Brands Of Syringes Research Articles

Microplastics in different nasal irrigation options.

We aimed to assess the presence of microplastics in nasal irrigation methods commonly used in the treatment of sinusitis and rhinitis, and to evaluate human exposure. A total of 150 samples were included in the study, consisting of nasal wash bottles containing nasal irrigation solution, seawater spray, syringes for nasal irrigation with isotonic solution. The amount of microplastics per millilitre in the samples and patient exposure during single use were assessed separately for each method and product. All samples were filtered using a stainless steel vacuum filter on filter paper with a pore size of 1.2μm, washed at least three times with distilled water and incubated at 45°C for 24h to prevent mould growth. Identification and counting of microplastics was performed using a Leica Flexacam C1 camera connected to an M80 stereomicroscope. The presence of microplastics was confirmed by the hot needle method and Nile red staining. An average of 6.49 ± 13.08 microplastics/product was detected in all filtered samples. The lowest microplastic count was 0 microplastics/product in syringes and the highest was 92 microplastics/product in nasal wash bottles. Significant differences in the amount of microplastics individuals were exposed to during a single use were found between nasal wash bottles and seawater brands, while no significant differences were found between syringe brands. When nasal wash kits, seawater sprays and isotonic nasal rinses were evaluated separately, significant differences were found in the number of microplastics, the microplastics/ml ratio and the number of microplastics exposed during a single use. The highest microplastic exposure was found in nasal irrigation bottles. The exposure of individuals to microplastics increases with medical support treatments, regardless of intranasal or intravenous administration. Due to the inflammation, oxidative stress and proliferation caused by microplastics, new regulations and inspections of production conditions should be implemented worldwide to reduce exposure.

Stability of Epinephrine, Norepinephrine, and Phenylephrine for Intravenous Infusions Stored in Three Commercial Plastic Syringe Brands.

Stability of Epinephrine, Norepinephrine, and Phenylephrine for Intravenous Infusions Stored in Three Commercial Plastic Syringe Brands.

The Cost of Safe Injection: Insights on Nonprescription Syringe Price Variability From Systematic Secret Shopping.

Although the sale of nonprescription syringes in pharmacies is legal in most states, people who inject drugs (PWID) continue to face obstacles to syringe purchase like stigma, prohibitive costs, restrictive policies, and stocking issues. We examined the consistency of syringe pricing as another possible barrier. We analyzed data on syringe prices and other relevant variables from 153 unique secret shopper visits to 2 retail chain pharmacies in Massachusetts (MA), New Hampshire (NH), Oregon (OR), and Washington (WA) as part of the fidelity component of a large pharmacy-focused intervention study. Pretax prices from purchases made between August 2019 and May 2021 were adjusted for inflation to 2022 dollars, and a linear regression of the price of a 10-pack of syringes was constructed to examine the determinants of syringe pricing. The average real price of a 10-pack of syringes across all states was $4.53 (SD = 0.99), with wide variability between pharmacies (max = $11.44, min = $1.70) and between states (mean OR = $5.76, WA = $4.74, MA = $4.33, NH = $4.30). Forty-seven percent (n = 72) of the purchases were taxed despite syringes being tax exempt in MA and WA, and not having a sales tax in NH or OR. The results of the regression suggest that certain needle gauges were associated with lower overall prices, while 1 pharmacy chain and 2 syringe brands were associated with higher overall prices. The high variability in syringe pricing presents another barrier to pharmacy-based syringe access since high prices may leave PWID no choice but to reuse or share needles, especially in areas with limited alternatives or without a syringe service program. Leadership from healthcare systems, pharmacy chains, and state and local policymakers is essential to reduce stigma and to implement policies that streamline syringe purchases, eliminate the taxation of exempt syringes in accordance with state laws, and reduce the variation in syringe prices.

10 clinical tips for advancing patient safety when using syringe pump systems for microinfusion intravenous drug therapy.

10 clinical tips for advancing patient safety when using syringe pump systems for microinfusion intravenous drug therapy.

