Needle Insertion Research Articles

Pain management associated with arteriovenous fistula cannulation among children undergoing haemodialysis: Systematic review.

To evaluate studies related to pain management associated with arteriovenous fistula cannulation among children. The systematic review comprised literature search on Embase, ProQuest, Science Direct, Scopus, SpringerLink and Wiley Online databases for studies published in English between 1998 and 2021. The search used key words, including pain management OR analgesia AND child OR paediatric AND haemodialysis OR dialysis AND arteriovenous fistula OR arteriovenous fistula cannulation OR fistula needle OR arteriovenous fistula insertion OR needle insertion. The quality of the studies was evaluated using the Joana Briggs Institute checklist. General characteristics of the and pain outcomes were noted. Of the 2,877 studies initially identified, 8(0.27%) were analysed; 7(87.5%) quasi-experimental and 1(12.5%) randomised controlled trial. Overall, there were 283 participants aged 6-18 years. The strategies used for reducing arteriovenous fistula puncture-related pain among children undergoing haemodialysis included cryotherapy, lidocaine agents, virtual reality (VR), guided visualisation, balloon inflation, aromatherapy, and other programmed distractions. The strategies had a positive effect on reducing arteriovenous fistula cannulation-related pain among children. Non-pharmacological pain management is an easier, simpler, inexpensive and more effective method of atraumatic care among children undergoing haemodialysis.

Assessing the Premedication Properties of Sublingual Melatonin in Young Women Undergoing Cesarean Section With Spinal Anesthesia: A Double-Blind Randomized Study.

Preoperative anxiety can negatively impact patient outcomes by influencing the intraoperative requirements for anesthetics and analgesics, increasing postoperative pain intensity, and augmenting the need for analgesia. Moreover, it may contribute to higher rates of postoperative morbidity and mortality following certain types of surgery. This study investigates the anxiolytic and sedative properties of sublingual melatonin as a premedication agent in young females undergoing cesarean section under spinal anesthesia. A double-blind, randomized, placebo-controlled trial was conducted in Nasiriyah, Iraq. Eighty females were included, 40 in each group, based on specific inclusion and exclusion criteria. Premedication was administered in the morning, 60 minutes before the procedure. In the melatonin group (M), patients received 10 mg of sublingual melatonin, while the placebo group (P) received placebo premedication. Anxiety and sedation levels were evaluated three times: before taking premedication, five minutes before the insertion of the spinal needle, and one hour postoperatively, using the visual analog scale and Richmond Sedation Scale. The results show a highly significant P-value regarding anxiety levels between the M Group and P Group (p-value < 0.001). There was a significant difference in the median sedation scores between the studied groups at pre-spinal insertion and postoperatively (p-value < 0.001). The mean heart rate in the M Group was significantly lower than in the P Group (p-value = 0.0019). Significant differences were noted in systolic and diastolic blood pressures between the two groups, measured five minutes before and after spinal needle insertion (p-value < 0.001). These findings contribute to understanding the impact of sublingual melatonin as an anxiolytic and sedative premedication agent on patients undergoing elective cesarean sections under spinal anesthesia. Further research is warranted to fully elucidate the benefits and implications of melatonin administration in such procedures.

Bevel-Tip Needle Deflection Modeling, Simulation, and Validation in Multi-Layer Tissues.

Percutaneous needle insertions are commonly performed for diagnostic and therapeutic purposes as an effective alternative to more invasive surgical procedures. However, the outcome of needle-based approaches relies heavily on the accuracy of needle placement, which remains a challenge even with robot assistance and medical imaging guidance due to needle deflection caused by contact with soft tissues. In this paper, we present a novel mechanics-based 2D bevel-tip needle model that can account for the effect of nonlinear strain-dependent behavior of biological soft tissues under compression. Real-time finite element simulation allows multiple control inputs along the length of the needle with full three-degree-of-freedom (DOF) planar needle motions. Cross-validation studies using custom-designed multi-layer tissue phantoms as well as heterogeneous chicken breast tissues result in less than 1mm in-plane errors for insertions reaching depths of up to 61 mm, demonstrating the validity and generalizability of the proposed method.

