon application of a threshold force on the driveshaft in the direction of the proximal end of the housing, the driveshaft and gearbox will slide toward the proximal end of the housing and thereby close an electrical circuit between the motor and the battery. In some embodiments, the driveshaft is biased in the direction of the distal end of the housing (e.g., by a spring disposed between the gearbox and the distal end of the housing). 
     Some embodiments of the present drivers further comprise: a switch coupled to the battery and the motor, the switch disposed between the proximal end of the housing and at least a portion of the gearbox; where the switch is configured to close the circuit upon application of the threshold force on the driveshaft. In some embodiments, the switch is disposed between the motor and the proximal end of the housing. In some embodiments, the switch comprises a base and plunger axially movable relative to the base. In some embodiments, the motor and gearbox are coupled in fixed axial relation to each other and are together slidable within the housing. In some embodiments, the motor and gearbox are biased in the direction of the distal end of the housing (e.g., by a spring disposed between the motor and the distal end of the housing). 
     In some embodiments of the present drivers, the housing defines a primary portion extending between the distal end and the proximal end, and a handle portion extending laterally from the primary portion at a non-parallel angle relative to a longitudinal axis of the primary portion. In some embodiments, at least a portion of the driveshaft has an equilateral polygonal cross-sectional shape. In some embodiments, the at least a portion of the driveshaft has a pentagonal cross-sectional shape. 
     Some embodiments of the present drivers further comprise: an electrical lockout comprising a strip configured to be removably inserted into the housing between two electrically conductive portions of the electrical circuit to prevent the apparatus from energizing during sterilization. In some embodiments, the strip comprises a polymer (e.g., Mylar). 
     Some embodiments of the present drivers further comprise: a mechanical lockout including a tab configured to be removably inserted into the housing proximal to at least a portion of the driveshaft such that upon application of the threshold force on the driveshaft in the direction of the proximal end of the housing, the mechanical lockout prevents the driveshaft and gearbox from sliding toward the proximal end of the housing and thereby prevents the driveshaft and gearbox from closing the electrical circuit between the motor and the battery. In some embodiments, the mechanical lockout includes a needle cover. Some embodiments further comprise: an electrical lockout comprising a strip configured to be removably inserted into the housing between two electrically conductive portions of the electrical circuit to prevent the apparatus from energizing during sterilization; where the mechanical lockout is coupled to the electrical lockout. 
     Some embodiments of the present kits comprise: an embodiment of the present apparatuses; and an intraosseous device comprising a connector configured to be coupled to the driveshaft of the driver. In some embodiments, the connector comprises a recess configured to receive a distal end of the driveshaft. In some embodiments, the intraosseous device comprises: a hub; a cannula extending from the hub to a distal end spaced from the hub; and a trocar extending from the connector to a distal end spaced from the connector; where the cannula is configured to be inserted into the cannula and the connector coupled to the hub to hold the trocar in fixed relation to the cannula. In some embodiments, connector is configured to be coupled to the hub by a Luer lock connector. In some embodiments, the connector comprises a female threaded portion surrounding a portion of the trocar, the hub comprises a male threaded portion extending away from the distal end of the cannula, and the male threaded portion is configured to be coupled to the female threaded portion to couple the connector to the hub. 
     Some embodiments of the present methods comprise: disposing a distal end of an intraosseous (IO) device at a desired insertion site on a patient, the IO device coupled to the driveshaft of an embodiment of the present apparatuses; and applying a force to the distal end of the IO device via the housing of the driver such that the driveshaft of the driver slides toward the proximal end of the housing relative to the housing and activates the motor of the driver to rotate the driveshaft and IO device. In some embodiments, the force is applied until the IO device is inserted into a bone of the patient. In some embodiments, the desired insertion site is disposed over a proximal portion of the patient&#39;s humerus, a proximal portion of the patient&#39;s tibia, a distal portion of the patient&#39;s femur, a patient&#39;s clavicle, a patients iliac crest, or a patient&#39;s calcaneous. In some embodiments, the desired insertion site is disposed over the patient&#39;s sternum. 
     Some embodiments of the present apparatuses or drivers comprise: a housing having a distal end and a proximal end; a motor disposed in the housing; a driveshaft extending outward from the distal end of the housing in a direction away from the proximal end; a gearbox coupled to the motor and to the driveshaft such that activation of the motor will cause rotation of the driveshaft; a battery configured to power the motor; and a mechanical lockout including a tab configured to be removably inserted into the housing proximal to at least a portion of the driveshaft such that upon application of a threshold force on the driveshaft in the direction of the proximal end of the housing, the mechanical lockout prevents the driveshaft and gearbox from closing an electrical circuit between the motor and the battery. In some embodiments, the mechanical lockout includes a needle cover: 
     Some embodiments of the present apparatuses or drivers comprise: a housing having a distal end and a proximal end; a motor disposed in the housing; a driveshaft extending outward from the distal end of the housing in a direction away from the proximal end; a gearbox coupled to the motor and to the driveshaft such that activation of the motor will cause rotation of the driveshaft; a battery configured to power the motor; an electrical lockout comprising a strip configured to be removably inserted into the housing between two electrically conductive portions of an electrical circuit to prevent the apparatus from energizing during sterilization. 