The Performance Analysis of the Infrared Photodiode Sensor to Infusion Set on Infusion Device Analyzer Machine

Infusion pumps and syringe pumps are devices used to administer liquid medicines to patients. The frequency of using the infusion pump and syringe pump in the long term will affect the accuracy of the tool. Accuracy is very important in dosing to patients in critical conditions who require intensive care to prevent fluid balance in the body. Therefore, periodic calibration of medical devices is required at least once a year. Calibration according to Permenkes No. 54 of 2015 is a calibration activity to determine the correctness of a tool. The purpose of this research is to make an Infusion Device Analyzer (IDA) with a TFT LCD displaying a graph of flowrate parameters. The method used is to analyze the flowrate value using an infrared photodiode sensor and can see the stability of the flowrate graph on a 7-inch TFT LCD from the use of 2 brands of syringes and an infusion set. The results obtained can be stored on the SD Card. The measurement results show that the error in the performance of the syringe and infusion pump read by the module on Channel 1 with the Terumo syringe is 0.15 (10 ml/h), 0.1 (50ml/h) and 0.03 (100ml/h). . On Channel 2 it is 0.02(10ml/hour), 0.03 (50ml/hour) and 0.04(100ml/hour). When using the B-Braun Channel 1 syringe, 0.25 (10ml/h), 009(50ml/h) and 0.08(100ml/h) are used. And on Channel 2 it is 0.62 (10ml/h), 0.15 (50ml/h), and 7.3 (100ml/h). When using the Terumo Channel 1 brand infusion set at 0.05 (10ml/h), 0.3(50ml/h), and 0.04(100ml/h). On Channel 2 it is 0.14(10ml/hour), 0.02 (50ml/hour) and 0.18 (100 ml/hour). When using the B-Braun Channel 1 Infusion Set, it is 0.07(10ml/h), 0.02(50 ml/h), and 0.03 (100ml/h). Then on Channel 2 0.07 (10ml/hour), 0.02(50 ml/hour), and 0.1(100ml/hour). The conclusion of this study is that the use of 2 different infusion sets greatly affects the readings, other than that other factors can also affect the readings including the position of the hose and the placement of sensors on each channel. From the manufacture of this tool, it is expected that users can be more efficient in using a 2-channel Infusion Device analyzer which can be run at the same time.

Identification of extractables by liquid chromatography-high resolution mass spectrometry: A case study to understand the extraction profile of different disposable syringes

The current study was undertaken to evaluate clinical-grade disposable syringes of various brands based on the identification of an extraneous impurity leaching out from the rubber gasket of the syringe during sample preparation for liquid chromatography method development. The syringes were evaluated using aqueous and organic solvents and their mixtures to understand susceptibility towards extractables. It was observed that the extraction propensity of different brands of syringes was varying in terms of number and levels of extractables. A total of eight extractables (including the extraneous impurity observed during method development) were identified from the syringe gaskets with the help of liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS), nuclear magnetic resonance (NMR) and/or infrared (IR) spectroscopy. To the best of authors' knowledge, four out of eight proposed extractables are not reported in the literature. A tentative pathway for the formation of the extractables was also proposed.

Flow irregularities from syringe infusion pumps caused by syringe stiction.

The current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringes at various infusion rates and filling positions. Fluid delivery from three 50-mL infusion syringe brands (BD; Codan; Fresenius) was investigated using a flow sensor at flow rates of 0.5, 1.0, or 5.0mLh-1 , with the syringes filled with either 10, 30, or 50mL of distilled water. Two identical models (A/B) of the same infusion pump model were used. The effect of flow rate variations on the plasma concentration of a continuous epinephrine infusion in a 3kg neonate receiving a continuous infusion of 0.1μgkgmin-1 epinephrine was studied using a pharmacokinetic simulation model. Considerable variations in calculated plasma epinephrine concentration were detected between flow rates of 5 and 0.5 or 1mLh-1 for all syringe types and filling volumes. The median deviation of plasma concentration for the 5mLh-1 flow rate varied depending on assembly from 1.3% (Codan) to 1.8% (Fresenius). This was more pronounced for lower flow rates, where at 1mLh-1 the deviation varied from 3.3% (BD) to 4.8% (Fresenius) and at 0.5mLh-1 from 4.9% (BD) to 5.4% (Fresenius). Differences between filling volumes (within syringe type and flow rate) did not appear to have relevant influence on variations in calculated plasma epinephrine concentration. Infusion set rate rather than syringe brand or filling volume was a major predictor for syringe stiction-related amount of variation in the calculated plasma epinephrine concentration.