Improving Needle Tip Tracking and Detection in Ultrasound-Based Navigation System Using Deep Learning-Enabled Approach.

Ultrasound-guided percutaneous interventions have numerous advantages over traditional techniques. Accurate needle placement in the target anatomy is crucial for successful intervention, and reliable visual information is essential to achieve this. However, previous studies have revealed several challenges, such as the variability in needle echogenicity and the common misalignment of the ultrasound beam and the needle. Advanced techniques have been developed to optimize needle visualization, including hardware-based and image-processing-based methods. This paper proposes a novel strategy of integrating ultrasound-based deep learning approaches into an optical navigation system to enhance needle visualization and improve tip positioning accuracy. Both the tracking and detection algorithms are optimized utilizing optical tracking information. The information is introduced into the tracking network to define the search patch update strategy and form a trajectory reference to correct tracking results. In the detection network, the original image is processed according to the needle insertion position and current position given by the optical localization system to locate a coarse region, and the depth-score criterion is adopted to optimize detection results. Extensive experiments demonstrate that our approach achieves promising tip tracking and detection performance with tip localization errors of 1.11 ± 0.59 mm and 1.17 ± 0.70 mm, respectively. Moreover, we establish a paired dataset consisting of ultrasound images and their corresponding spatial tip coordinates acquired from the optical tracking system and conduct real puncture experiments to verify the effectiveness of the proposed methods. Our approach significantly improves needle visualization and provides physicians with visual guidance for posture adjustment.

Spatial sensitivity distribution assessment and Monte Carlo simulations for needle-based bioimpedance imaging during venipuncture using the finite element method.

Despite being among the most common medical procedures, needle insertions suffer from a high error rate. Impedance measurements using electrode-equipped needles offer promise for improved tissue targeting and reduced errors. Impedance visualization usually requires an extensive pre-measured impedance dataset for tissue differentiation and knowledge of the electric fields contributing to the resulting impedances. This work presents two finite element simulation approaches for both problems. The first approach describes the generation of a multitude of impedances with Monte Carlo simulations for both, homogeneous and inhomogeneous tissue to circumvent the need to rely on previously measured data. These datasets could be used for tissue discrimination. The second method describes the simulation of the spatial sensitivity distribution of an electrode layout. Two singularity analysis methods were employed to determine the bulk of the sensitivity within a finite volume, which in turn enables consistent 3D visualization. The modeled electrode layout consists of 12 electrodes radially placed around a hypodermic needle. Electrical excitation was simulated using two neighboring electrodes for current carriage and voltage pickup, which resulted in 12 distinct bipolar excitation states. Both, the impedance simulations and the respective singularity analysis methods were compared with each other. The results show that the statistical spread of impedances is highly dependent on the tissue type and its inhomogeneities. The bounded bulk of sensitivities of both methods are of similar extent and symmetry. Future models should incorporate more detailed tissue properties such as anisotropy or changing material properties due to tissue deformation to gain more accurate predictions.

Emergency Physician Performed Ultrasound-Guided Abdominal Paracentesis: A Retrospective Analysis.