     The term “coupled” is defined as connected, although not necessarily directly, and not necessarily mechanically; two items that are “coupled” may be unitary with each other. The terms “a” and “an” are defined as one or more unless this disclosure explicitly requires otherwise. The term “substantially” is defined as largely but not necessarily wholly what is specified (and includes what is specified; e.g., substantially 90 degrees includes 90 degrees and substantially parallel includes parallel), as understood by a person of ordinary skill in the art. In any disclosed embodiment, the terms “substantially,” “approximately,” and “about” may be substituted with “within [a percentage] of” what is specified, where the percentage includes 0.1, 1, 5, and 10 percent. 
     Further, a device or system that is configured in a certain way is configured in at least that way, but it can also be configured in other ways than those specifically described. 
     The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”), and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, an apparatus that “comprises,” “has,” “includes,” or “contains” one or more elements possesses those one or more elements, but is not limited to possessing only those elements. Likewise, a method that “comprises,” “has,” “includes,” or “contains” one or more steps possesses those one or more steps, but is not limited to possessing only those one or more steps. 
     Any embodiment of any of the apparatuses, systems, and methods can consist of or consist essentially of—rather than comprise/include/contain/have—any of the described steps, elements, and/or features. Thus, in any of the claims, the term “consisting of” or “consisting essentially of” can be substituted for any of the open-ended linking verbs recited above, in order to change the scope of a given claim from what it would otherwise be using the open-ended linking verb. 
     The feature or features of one embodiment may be applied to other embodiments, even though not described or illustrated, unless expressly prohibited by this disclosure or the nature of the embodiments. 
     Some details associated with the embodiments described above and others are described below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The following drawings illustrate by way of example and not limitation. For the sake of brevity and clarity, every feature of a given structure is not always labeled in every figure in which that structure appears. Identical reference numbers do not necessarily indicate an identical structure. Rather, the same reference number may be used to indicate a similar feature or a feature with similar functionality, as may non-identical reference numbers. The embodiments of the present assistive devices, coupler assemblies, drivers, intraosseous (IO) devices, and their components shown in the figures are drawn to scale for at least the embodiments shown. 
         FIGS.  1  and  2    depict perspective views of a first embodiment of the present drivers. 
         FIGS.  3 A and  3 B  depict a cutaway perspective view and a side view, respectively, of the driver of  FIGS.  1 - 2   . 
         FIG.  4 A  depicts an exploded and partially cutaway side view of one example of an intraosseous needle set or penetrator assembly which may be inserted into a patient&#39;s bone and, thus, into a patient&#39;s vascular system using one of the present drivers and may be included in certain ones of the present kits. 
         FIG.  4 B  depicts a partial perspective view of a connector receptacle of the IO needle set of  FIG.  4 A  that may be releasably engaged with embodiments of the present powered drivers. 
         FIGS.  5  and  6    depict side views of a second embodiment of the present drivers with an IO needle set of  FIGS.  4 A- 4 B  coupled to the driver. 
         FIG.  7    depicts a side cross-sectional view of the driver of  FIGS.  5 - 6   . 
         FIG.  8    depicts a cutaway perspective view of the driver of  FIGS.  5 - 6   . 
         FIGS.  9 A- 9 C  depict various views of another embodiment of the present drivers with a more ergonomic handle. 
         FIG.  10 A  depicts a perspective view of a mechanical lockout for use with the driver of  FIGS.  9 A- 9 C . 
         FIGS.  10 B and  10 C  depict side and perspective views, respectively, of the mechanical lockout of  FIG.  10 A  and an electrical lockout in combination with the driver of  FIGS.  9 A- 9 C . 
         FIG.  11    depicts a cross-sectional view of the lockouts of  FIGS.  10 B and  10 C  in combination with the driver of  FIGS.  9 A- 9 C . 
         FIG.  12 A  depicts a perspective view of a second embodiment of a mechanical lockout for use with the driver of  FIGS.  9 A- 9 C . 
         FIG.  12 B  depicts a side view of the mechanical lockout of  FIG.  12 A  and an electrical lockout in combination with the driver of  FIGS.  9 A- 9 C . 
     
    
    
     DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS 
     Embodiments of the present powered drivers may be used to insert an IO device incorporating teachings of the present disclosure into a selected target area or target site (e.g., in ten seconds or less). 
     Vascular system access may be essential for treatment of many serious diseases, chronic conditions, and acute emergency situations. Yet, many patients experience extreme difficulty obtaining effective treatment because of an inability to obtain or maintain intravenous (IV) access. An intraosseous (IO) space provides a direct conduit to a patent&#39;s vascular system and systemic circulation. Therefore, IO access is generally an effective route to administer a wide variety of drugs, other medications, and/or IV fluids. Rapid IO access or emergency vascular access (EVA) offers great promise for almost any serious emergency that requires vascular access to administer life-saving drugs, other medications, and/or fluids when traditional IV access is difficult or impossible. 
     Bone marrow typically includes blood, blood forming cells, and connective tissue disposed in an intraosseous space or cavity surrounded by compact bone. Long bones such as the tibia typically have an elongated central cavity filled with yellow bone marrow and adipose or connective tissue. Such cavities may also be referred to as a “medullary cavity,” “bone marrow cavity,” and/or “intraosseous space.” 
     Compact bone disposed near an anterior or dorsal surface may be referred to as “anterior compact bone” or “anterior bone cortex.” Compact bone disposed farther from the dorsal or anterior surface may be referred to as “posterior compact bone” or “posterior bone cortex.” 