Systematic Assessment of the Adsorption of 99mTc-Radiopharmaceuticals onto Plastic Syringes.

The phenomenon of adsorption of several 99mTc-radiopharmaceuticals onto disposable syringes is common knowledge and can reach a level of up to 50%, with the result being inadequate dosing. The resulting underdosing has a substantial influence on the quality of imaging, especially in pediatric patients. Therefore, we aimed to establish a standardized in vitro assessment to investigate the adsorption of several 99mTc-radiopharmaceuticals on various brands of syringes. Methods: The 99mTc-radiopharmaceuticals were prepared according to manufacturer instructions. For the assessment, the disposable syringes (n = 3) were filled to one third of capacity with the 99mTc preparation and incubated for 30 min at room temperature. The syringes were emptied into evacuated vials, and the radioactivity of the syringes was measured before and after they were emptied. Furthermore, the dilution effect of 99mTc preparations was studied. We used 2 different brands of syringes and systematically examined 99mTc-pertechnetate, 99mTc-butedronate, 99mTc-oxidronate, 99mTc-medronate, 99mTc-tetrofosmin, 99mTc-sestamibi, 99mTc(V)-dimercaptosuccinic acid, and 99mTc-succimer. Additionally, 99mTc-succimer was retested with 5 brands of syringes. Results: 99mTc-pertechnetate, 99mTc-phosphonates, and 99mTc(V)-dimercaptosuccinic acid showed no significant adsorption. The measured radioactive retention of 2%-5% was equivalent to the determined dead volume. Using 99mTc-tetrofosmin, we found a slight but significant adsorption of 4%-7%. The 99mTc-sestamibi preparation showed a nonsignificant retention of 3%-5%. However, when the 99mTc-sestamibi was diluted 1:10 with saline, the adsorption rate increased to 9%-13%. 99mTc-succimer displayed different adsorption levels depending on the brand of syringe and the preparation technique. The adsorption of 99mTc-succimer, prepared from kits according to the instructions, did not exceed 15%. The 1:10 saline dilution of a 99mTc-succimer kit preparation, as well as an in-house preparation, demonstrated a radioactive syringe adsorption rate of more than 30%. Conclusion: The results revealed the significance of syringe adsorption of radiopharmaceuticals in the prevention of underdosing. Therefore, a quality assurance assessment is recommended before the introduction of new brands of plastic syringes or routine application of diluted or in-house radiopharmaceuticals.

Release of silicone oil and the off-label use of syringes in ophthalmology

Background/aimsTo assess silicone oil (SO) release by different brands of syringes used for intravitreal injection under different handling conditions.MethodsEight syringes were analysed: from the USA, Terumo 0.5 mL, Becton-Dickinson (BD)...

A systematic review of epinephrine stability and sterility with storage in a syringe

BackgroundEpinephrine is a lifesaving medication in the treatment of anaphylaxis. Epinephrine auto-injectors are the preferred method of epinephrine administration, but are not universally available or affordable. Little is known about the effects on epinephrine when it is drawn up in advance and stored as prefilled syringes.ObjectiveTo study the stability and sterility of epinephrine when stored in syringes.MethodsWe searched Embase, Medline, and Web of Science in June 2016 for all studies of epinephrine stored in syringes in concentrations between 0.1 and 1 mg/mL that measured epinephrine stability and/or sterility over time, regardless of date published or language.ResultsThree studies were included, one testing two concentrations of epinephrine. Only one study tested epinephrine 1 mg/mL, the concentration clinically relevant for intramuscular use during anaphylaxis. Neither this study nor the one study testing 0.7 mg/mL epinephrine found significant degradation after 56 and 90 days, respectively. One of the two studies testing epinephrine at a concentration of 0.1 mg/mL found significant degradation by 14 days; the other found no degradation up to 168 days. Two studies tested for bacterial growth, with none detected after 28 and 90 days, respectively. One study tested for fungal growth, with none detected after 90 days.ConclusionsLimited evidence suggests that syringes filled with 1 mg/mL epinephrine are stable and sterile for 90 days. More research is needed testing the duration of stability and sterility of prefilled syringes with the 1 mg/mL concentration most commonly used in anaphylaxis, testing more extensively in different storage conditions and across a wider range of marketed syringe brands.