Emergency physicians commonly perform ultrasound-assisted abdominal paracentesis, using point of care ultrasound (POCUS) to identify ascites and select a site for needle insertion. However, ultrasound-guided paracentesis has the benefit of real-time needle visualization during the entire procedure. Our objective was to characterize the performance of emergency physician-performed ultrasound-guided paracentesis using POCUS, their ability to achieve good in-plane needle visualization, and factors associated with procedural success. A POCUS database was retrospectively reviewed for examinations where abdominal paracentesis was performed by an emergency physician at two academic urban emergency departments over a six-year period. Medical records were reviewed for demographics, presenting history, complications, and hospital course. Descriptive statistics were used to summarize the data. 131 patients were included in the final analysis. The success rate for ultrasound-guided paracentesis was 97.7% (84/86 [95% CI: 92-100%]) compared to 95.6% (43/45 [95% CI: 85-99%]) for ultrasound-assisted paracentesis (p=0.503). 58% (50/86) demonstrated good in-plane needle visualization; 17% (15/86) had partial or out-of-plane visualization; and 24% (21/86) did not demonstrate needle visibility on their saved POCUS images. All four procedural failures were performed by first- or second-year residents using a curvilinear transducer, while all procedures using a linear transducer were successful. The most common complications were ascites leak, infection at the site, and minor bleeding. Emergency physicians with training in real-time needle guidance with ultrasound were able to use POCUS to perform ultrasound-guided paracentesis in the emergency department with a high success rate and no fatal complications. Based on our experience, we recommend performing ultrasound-guided paracentesis using a linear transducer, with attention to identifying vessels near the procedure site and maintaining sterile technique.

Press Needle: A Traditional Chinese Medicine Therapy for Myopia Patients with Dry Eye.

Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with myopia. Needle prickling has been shown to be effective in providing symptom relief in patients with myopia and dry eye. Press needle is a long-lasting, easy-to-operate, and inexpensive traditional Chinese medicine treatment. The standard practice of needle insertion is very important for the treatment of myopia and dry eye. The specific steps include selecting the appropriate acupoints, piercing them with appropriate needles, and fixing them in the skin or subcutaneously at the acupoints, burying them for 2 days, resting for 1 day; the course of treatment lasts for 2 weeks. Specifically, the following indicators were assessed: uncorrected visual acuity and the ocular surface disease index. This article will explain how to standardize the operation of a press needle in the treatment of myopia and dry eye.

Using cryotherapy, EMLA (eutectic lidocaine/prilocaine) cream, or lidocaine spray to reduce pain during arteriovenous fistula puncture: A randomized controlled trial.

In hemodialysis patients, pain associated with needle insertion into an arteriovenous fistula is a physical and psychological problem. The aim of this study was to assess the effectiveness of pre-puncture application of an ice pack, EMLA cream, or lidocaine spray to reduce pain associated with access puncture. This was a multicenter study done in nine hemodialysis centers in Iraq. The study utilized a randomized, parallel-group design, in which patients being dialyzed using an arteriovenous access were allocated into one of four groups. Access puncture was preceded by nothing (control group), by use of ice pack cooling at the puncture site, by application of EMLA cream, or by application of lidocaine spray. Pain after access puncture was assessed during a single treatment for each patient. Pain was quantified using a Visual Analogue Scale. A total of 1548 patients agreed to participate, and 1041 patients were included in the data analysis. Use of an ice pack, EMLA cream, or lidocaine spray each was associated with a lower pain score on access puncture compared with no pretreatment. The mean Visual Analogue Scores in the four groups were: 69.7 ± 15.7 in the controls, 39.8 ± 13.2 in the ice pack group, 45 ± 18.4 in the EMLA group, and 52.9 ± 15.2 in lidocaine group. Ranking of the pain severity scores suggested that ice pack use was associated with the least pain, followed by use of EMLA cream and use of lidocaine spray (severity score ranking, from lowest to highest, being 1.62, 2.18, and 2.63, respectively). Application of an ice pack prior to vascular access puncture is a fast and inexpensive technique to limit pain associated with this procedure.

Design of composite puncture blood collection system and research on puncture force.