     Examples of insertion sites for an IO device to establish access with a patient&#39;s vascular system include the upper tibia proximate a patient&#39;s knee, the humeral head proximate a patient&#39;s shoulder, and the patient&#39;s sternum. Availability of multiple intraosseous insertion sites and associated target areas in adjacent bone marrow have proven to be particularly important in applications such as emergency treatment of battlefield casualties or other mass casualty situations. Teachings of the present disclosure may be used to obtain intraosseous access at a wide variety of insertion sites and target areas. 
     IO access may be used as a “bridge” for temporary fluid and/or drug therapy during emergency conditions until conventional IV sites can be found and used. Conventional IV sites often become available because fluids and/or medication provided via IO access may stabilize a patient and expand veins and other portions of a patient&#39;s vascular system. IO devices and associated procedures incorporating teachings of the present disclosure may become standard care for administering medications and fluids in situations when IV access is difficult or otherwise impossible. 
     Intraosseous access may be used as a “routine” procedure with chronic conditions which substantially reduce or eliminate availability of conventional IV sites. Examples of such chronic conditions may include, but are not limited to, dialysis patients, patients in intensive care units, and/or epilepsy patients. Intraosseous devices and associated apparatuses incorporating teachings of the present disclosure may be quickly and safely used to provide IO access to a patient&#39;s vascular system in difficult cases, such as status epilepticus, to give medical personnel an opportunity to administer crucial medications and/or fluids. Further examples of such acute and chronic conditions are listed near the end of this written description. 
     Apparatuses and methods incorporating teachings of the present disclosure may include using a first IO needle set having (e.g., a fifteen (15) gauge) cannula with a length of approximately fifteen (15) millimeters to establish vascular access for patients weighing between approximately three (3) kilograms and thirty nine (39) kilograms. A second IO needle set having a (e.g., a fifteen (15) gauge) cannula with an approximate length of twenty-five (25) millimeters may be used to establish vascular access for patients weighing forty (40) kilograms and greater. In other embodiments, a single size of IO needle set having a (e.g., a fifteen (15) gauge) cannula with an approximate length of twenty-five (25) millimeters may be used to establish vascular access for patients weighing three (3) kilograms and greater. 
     The term “driver” may be used in this application to include any type of powered driver satisfactory for inserting an intraosseous (IO) device such as a penetrator assembly, a catheter, an IO needle, and/or an IO needle set into a selected portion of a patient&#39;s vascular system. Various techniques may be satisfactorily used to releasably engage or attach an IO device with a driver incorporating teachings of the present disclosure. A wide variety of connectors and associated connector receptacles, fittings, and/or other types of connections with various dimensions and configurations may be satisfactorily used to releasably engage an IO device with a driver. A battery powered driver incorporating teachings of the present disclosure may be used to insert an intraosseous device into a selected target area in ten (10) seconds or less. The reduced size and weight of drivers incorporating teachings of the present disclosure may accommodate use in emergency medical vehicles, in emergency crash carts at medical facilities and/or in carrying in backpacks of military personnel deployed for extended periods of time in remote locations. 
     The term “fluid” may be used in this application to include liquids such as, but not limited to, blood, water, saline solutions, IV solutions, plasma, any mixture of liquids, particulate matter, dissolved medication, and/or drugs associated with biopsy and/or aspiration of bone marrow, and/or communication of fluids with bone marrow or other target sites. The term “fluid” may also be used in this patent application to include any body fluids and/or liquids containing particulate matter such as bone marrow and/or cells which may be withdrawn from a target area. 
     The term “insertion site” may be used in this application to describe a location on a bone at which an intraosseous device may be inserted or drilled into the bone and associated bone marrow. Insertion sites are generally covered by skin and soft tissue. The term “target area” refers to any location on or within biological material, such as the biological material of a human being. 
     The term “intraosseous (IO) device” may be used in this application to include, but is not limited to, any hollow needle, hollow drill bit, penetrator assembly, bone penetrator, catheter, cannula, trocar, stylet, inner penetrator, outer penetrator, IO needle, biopsy needle, aspiration needle, IO needle set, biopsy needle set, and/or aspiration needle set operable to access or provide access to an intraosseous space or interior portions of a bone. Such IO devices may be formed, at least in part, from metal alloys such as 304 stainless steel and/or other biocompatible materials associated with needles and similar medical devices. 
     For some applications an IO needle or IO needle set may include a connector with a trocar or stylet extending from a first end of the connector. A second end of the connector may be operable to be releasably engaged with a powered driver incorporating teachings of the present disclosure. An IO needle or IO needle set may also include a hub with a hollow cannula or catheter extending from a first end of the hub. A second end of the hub may include an opening sized to allow inserting the trocar through the opening and the attached hollow cannula. The second end of the hub may be operable to be releasably engaged with the first end of the connector. As previously noted, the second end of the connector may be releasably engaged with a powered driver. A wide variety of connectors and hubs may be used with an IO device incorporating teachings of the present disclosure. The present disclosure is not limited to connector  180  or hub  200  as shown in  FIGS.  4 A and  4 B . 
     The IO device shown in  FIGS.  4 A and  4 B  is a prior art device, and the description of it is provided to give the reader context for the types of devices and components that can be used consistently with embodiments of the present drivers and kits. 
     Referring now to the drawings, and more particularly to  FIGS.  1 - 3 B , shown therein and designated by the reference numeral  10  is one embodiment of the present apparatuses or powered drivers. Powered driver  10  may be satisfactorily used to insert an intraosseous device at a desired insertion site adjacent to a bone and associated bone marrow. Powered driver  10  may include one or more of the present features. One or more additional and/or alternative ones of the present features may also be included in or with powered driver  10   a  of  FIGS.  5 - 8   . 