Release of silicone oil droplets from syringes

BackgroundIntravitreal silicone oil droplets have been found in the vitreous. The aim of this study is to compare the rates of silicone oil released by different brands of commonly used syringes for intravitreal injection after agitation by flicking.MethodsThree models of two brands of syringes were analyzed for their rates of silicone oil release: Saldanha Rodrigues (SR) 1 mL insulin syringe (SR, Brazil, syringe 1), Becton–Dickinson (BD) Plastipak 1 mL insulin syringe (Brazil, syringe 2), and BD Safety-Glide 1 mL insulin syringe (USA, syringe 3). All syringes were tested under four different conditions: positive control (fluid with addition of silicone oil) without agitation (group 1, n = 5); positive control with agitation (group 2, n = 3); fluid only without agitation (group 3, n = 5); and fluid only with agitation (group 4, n = 5). Masked graders performed all analyses using light microscopy.ResultsAll syringes (1, 2, and 3) released silicone oil droplets in the positive control group regardless of the agitation status (groups 1 and 2). When no oil was added and the syringes were not agitated, only syringe 1 released silicone oil droplets (40% of samples). After agitation, syringes 1 and 3 released silicone oil droplets in all samples. Quantitative analysis showed a significantly (P = 0.011; 11.2 ± 2.9 vs. 0.6 ± 0.9, respectively) higher mean number of silicone oil droplets released by syringe 1 after agitation compared to no agitation. Syringe 1 also had significantly (P = 0.002, 11.2 ± 2.9 vs. 0.0 ± 0.0 vs. 2.2 ± 0.8, respectively) more droplets than syringes 2 and 3 after agitation.ConclusionsSyringes commonly used for intravitreal injections frequently release silicone oil droplets when agitated by flicking, especially the SR insulin ones. We recommend that they not be agitated at the time of intravitreal injection and that the manufacturers consider producing syringes adapted for intraocular use.

Evaluation of a low-cost, low-power syringe pump to deliver magnesium sulfate intravenously to pre-eclamptic women in a Malawian referral hospital

BackgroundMagnesium sulfate is an affordable and effective treatment for pre-eclampsia and eclampsia. In settings where infusion pumps are not available to regulate the flow rate of intravenous delivery, healthcare providers must administer magnesium sulfate (MgSO4) via time-consuming and painful, large-volume intramuscular injections. As an alternative to costly commercially available syringe pumps, we developed AutoSyp, an accurate, low-cost, and low-powered syringe pump designed to meet the needs and constraints these low-resource settings. This paper describes results of a pilot study to evaluate the feasibility of using AutoSyp to administer MgSO4 intravenously to women suffering from pre-eclampsia at a referral hospital in Blantyre, Malawi.MethodsAutoSyp was programmed to deliver MgSO4 following the Zuspan regimen to pregnant and post-partum women suffering from pre-eclampsia at Queen Elizabeth Central Hospital in Blatnyre, Malawi. Given the selection of either loading or maintenance dose on AutoSyp’s user interface, the flow rate was automatically programmed to dispense 60 mL/h or 5 mL/h of 20% MgSO4 solution, respectively. During each treatment, the dispensed volume was automatically calculated by the device based on the plunger position and stored on a computer for accuracy analysis of the mean flow rate and total volume delivered. The clinical results for both the loading and maintenance dose administrations were compared to the device’s accuracy during tests performed in the laboratory setting.ResultsTwenty-two women were enrolled in this study. In both the clinical and laboratory settings, the mean flow rate errors for the loading and maintenance dose infusions were under 2%. During 466 h of testing, the device sounded 129 occlusion alarms across 14 subjects. Of these, 71 alarms were false positives.ConclusionResults of this study support the use of AutoSyp as a less painful and accurate means of MgSO4 administration in clinical environments that lack infusion systems.There were a large number of false alarms in the current system which will be addressed in future designs. AutoSyp maintains the comfort of intravenous MgSO4 administration, but unlike commercially available syringe pumps, it is capable of operating with a variety of syringe brands and sizes and requires no additional consumables. AutoSyp’s appropriate design will benefit its implementation and sustained use in low-resource settings.Trial RegistrationTrial registered prospectively on November 18, 2014 with ClinicalTrials.gov (NCT02296931)