Venous blood collection testing is one of the most commonly used medical diagnostic methods. Compared with conventional venous blood collection, robotic collection can reduce needle-stick injuries, medical staff workload, and infection risk; allow doctor-patient isolation; and improve collection reliability. Existing venous blood collection robots use rigid puncture needles, which can easily puncture the lower wall of blood vessels, causing vessel damage and collection failure. This paper proposes a bionic blood collection strategy based on a composite puncture needle that mimics the structure and function of mosquito mouthparts. A bionic composite puncture needle insertion system with puncture-force sensing was designed, and venipuncture forces were simulated and mathematically modelled. A prototype insertion system was built and used in an experiment, which demonstrated effective composite puncture blood collection and explored the factors influencing puncture force. Puncture force decreases with increased puncture speed and angle and with a decreased needle diameter. This provides a basis for optimising the parameters of blood collection robots.

Phantom study of a fully automatic radioactive seed placement robot for the treatment of skull base tumours

BackgroundInterstitial brachytherapy is a form of intensive local irradiation that facilitates the effective protection of surrounding structures and the preservation of organ functions, resulting in a favourable therapeutic response. As surgical robots can perform needle placement with a high level of accuracy, our team developed a fully automatic radioactive seed placement robot, and this study aimed to evaluate the accuracy and feasibility of fully automatic radioactive seed placement for the treatment of tumours in the skull base.MethodsA fully automatic radioactive seed placement robot was established, and 4 phantoms of skull base tumours were built for experimental validation. All the phantoms were subjected to computed tomography (CT) scans. Then, the CT data were imported into the Remebot software to design the preoperative seed placement plan. After the phantoms were fixed in place, navigation registration of the Remebot was carried out, and the automatic seed placement device was controlled to complete the needle insertion and particle placement operations. After all of the seeds were implanted in the 4 phantoms, postoperative image scanning was performed, and the results were verified via image fusion.ResultsA total of 120 seeds were implanted in 4 phantoms. The average error of seed placement was (2.51 ± 1.44) mm.ConclusionThis study presents an innovative, fully automated radioactive particle implantation system utilizing the Remebot device, which can successfully complete automated localization, needle insertion, and radioactive particle implantation procedures for skull base tumours. The phantom experiments showed the robotic system to be reliable, stable, efficient and safe. However, further research on the needle-soft tissue interaction and deformation mechanism of needle puncture is still needed.

217 Early Experience With Robotic Microvascular Anastomoses

INTRODUCTION: Robotics are becoming increasingly widespread within various neurosurgical subspecialties. The adoption of robotic technology within vascular neurosurgery is of great interest, but data pertaining to its feasibility is currently limited. METHODS: 68 sutures were performed and assessed. 6 anastomoses (3 robotic and 3 hand-sewn) were performed on 1-1.5 mm caliber tubes and recorded with the operative microscope. We separately compared interrupted sutures (from needle insertion until third knot) and running sutures (from needle insertion until stitch pull-out). Average suture timing across all groups was compared using an unpaired student’s T test. RESULTS: We compared 29 robotic sutures to 39 hand-sewn sutures. There was no significant difference between the average time/stitch for the robotic running sutures (n = 18) and the hand-sewn running sutures (n = 16) (45.6 s vs. 41.2 s; p-value = 0.3). The average for the first robotic anastomosis (n=7) was significantly longer than the second (n = 11) (56.3 vs. 38.3; p = .03). The first robotic anastomosis had a negative slope (-8.5). Interestingly, both the second robotic end-to-side anastomosis and the hand-sewn control had shallow positive slopes (1.5 and 2.6). The average of the robotic interrupted sutures (n = 11) was significantly longer than the hand-sewn (n = 23) (286 s vs. 70; p&lt;.01). The average time for the first robotic interrupted anastomosis (n = 7) was significantly longer than the second (n = 4) (366.9 s vs. 144.5; p=0.008). CONCLUSIONS: Our results indicate that the learning curve for suturing robotic microanastomoses is short and encouraging. Similar performance to hand-sewn running sutures is possible robotically with minimal practice. Although the learning curve for the interrupted group was encouraging, we only reached similar results to hand-sewn in the very last robotic sutures. Overall, the use of robotics warrants further study for potential use in cerebrovascular bypass procedures.