     In the embodiment shown, powered driver  10  includes a housing  14 , a motor  18 , a driveshaft  22 , and a gearbox  26 . Housing  14  has a distal end  30  and a proximal end  34 , and motor  18  is disposed within the housing with driveshaft  22  extending outwardly from distal end  30  of the housing in a direction away from proximal end  34  such that a distal end  38  of the driveshaft is spaced apart from distal end  30  of the housing. In the embodiment shown, gearbox  26  is coupled to motor  18  and to driveshaft  22  such that activation of the motor will cause rotation of the driveshaft (suitable gearboxes described in more detail below). In this embodiment, driver  10  also comprises a battery (e.g., two batteries  40 , as shown) configured to power motor  18  (e.g., through electrical communication between batteries  40  and motor  18 , for example, through wiring, circuitry, and/or the like). In the embodiment shown, batteries  40  comprise two 9-volt batteries which may be commercially available from a variety of suppliers and retail outlets. Other embodiments can include any suitable battery and/or combination of batteries that permit the function(s) described in this disclosure. 
     In the depicted embodiment, driver  10  does not include a “trigger” configured to be squeezed or otherwise depressed with a user&#39;s finger during use to activate the motor. Instead, in this embodiment, gearbox  26  is slidably disposed in housing  14  and configured such that, upon application of a threshold force (e.g., a force at least large enough to move the driveshaft) on driveshaft  22  in direction  42  (toward proximal end  34  of the housing), the driveshaft and gearbox will slide toward the proximal end of the housing and thereby close an electrical circuit between the motor and the battery (and thus active the motor to rotate the driveshaft). For example, in the embodiment shown, driver  10  further comprises a switch  46  (e.g., having a body  50  and a piston  54  axially movable relative to the body, as shown) that is coupled to the battery and the motor (e.g., via wires or other conductors), where the switch is disposed between proximal end  34  of the housing and at least a portion of gearbox  26 . In this embodiment, switch  46  is configured to close the circuit (e.g., between the battery and the motor upon application of the threshold force on the driveshaft). In this embodiment, motor  18  and gearbox  26  are coupled in fixed axial relation to each other and are together slidable within the housing (e.g., along axis  58 ). In this embodiment, switch  46  is disposed between motor  18  and proximal end  34  of the housing. 
     In some embodiments, gearbox  26  (and driveshaft  22 ) is biased in the direction of distal end  30  (e.g., by a spring  62  disposed between the gearbox and the distal end of the housing) such that in the absence of the threshold force on the driveshaft, the circuit remains open and the motor is not active. For example, in this embodiment, motor  18  and gearbox  26  are together biased in the direction of distal end  30  of the housing by a spring  62  disposed between body  50  of the switch (e.g., and/or one or more tabs or other portions  66  of housing  14  to which the body of the switch is mounted or otherwise supported, such as, for example, against axial movement) and motor  18 . In this embodiment, housing  14  includes one or more internal tabs or portions  70  supporting motor  18  (e.g., against lateral displacement relative to axis  58 ) and permitting the motor to slide axially along axis  58  (e.g., configured to support motor  18  in coaxial alignment with axis  58 ). In the embodiment shown, housing  14  also includes one or more internal tabs or portions  74  configured to limit the depth of slidable movement of motor  18  (and gearbox  26  and driveshaft  22 ) in direction  42 . In this embodiment, tabs  74  are disposed on opposite sides of spring  62  and extend within a cross-sectional perimeter of a proximal end of motor  18  such that tabs  74  physically limit movement of motor  18  in direction  42 . In other embodiments, housing  14  (including tabs or portions  70  and/or  74 ) can be provided in any structure or configuration that permits the operation describes in this disclosure (e.g., such that axial displacement of motor  18 , gearbox  26 , and/or driveshaft  22  is limitably permitted and lateral displacement of motor  18 , gearbox  26 , and/or driveshaft  22  is substantially restricted). 
     Spring  62  may be configured with a spring constant of between 1 and 6 pounds of force per inch (lbf/in). In various embodiments, spring  62  may be configured differently for different applications. For example, in embodiments of the present drivers that are configured for pediatric use, the spring may be configured with a spring constant of between 1 and 4 lbf/in (e.g., 2-3 lbf/in); in embodiments of the present drivers that are configured for adult tibia and/or humerous insertion, the spring may be configured with a spring constant of between 2 and 6 lbf/in (e.g., 3-5 lbf/in); and, in embodiments of the present drivers that are configured for adult sternal insertions, the spring may be configured with a spring constant of between 1 and 4 lbf/in (e.g., 2-3 lbf/in). 
     Motors and gear assemblies satisfactory for use with a powered driver incorporating teachings of the present disclosure may be obtained from various vendors. Such motor and gear assemblies are typically ordered as “sets” with one end of each motor securely attached to an adjacent end of an associated gear assembly. A driveshaft having various dimensions and/or configurations may extend from the gear assembly opposite from the motor. The gear assemblies may sometimes be referred to as “reduction gears” or “planetary gears.” The dimensions and/or configurations of an associated housing may be modified to accommodate an associated motor and gear assembly. 