Accuracy of enteral syringes with commonly prescribed paediatric liquid medicines

ObjectiveOral syringes are the preferred method for delivering paediatric enteral drugs; however, little is known about factors affecting accuracy, particularly at volumes <5 mL. We investigated volumetric accuracy for enteral...

ACCURACY OF ENTERAL SYRINGES FOR LIQUID MEDICINES PRESCRIBED IN CHILDREN

AimTo investigate the accuracy of two main brands available in UK hospitals of enteral syringes of different sizes, in delivering a range of clinically relevant volumes of commonly prescribed paediatric...

Syringe drivers: incorrect selection of syringe type from the syringe menu may result in significant errors in drug delivery.

There have been many reported adverse incidents due to syringe driver use, most of which have been attributable to human error. In this paper we present a previously unreported, but potentially widespread practice which may result in significant over or under-delivery of medication. Even with the naked eye it is evident that syringes of equal volume have different dimensions and to quantify this we sectioned a range of syringes and measured the inner and outer dimensions. Extensive menus for syringe brand and volumes are available on syringe drivers, offering users greater flexibility. However, this feature also allows users to select an incorrect syringe brand with potential consequences for drug delivery. We measured outputs under all selectable permutations, to determine the degree of fluid delivery variation and discovered inaccuracies in volumes ranging from 10% under-delivery to 24% over-delivery. There is a wide variation in syringe metrics and complex syringe menus may increase errors, resulting in significant under or over-delivery of medication. Availability of more than one brand of syringe in a clinical area increases the risk of adverse drug delivery events. Systems need to be implemented to minimise the risk of adverse events.

Accuracy and Reproducibility of Seven Brands of Small-Volume Syringes Used for Intraocular Drug Delivery

Little is known about the accuracy and precision of syringes used to deliver small-volume intravitreal injection of medication. The authors investigated the accuracy and reproducibility of seven brands of small-volume syringes used for intravitreal injection. This experimental laboratory investigation compared EXELint 1 cc TB, BD Luer-lok, BD 1 cc TB, Kendall Monoject TB, Nipro TB, Terumo 1 cc, and Terumo 0.5 cc syringes. A calibrated Pipetman served as a control. One hundred syringes of each brand delivered 0.05 mL and 0.10 mL distilled water onto a balance. One-sample t-test (P < .01) compared delivered and intended volumes. The Nipro TB was the most accurate syringe at 0.05 mL. All other brands over-delivered the target volume. At 0.10 mL, the BD Luer-lok and Nipro TB were the most accurate. BD Luer-lok over-delivered while Nipro TB under-delivered, but these deviations were not statistically significant. The Pipetman control was the most accurate and reproducible device at both volumes. Nipro TB was the most accurate syringe at both volumes. Terumo 0.5 cc gave the most reproducible results but lacked accuracy. These findings may affect treatment efficacy and explain variability in treatment responses. Industry-standardized delivery devices may increase the accuracy and reproducibility of medication delivery.