A comparison of anesthesia induction by two different administration routes and doses of ketamine and medetomidine in red-eared sliders (Trachemys scripta elegans)

This study aimed to assess the efficiency of ketamine and medetomidine by two different doses and routes on anesthesia depth and cardiac stability in red-eared sliders. Each turtle was anesthetized two times, with seven days wash-out period. Induction of anesthesia consisted of a bolus combination of ketamine (10 mg/kg) and medetomidine (0.2 mg/kg) administered in the left brachial biceps in the intramuscular protocol, or a bolus combination of ketamine (20 mg/kg) and medetomidine (0.2 mg/kg) administered in subcarapacial sinus after clear blood presence confirmation in the intravenous protocol. Vital signs, reaction on the skin palpation, manual mouth opening for endotracheal intubation, palpebral and cloacal reflex, and the withdrawal reflex of the front and hind limbs were measured and recorded every 5 minutes for 60 minutes after anesthesia injection. Atipamezole (1 mg/kg) was administered in the right brachial biceps one hour after ketamine and medetomidine administration. Needle insertion and possible painful reactions to drug administration were also evaluated and recorded. Obtained data were analyzed for normality and paired t-tests, Wilcoxon, or McNamar tests were performed where appropriate. The values of P≤0.05 were considered significant. A significantly less pronounced decrease in heart rate was observed with intravenous anesthesia protocol. Both protocols recorded complete anesthesia recovery 60 minutes after intramuscular atipamezole administration. A ketamine-medetomidine dose combination administered intravenously provides a more stable and consistent anesthetic plane in red-eared sliders than ketamine-medetomidine administered intramuscularly.

Towards Autonomous Retinal Microsurgery Using RGB-D Images.

Retinal surgery is a challenging procedure requiring precise manipulation of the fragile retinal tissue, often at the scale of tens-of-micrometers. Its difficulty has motivated the development of robotic assistance platforms to enable precise motion, and more recently, novel sensors such as microscope integrated optical coherence tomography (OCT) for RGB-D view of the surgical workspace. The combination of these devices opens new possibilities for robotic automation of tasks such as subretinal injection (SI), a procedure that involves precise needle insertion into the retina for targeted drug delivery. Motivated by this opportunity, we develop a framework for autonomous needle navigation during SI. We develop a system which enables the surgeon to specify waypoint goals in the microscope and OCT views, and the system autonomously navigates the needle to the desired subretinal space in real-time. Our system integrates OCT and microscope images with convolutional neural networks (CNNs) to automatically segment the surgical tool and retinal tissue boundaries, and model predictive control that generates optimal trajectories that respect kinematic constraints to ensure patient safety. We validate our system by demonstrating 30 successful SI trials on pig eyes. Preliminary comparisons to a human operator in robot-assisted mode highlight the enhanced safety and performance of our system.

Predicting clinical entry point for thoracic epidural catheter insertion during paramedian approach: A prospective observational study.

Thoracic epidural insertion has high failure rates in the mid-thoracic region due to steep angulation of oblique bending of spinous processes. The preferred skin puncture point for epidural needle insertion in the paramedian sagittal plane with respect to the superior/inferior tip of spinous process or inter-spinous cleft in the mid-thoracic region (T5-8) is not standard. The primary objective of this prospective observational study was to find the skin puncture point which had the best success rate for a successful epidural catheterization. Secondary objectives were to study the number of attempts and passes required to locate epidural space, incidence of failed epidural, and its relationship with patient characteristics and demographics. After informed consent, 155 patients planned for general anesthesia with epidural analgesia in the mid-thoracic region were included in the trial. Patient demographics, the details of epidural attempts with respect to anatomical landmarks, distance from the midline, and number of passes in each attempt were noted. Epidural catheterization was considered successful after demonstrating dermatomal band of sensory blockade. The success rate at different skin puncture sites was not statistically significant (P = 0.58). We found a failure rate of 12.9%. Failed epidural catheterization was significantly high in the age group >56 years (n = 62 and P = 0.007). In our study, none of the skin puncture points had a significant association with successful epidural insertion in mid-thoracic segments using a para-median approach.