     While driver  10  is configured such that motor  18 , gearbox  26 , and driveshaft  22  are axially slidable together, other embodiments may be configured such that the motor is held in a fixed axial position relative to the housing and the gearbox and the driveshaft slide relative to the motor (e.g., along a stub shaft extending from the motor), or such that the motor and gearbox are held in a fixed axial position relative to the housing and the driveshaft slides relative to the motor and gearbox, to activate the motor and rotate the driveshaft. In some embodiments, the motor is configured to rotate at a satisfactory speed and a satisfactory torque such that the gearbox can be omitted and the motor can directly drive the driveshaft. 
     In the embodiment shown, housing  14  defines a primary portion  78  extending between distal end  30  and proximal end  34 , and a handle portion  82  (e.g., having a central longitudinal axis  86 ) extending laterally from primary portion  78  at a non-parallel angle  84  (e.g., between thirty degrees (30°) and sixty degrees (60°), and in some embodiments, up to or greater than ninety degrees)(90°) relative to axis  58  of the primary portion. In this embodiment, housing  14  can be described has having the general configuration of a small pistol (e.g., housing  14  resembles a pistol-grip). Handle portion  82  may be described as an elongated, hollow container sized to receive batteries  40 , as shown. Housing  14  may be formed from relatively strong, heavy duty polymeric material. For some applications housing  14  may be formed in two halves which are joined together to form a fluid tight seal with certain components of driver  10  disposed in the housing, as shown. In some embodiments, batteries  40  are not removable from housing  14 . For example, two halves of the housing may be glued or otherwise coupled (e.g., welded) together such that the housing generally cannot be reopened (e.g., to replace batteries) without damaging the housing. In other embodiments, batteries  40  may be removable for replacement and/or recharging. 
     In the embodiment shown, distal end  30  of housing  14  includes an opening  90  with portions of driveshaft  22  extending therethrough. In the embodiments shown driver  10  further includes an O-ring (e.g., a resilient polymeric or rubber O-ring)  94  disposed around driveshaft  22  and between gearbox  26  and distal end  30  of the housing to seal opening  90 . In some embodiments, at least a portion (e.g., distal end  38 ) of driveshaft  22  has an equilateral polygonal cross-sectional shape. For example, in the embodiment shown, a portion of the driveshaft terminating in distal end  38  has a pentagonal cross-sectional shape defined by five surfaces  98 . In some embodiments, such as the one shown, surfaces  98  may be tapered and/or disposed at an angle relative to axis  58  (e.g., an angle of three degrees)(3°±two degrees (2°) relative to axis  58 ). In some embodiments, a magnet can be disposed on and/or in distal end  38  of the driveshaft (e.g., or distal end  38  may otherwise be magnetic). Fittings and/or connectors with various dimensions and/or configurations other than the depicted configuration of distal end  38  of the driveshaft may also be satisfactorily used with a powered driver incorporating teachings of the present disclosure (e.g., in the shown embodiment, distal end  38  of driveshaft  22  is configured to releasably secure IO needle set  160 , however, in other embodiments, driveshaft  22  can be configured to releasably secure other IO needle sets and comprise any associated structure). 
     In the embodiment shown, driveshaft  22  includes an annular groove  102  configured to receive O-ring  94  when driveshaft  22  is pressed fully in direction  42 , such that O-ring  94  will contract into groove  102  and prevent driveshaft  22  from returning to its extended position. This is but one example of a way in which driver  10  can be configured as a single-use driver (e.g., to permit the use of inexpensive batteries while preventing re-use to maintain efficacy and patient safety, such as, for example, where the batteries provide sufficient power to insert a single IO device but may not provide sufficient power to insert a second IO device). In other embodiments, switch  46  may be configured as a single-use switch that prevents a second activation, such as, for example, with a fuse that terminates the functionality of the switch after a single use, or a simple timer circuit that terminates the functionality of the switch after a prescribe period of time (e.g., 10 seconds) that is sufficient to insert a single IO device but not sufficient to couple a second IO device to driveshaft  22  and attempt to insert the second IO device. In other embodiments, spring  62  may comprise a collapsible member and/or otherwise be configured to irreversibly yield after compression. In yet other embodiments, similar single-use structure can be provided (e.g., alone or in addition to the above) through collapsible internal support members (e.g., collapsible internal tabs or protrusions  66 ,  70 , and/or  74 ). In further embodiments, the driver is configured to have sufficient power to insert and/or re-insert up to but not more than a threshold number (e.g., 3, 4, 5, or more) of IO devices such that a user can insert, adjust the depth of, and/or re-insert an IO device with a single driver. In other embodiments, driver  10  can be configured to allow removal of batteries  40  by pressing tabs or snaps incorporated into housing  14 . These tabs or snap can be located in the handle portion  82 , such as one tab or snap on each side of handle portion  82 . Pressing the tabs or snaps causes batteries  40  to be released from driver  10   b , such as from the bottom or back side of handle portion  82 , and can render the driver inoperable for future use. 
     Intraosseous (IO) devices having corresponding tapered openings or connector receptacles may be releasably engaged with distal end  38  of driveshaft  22 . For example, distal end  38  extending may be releasably engaged with a tapered opening (e.g.,  186 ) in a connector (e.g.,  180 ) as shown in  FIGS.  4 A and  4 B , which depict an example of an IO device or penetrator assembly  160  that is usable with driver  10 . 