False selection of syringe-brand compatibility and the method of correction during target-controlled infusion of propofol

BackgroundWe evaluated volumetric differences of syringe brand compatibilities, and investigated the impact of false brand settings on target-controlled infusion (TCI) and their methods of correction.MethodsGravimetric measurement of 10 ml bolus infusions was performed using BD Plastipak (BDP) and Terumo compatible syringes, while setting to 7 different kinds of brand compatibilities (BDP, Sherwood Monoject, BD Perfusion, Braun Perfusor, Braun Omnifix, Fresenius Injectomat, and Terumo). To investigate the performance of TCI using BDP with a false setting to Terumo (BDPTERUMO) and Terumo to BDP (TERUMOBDP), 24 TCI targeting 4.0 µg/ml of effect-site concentration (Ceff) of propofol were performed. Subsequently, another 24 TCI were evaluated for simple corrections of false settings at 30 min. We also investigated 24 TCI using active corrections (fill-up for BDPTERUMO, evacuation for TERUMOBDP) based on the pharmacokinetics of propofol. The Ceff at 30 min of TCI and time to normalize to ± 5% of target concentration (T±5%target) were compared.ResultsThe Ceff of BDPTERUMO showed negative bias and 17.2% inaccuracy, and the Ceff of TERUMOBDP showed positive bias and 19.5% inaccuracy. The Ceff at 30 min showed no difference between the methods of correction in BDPTERUMO or TERUMOBDP. The T±5%target in both the active corrections was significantly shorter than that of each simple corrections (P < 0.001).ConclusionsFalse brand setting of syringe proportionally maintained different predicted concentrations as much as the volumetric differences of syringe brand. Based on the results, it is proposed that correction methods based on pharmacokinetics could effectively normalize the differences, without giving up the wrong TCI.

Experimental investigation of needles, syringes and techniques for intravitreal injections

To assess the techniques and materials used in intravitreal injections. Descriptive study realized at the Vision Institute of the Federal University of São Paulo, Brazil. Different brands of needles and syringes, as well as enucleated porcine eyeballs. The ultra-structures of commonly used needles were analysed by scanning electron microscope, and they were compared using different criteria, such as irregularities and debris from the lubrication process. The scleral incision was also assessed using needles of different brands and sizes. Accuracies in drug administration were studied by comparing the residual and delivered volume of needles and also by the analysis of reflux after intravitreal injections. Efficiency and quality of materials used in intravitreal injections. Ultra-structure analyses showed that all needles had different types of irregularities. Some photographs showed debris from the lubrication process, especially in BD needles. Scleral incision analysis showed a tendency of reducing the ocular damage with increasing gauge (P=0.024). The investigation of delivery accuracy showed that almost all needles underdosed the amount injected (P<0.05), and that the reflux could be minimized by tunnelled injections with thinner needles. Needles used in intravitreal injections possess many irregularities in their structures, which may cause different injection outcomes. Analyses of scleral incisions showed that the larger the needle gauge, the lesser the scleral damage and the risk of complications. Moreover, drug administration inaccuracies might be one of the causes for some unsuccessful attempts of treatment.

TOXIC VITREITIS OUTBREAK AFTER INTRAVITREAL INJECTION

To report clinical and epidemiologic findings of 11 patients with severe intraocular inflammation after intravitreal injection. This is a single-center, retrospective, interventional case series of 11 patients with severe intraocular inflammation after intravitreal injection at 1 referral center. The clinical data of all patients (3,357) who underwent intravitreal injection between February 2007 and February 2008 were analyzed. All incidents of postoperative intraocular inflammatory reaction were documented. During the examination period, we identified 11 cases of intraocular inflammation after intravitreal injection. Only one thereof was infectious endophthalmitis with retinal abscess. All others were toxic vitreitis. Seven eyes exhibited hypopyon and five disseminated retinal hemorrhages. The toxic reaction occurred within 48 hours after injection, whereas in the endophthalmitis case, it occurred after 72 hours. We believe that the cause of this reaction was the particular syringe brand used. After changing to another syringe brand, no further cases of toxic vitreitis occurred during the next 6 months. Toxic inflammatory reaction is not only a complication of cataract surgery, but may also occur after intravitreal injection. A critical review of all processes involved and materials used would help to prevent further cases of toxic vitreitis.

The Ergonomics of Retraction: A Comparison of Two Brands of Retractable Syringes

The Ergonomics of Retraction: A Comparison of Two Brands of Retractable Syringes