Practice Guidelines for Central Venous Access 2020 - Time for German Guidelines

The American Society of Anesthesiologists released practice guidelines for central venous access in 2020, and the entire world literature was examined for evidence on how to perform the entire process with best practice and minimal risk and harm to the patient. These guidelines may serve as a gold standard for individual procedural steps, allowing practitioners and hospital departments to critically question the own standard and improve upon them.We interpreted the guidelines for individual procedural steps on how to improve success of catheterization, minimize risks or adverse effects, enhance the management of accidental arterial punctures, adhere to evidence-based practices, and generally reduce the trauma of puncturing. In our opinion, the most needed recommendation for central venous access is to utilize ultrasound guidance, a practice that many international societies have already incorporated into their published national guidelines.In our view, it is time to implement a national guideline for central venous access using ultrasound in Germany. Doing so may improve success rates in the first attempt, reduce procedural time, decrease the number of needle insertions per patient, and lower the rate of arterial punctures. This approach represents best practice from ethical, insurance, civil rights, and patient security perspectives, and is supported by relevant societies.

A mechanics-based model for a tendon-driven active needle navigating inside a multiple-layer tissue.

Percutaneous minimally invasive procedures such brachytherapy and biopsy require a flexible active needle for precise movement inside tissue and accurate placement at target positions for higher success rates for diagnosis and treatment, respectively. In a previous work, we presented a tendon-driven active needle to navigate inside tissue. This work presents a new model to predict the deflection of the tendon-driven needle while steering in a multiple-layer soft tissue. A multi-layer phantom tissue with different localized stiffness was developed for needle insertion tests followed by indentation tests to identify its mechanical properties. Using a robot that inserts and actively bends the tendon-driven needle inside the soft tissue while simultaneously tracking the needle through ultrasound imaging, various experiments were conducted for model validation. The proposed model was verified by comparing the simulation results to the empirical data. The results demonstrated the accuracy of the model in predicting the tendon-driven needle deflection in multiple-layer (different stiffness) soft tissue.

Analysis of guide wire displacement in robot-assisted spinal pedicle screw implantation

Robot-assisted pedicle screw placement is prone to guide wire migration, and the related influencing factors have not yet been discussed. Therefore, this study aimed to investigate and analyze the causes of robot-assisted spinal pedicle guide wire displacement and summarize the relevant treatment strategies. The surgical outcomes of 82 patients who underwent robotic-assisted pedicle screw spinal placement at our hospital between July 2022 and June 2023 were retrospectively analyzed. A total of 342 screws were placed in 82 patients; 47 guide wires were offset, 47 guide wires were replaced, and 295 guide wires were not significantly offset, with a first guide wire offset rate of 13.7% and a total guide wire offset rate of 12.1%. Univariate analysis showed that Screw placement level, whether respiration was controlled during guide wire placement, Hu value of CT, the position of needle insertion point, and operation time had a significant effect on guide wire deviation (P < 0.05). Multivariate logistic regression analysis showed that the inclusion of screw placement segments, whether breathing was controlled during guide wire placement, and Hu value of CT had a significant effect on guide wire offset (P < 0.05). Whether the guide wire was offset had no significant effect on the accuracy of subsequent pedicle screw implantation (P > 0.05). The level of screw placement, whether breathing was controlled during guide wire placement, and Hu value of CT were independent risk factors for guide wire deviation. When causing an excursion, screw orientation can be adjusted during intraoperative screw placement, and guide wire excursion has no significant impact on the accuracy of subsequent pedicle screw placement.