     Penetrator assembly  160  as shown in  FIGS.  4 A and  4 B  may include connector  180 , associated hub  200 , outer penetrator  210 , and inner penetrator  220 . Penetrator assembly  160  may include an outer penetrator such as a cannula, a hollow tube or hollow drill bit, and an inner penetrator such as a stylet or trocar. Various types of stylets and/or trocars may be disposed within an outer penetrator. For some applications, outer penetrator or cannula  210  may be described as a generally elongated tube sized to receive inner penetrator or stylet  220  therein. Portions of inner penetrator  220  may be disposed within longitudinal passageway  184  extending through outer penetrator  210 . The outside diameter of inner penetrator  220  and the inside diameter of longitudinal passageway  184  may be selected such that inner penetrator  220  may be slidably disposed within outer penetrator  210 . 
     Metallic disc  170  may be disposed within opening  186  for use in releasably attaching connector  180  with a magnet disposed on distal end  38  of driveshaft  22  (e.g., or an otherwise magnetic driveshaft  22 ). End  223  of inner penetrator  220  may be spaced from metallic disc  170  with insulating or electrically nonconductive material disposed therebetween. In some embodiments, metallic disc  170  may be magnetic and the distal end  38  of driveshaft  22  and/or driveshaft  22  may comprise metallic materials configured to releasably attach to the magnetic metallic disc of connector  180 . 
     Tip  211  of outer penetrator  210  and/or tip  222  of inner penetrator  220  may be operable to penetrate bone and associated bone marrow. The configuration of tips  211  and/or  222  may be selected to penetrate a bone or other body cavities with minimal trauma. First end or tip  222  of inner penetrator  220  may be trapezoid shaped and may include one or more cutting surfaces. In one embodiment, outer penetrator  210  and inner penetrator  220  may be ground together as one unit during an associated manufacturing process. Providing a matching fit allows respective tips  211  and  222  to act as a single drilling unit which facilitates insertion and minimizes damage as portions of penetrator assembly  160  are inserted into a bone and associated bone marrow. Outer penetrator  210  and/or inner penetrator  220  may be formed from stainless steel, titanium, and/or other materials of suitable strength and durability to penetrate bone. 
     Hub  200  may be used to stabilize penetrator assembly  160  during insertion of an associated penetrator into a patient&#39;s skin, soft tissue, and adjacent bone at a selected insertion site. First end  201  of hub  200  may be operable for releasable engagement or attachment with associated connector  180 . Second end  202  of hub  200  may have a size and configuration compatible with an associated insertion site for outer penetrator  210 . The combination of hub  200  with outer penetrator  210  may sometimes be referred to as a “penetrator set” or “intraosseous needle.” 
     Connector  180  and attached inner penetrator  220  may be releasably engaged with each other by Luer type fittings, threaded connections, and/or other suitable fittings formed on first end  201  of hub  200 . Outer penetrator  210  extends from second end  202  of hub  200 . 
     For some applications connector  180  may be described as a generally cylindrical tube defined in part by first end  181  and second end  182 . The exterior of connector  180  may include an enlarged tapered portion adjacent to end  181 . A plurality of longitudinal ridges  190  may be formed on the exterior of connector  180  to allow an operator to grasp associated penetrator assembly  160  during attachment with a driveshaft. Longitudinal ridges  190  also allow connector  180  to be grasped for disengagement from hub  200  when outer penetrator  210  has been inserted into a bone and associated bone marrow. 
     Second end  182  of connector  180  may include opening  185  sized to receive first end  201  of hub  200  therein. Threads  188  may be formed in opening  185  adjacent to second end  182  of connector  180 . Threads  188  may be used in releasably attaching connector  180  with threaded fitting  208  adjacent to first end  201  of hub  200 . 
     First end  201  of hub  200  may include a threaded connector  208  and/or other suitable fittings formed on the exterior thereof. First end  201  may have a generally cylindrical pin-type configuration compatible with releasably engaging second end or box end  182  of connector  180 . 
     For some applications end  202  of hub  200  may have the general configuration of a flange. Angular slot or groove  204  sized to receive one end of protective cover or needle cap  234  may be formed in end  202 . Slot or groove  204  may be used to releasable engage needle cover  234  (shown in  FIG.  5   ) with penetrator assembly  160 . 
     For some applications a penetrator assembly may include only a single, hollow penetrator. For other applications a penetrator assembly may include an outer penetrator such as a cannula, a hollow needle or hollow drill bit, and an inner penetrator such as a stylet, trocar or other removable device disposed within the outer penetrator. Penetrator  210  is one example of a single, hollow penetrator or cannula. 
     The size of a penetrator may vary depending upon the intended application for the associated penetrator assembly. Penetrators may be relatively small for pediatric patients, medium size for adults, and large for oversize adults. By way of example, a penetrator may range in length from five (5) mm to thirty (30) mm. The diameter of a penetrator may range from eighteen (18) gauge to ten (10) gauge. The length and diameter of the penetrator used in a particular application may depend on the size of a bone to which the apparatus may be applied. Penetrators may be provided in a wide variety of configurations depending upon intended clinical purposes for insertion of the associated penetrator. For example, there may be one configuration for administering drugs and/or fluids to a patient&#39;s bone marrow and an alternative configuration for sampling bone marrow and/or blood from a patient. Other configurations may be appropriate for bone and/or tissue biopsy. 
     For some applications connector  180  may be described as having a generally cylindrical configuration defined in part by first end  181  and second end  182 . Exterior portions of connector  180  may include an enlarged tapered portion adjacent to end  181 . A plurality of longitudinal ridges  190  may be formed on the exterior of connector  180  to allow an operator to grasp associated penetrator assembly  160  during attachment with a drive shaft. Longitudinal ridges  190  also allow connector  180  to be grasped for disengagement from hub  200  when outer penetrator  210  has been inserted into a bone and associated bone marrow. 
     First end  181  of connector of  180  may include opening  186  sized to receive portions driveshaft  22  therein. A plurality of webs  136  may extend radially outward from connector receptacle  186 . Webs  136  may cooperate with each other to form a plurality of openings  138  adjacent to first end  181 . Opening  186  and openings  138  may cooperate with each other to form portions of a connector receptacle operable to receive respective portions of a connector (not expressly shown) therein. 
     Referring now to  FIGS.  5 - 8   ;  FIGS.  5  and  6    depict side views of a second embodiment  10   a  of the present drivers with an IO needle set  160  ( FIGS.  4 A- 4 B ) coupled to the driver (e.g., with distal end  38  of driveshaft  22  disposed in a receptacle or recess  186  of the IO needle set); 
       FIG.  7    depicts a side cross-sectional view of driver  10   a ; and  FIG.  8    depicts a cutaway perspective view of driver  10   a . Driver  10   a  is substantially similar to driver  10  with the primary exception that housing  14   a  of driver  10   a  is not configured with a pistol-grip design (e.g., does not include a handle portion that is disposed at a non-parallel angle to rotational axis  58  of the driveshaft. As such, similar reference numerals are used to designate components and assemblies that are similar and/or may even be identical (e.g., driveshaft  22  of driver  10  and driveshaft  22  of driver  10   a ) and dissimilar reference numerals are used to designate components and assemblies that necessarily differ (e.g., driver  10  and driver  10   a , housing  14  and housing  14   a ). 
     As noted, driver  10   a  primarily differs from driver  10  in that handle portion  82   a  of housing  14   a  is not disposed at a non-parallel angle relative to primary portion  78   a ; instead, handle portion  82   a  is parallel to (and, in the depicted embodiment, coaxial with) primary portion  78   a . In this embodiment, driver  10   a  comprises a switch mount  106  having a proximal end  110 , a shelf  114  spaced from proximal end  110 , and a pair of stepped motor guides  118  extending to a distal end  122  and including steps  126 . In the depicted embodiment, shelf  114  is configured to be coupled to body  50  of switch  46 , and proximal end  110  is configured to contact batteries  40  to prevent axial movement of the switch body when driver  10   a  is assembled. In this embodiment, motor guides  118  extend parallel to planar sides of motor  18  and steps  126  limit axial movement of motor  18  relative to housing  14   a  (e.g., similar to as described above for tabs  74  of driver  10 ). In this embodiment, housing  14   a  includes an open proximal end  34   a  and an end cap  130  is configured enclose the open proximal end (e.g., as shown). In the embodiment shown, end cap  130  includes barbed tabs  134  configured to extend into corresponding openings in housing  14   a  to resist separation of end cap  130  from housing  14   a . In some embodiments, end cap  130  is additionally or alternatively coupled to housing  14   a  with adhesive, welds, and/or the like such that end cap  130  is not removable from housing  14   a  without damaging end cap  130  and/or housing  14   a.    
     In operation, an IO needle set  160  can be coupled to driveshaft  22  (e.g., with needle cover  234  disposed over cannula  210  and trocar  220  and received in annular groove  204 , which is then removed prior to positioning the needle set for use). A distal end of the IO needle set can then be disposed at a desired insertion site  142  on a patient and a force applied to the distal end of the IO device via the housing of the driver such that the driveshaft of the driver slides toward proximal end  34  of the housing relative to the housing (as illustrated by the change in dimension  144  between  FIGS.  5  and  6   ) and activates the motor of the driver (e.g., via operation of switch  46 ) to rotate the driveshaft and IO device. As illustrated, the needle set may puncture skin  146  and soft tissue  150  such that the force may be applied to the IO needle set and driveshaft by a layer of cortical bone  154  responsive to the force applied by a user on the housing in the direction of the insertion site. Alternatively, the threshold force required to move driveshaft  22  toward proximal end  34  may be low enough (e.g., spring  62  may be weak enough), that driveshaft  22  begins to move before the skin is punctured or before all of soft tissue  150  is penetrated. While described with reference to driver  10   a , the function of driver  10  is substantially similar in that application of a threshold force to housing  14  in the direction of an insertion site will cause motor activation via operation of switch  46 , and thus rotation of the driveshaft and IO device. 
     Embodiments of the present kits can comprise an embodiment of the present drivers (e.g.,  10 ,  10   a ) and an IO device (e.g.,  160 ). Some embodiments of the present kits are sterile. 
       FIGS.  9 A- 9 C  depict various views of another embodiment of driver  10   b . Driver  10   b  is substantially similar in many respects to driver  10 , with the primary exceptions that: (1) handle portion  82   b  is shaped for improved ergonomics, (2) housing  14   b  includes slot  300  configured to receive a portion of a mechanical lockout to prevent accidental activation of driver  10   b  for increased safety when handling driver  10   b , and (3) housing  14   b  includes a slot  304  in handle portion  82   b  configured to receive a portion of an electrical lockout for increased safety when handling driver  10   b . In this embodiment, slot  300  is sized and positioned to allow a portion of a mechanical lockout to be inserted into housing  14   b  to prevent rearward movement of driveshaft  22  and thereby prevent closing of the electrical circuit that activates driver  10   b . Similarly, in the depicted embodiment, slot  304  is sized and positioned to allow a portion of an electrical lockout to be inserted into housing  14   b  to prevent the electrical circuit from being closed and thereby energizing driver  10   b  (e.g., to prevent activation of the driver during sterilization, packaging, transportation, or the like). 