Phlebotomy- A gateway to laboratory diagnostics

Objective: To assess the knowledge, practice and attitude about venipuncture amongst Nursing staff of a tertiary care hospital. Material and Methods: This questionnaire-based survey was done at Rawal General and dental hospital, Islamabad, from January to April 2022. The Questionnaire was developed as per the CLSI H3-A6 and WHO‘s venipuncture guidelines. It was distributed to nursing staff by hand. Most were filled inside the classes in front of the teacher. Results: The frequency of correct responses in the knowledge section varied from 4(4.6%) about the number of tube inversions to 79(90.8%) about wearing of gloves before taking a sample while 47(54%) selected the correct option of identifying a patient. Regarding the standard phlebotomy protocols, the response was quite low which was 26(29.9%), 18(20.7%) and 8(9.2%) about the correct angle of needle insertion, what to inspect of the supplies and the location of applying the tourniquet respectively. Recapping with two hands is still done by 13% and 79% still put the sample by holding tube in the other hand. In spite of all this 66% still think that one can learn venipuncture by practicing the techniques without going through a proper course. Conclusion: Nursing staff in Rawal General and dental hospital is not fully aware about basic laboratory protocols and their importance. This unawareness can lead to generation of erroneous lab reports. Formal education, training with summative assessments should be a part of the curriculum of nursing courses followed by rigorous implementation monitoring. Keywords: Awareness, Nurses, Phlebotomy, Venipuncture, Sample

Evaluation of the Factors Influencing Needle stick Injury And Bloodborne Pathogens among Healthcare Workers in Benue State University Teaching Hospital Makurdi, North-Central Nigeria

It is well recognized that the danger of needle stick injuries and the blood-borne diseases they can cause is higher for healthcare professionals. In order to do this, a survey on the variables influencing blood-borne infections and needle stick injuries among medical personnel at the Benue State University Teaching Hospital (BSUTH) in Benue State, North Central Nigeria, was carried out. A descriptive cross-sectional survey was used as the methodology, and questionnaires were given to medical professionals at BSUTH in Makurdi, Benue State, including doctors, nurses, and medical laboratory scientists. Using a straightforward random sample method, the participants who fulfilled the inclusion requirements were chosen. Findings: The questionnaires were distributed to participants between the ages of 20 and 35. Of those, 190 (68.8%) were female, and 177 (64.10%) were single. The study’s findings also showed that 39% of the respondents were physicians. In addition, 74% of respondents had worked for less than five years, 13% for six to ten years, and a further 13% for ten years or more. The most reliable source of information for blood-borne infections (89.1%) and needle stick injuries (78.4%) was the Teaching Hospital. Of the 109 people who had needle stick injuries at that time, 84.4% had done so fewer than five times in the previous six months, and 4.6% had done so more than ten times. For the last six months, Tin. According to the results, 16.5% of the participants in this category suffered an intravenous insertion needle stick injury, 18.3% during an injection, and 60% while recapping a needle. Males were also found to have a greater frequency of needle stick injuries (66.3%) than females, with medical professionals and those with six to ten years of experience having the highest prevalence. However, medical lab scientists had a greater prevalence of blood-borne infections (20.7%). The outcome demonstrated negative opinions regarding blood-borne infections and needle stick injuries.

Does Articular Pressure Change Vital Signs During Temporomandibular Joint Arthrocentesis?

Objective: The aim of this study was to compare the vital signs as mean arterial pressure and heart rate of patients undergoing two different temporomandibular joint (TMJ) arthrocentesis techniques.&#x0D; Methods: Thirty patients received TMJ arthrocentesis with either double puncture arthrocentesis (DPA) or single puncture arthrocentesis (SPA). Blood pressure and heart rate were assessed preoperatively, during the application of local anesthesia, and at needle insertion into the joint cavity, the 5th and 10th minute of the procedure, and the end of the procedure. &#x0D; Results: The heart rate and mean arterial pressure were highest during anesthesia and needle insertion (P