     Referring now to  FIGS.  10 A- 10 C ,  FIG.  10 A  depicts a perspective view of a first embodiment of mechanical lockout  400  for use with driver  10   b  of  FIGS.  9 A- 9 C . In this embodiment, mechanical lockout  400  is configured to be coupled to driver  10   b  to prevent accidental activation of driver  10   b  (e.g., for increased safety when handling driver  10   b , such as during sterilization or transportation).  FIGS.  10 B and  10 C  depict side and perspective views, respectively, of mechanical lockout  400  of  FIG.  10 A , and an embodiment of an electrical lockout  500 , in combination with driver  10   b  of  FIGS.  9 A- 9 C . As shown, mechanical lockout  400  is removably engaged with driver  10   b  with tab  404  of the mechanical lockout be removably inserted into slot  300  in housing  14   b  proximal to at least a portion of driveshaft  22 . 
     For example, as illustrated in  FIG.  11   , tab  404  extends into slot  300  and is shaped to extend around and receive a reduced-diameter part of driveshaft  22  (e.g., in a recess, as shown) to physically impede rearward movement of driveshaft  22  and gearbox  26 . In other embodiments, slot  300  could be located in housing  14   b  closer to proximal end  34   b  of housing  14   b  and still physically impede rearward movement to prevent accidental activation. For instance, slot  300  can be located proximal to a portion (e.g., all) of gearbox  26 , or a portion (e.g., all) of motor  18 . In the embodiment illustrated in  FIG.  11   , upon application of a threshold force on driveshaft  22  in the direction of proximal end  34   b  of housing  14   b , mechanical lockout  400  prevents driveshaft  22  and gearbox  26  from sliding toward proximal end  34   b  of housing  14   b , which prevents driveshaft  22  and gearbox  26  from closing the electrical circuit between motor  18  and battery  40 . In this embodiment, mechanical lockout  400  also includes needle cover  408 . 
       FIG.  11    depicts a cross-sectional view of the lockouts of  FIGS.  10 B and  10 C  in combination with driver  10   b .  FIG.  11    depicts an embodiment of electrical lockout  500  for increased safety when handling driver  10   b , such as during sterilization. Electrical lockout  500  comprises flexible strip  504  that is removably inserted into slot  304  in housing  14   b  in handle portion  82   b  between two electrically conductive portions of the electrical circuit to prevent driver  10   b  from energizing during sterilization. In this embodiment, strip  504  can comprise a polymer, such as Mylar, and/or other non-conductive material. Electrical lockout  500  can be used with driver  10   b  in conjunction with any embodiment of the present mechanical lockouts (e.g., mechanical lockout  400  or mechanical lockout  400   a ). As shown, electrical lockout  500  can be coupled to mechanical lockout  400 . Coupling can be achieved, for example, by attaching strip  504  to mechanical lockout  400 , such as at the proximal end of mechanical lockout  400 , so that strip  504  and electrical lockout  500  can be removed in a single pull when removing mechanical lockout  400 . 
       FIG.  12 A  depicts a perspective view of a second embodiment of mechanical lockout  400   a  for use with driver  10   b  to prevent accidental activation of driver  10   b  (e.g., for increased safety when handling driver  10   b , such as during sterilization, transportation, or when applying a needle set  160  to driver  10   b ). Mechanical lockout  400   a  is similar to mechanical lockout  400 , but does not include a needle cover.  FIG.  12 B  depicts a side view of mechanical lockout  400   a  of  FIG.  12 A  and electrical lockout  500  in combination with driver  10   b . In other embodiments, mechanical lockout  400   a  can also be used with driver  10   b  without an electrical lockout. As depicted in  FIG.  12 B , mechanical lockout  400   a  is removably engaged with driver  10   b . Mechanical lockout  400   a  includes tab  404   a , and similar to  FIG.  11   , tab  404   a  can be removably inserted into slot  300  in housing  14   b  proximal to at least a portion of driveshaft  22 . Similar to  FIG.  11   , upon application of a threshold force on driveshaft  22  in the direction of proximal end  34   b  of housing  14   b , mechanical lockout  400   a  prevents driveshaft  22  and gearbox  26  from sliding toward proximal end  34   b  of housing  14   b , which prevents driveshaft  22  and gearbox  26  from closing the electrical circuit between motor  18  and battery  40 . 
     The above specification and examples provide a complete description of the structure and use of illustrative embodiments. Although certain embodiments have been described above with a certain degree of particularity, or with reference to one or more individual embodiments, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the scope of this invention. As such, the various illustrative embodiments of the methods and systems are not intended to be limited to the particular forms disclosed. Rather, they include all modifications and alternatives falling within the scope of the claims, and embodiments other than the one shown may include some or all of the features of the depicted embodiment. For example, elements may be omitted or combined as a unitary structure, and/or connections may be substituted. Further, where appropriate, aspects of any of the examples described above may be combined with aspects of any of the other examples described to form further examples having comparable or different properties and/or functions, and addressing the same or different problems. Similarly, it will be understood that the benefits and advantages described above may relate to one embodiment or may relate to several embodiments. 
     The claims are not intended to include, and should not be interpreted to include, means-plus- or step-plus-function limitations, unless such a limitation is explicitly recited in a given claim using the phrase(s) “means for” or “step for,” respectively.