Types Of Syringes Research Articles

A Comparison of Pumping Infusion-Induced Contamination With Different Syringe Types.

Health care providers use several types of syringes in their daily routine to provide or safely deliver therapeutic agents to patients. Pump infusion with a syringe (PIS) are used for the rapid delivery of large amounts of fluid or blood to patients in critical conditions, such as hypovolemic shock. Patients often experience bacterial infections, such as catheter-related bloodstream infections, specifically when they are in critical condition in the intensive care unit (ICU) after surgery or undergoing resuscitation in an emergency department. A previous study has shown that PIS may cause intraluminal contamination. This study compared PIS-induced contamination among different types of available syringes, including disposable plastic syringes produced by several companies, glass syringes, and syringes with plastic covers. The authors found that plastic syringes caused approximately equivalent PIS-induced contamination and that glass syringes caused substantially more contamination than plastic syringes. However, syringes equipped with a plastic cover exhibited no contamination. Furthermore, disinfection with ethanol completely prevented PIS-induced contamination. This study supports the evidence that PIS may cause bacterial contamination and that a thorough aseptic technique is needed, especially when using glass syringes. These findings highlight the need to develop alternative devices for rapid infusion.

Clinical Perspectives on the Injectability of Cross-Linked Hyaluronic Acid Dermal Fillers: A Standardized Methodology for Commercial Product Benchmarking with Inter-Injector Assessments.

The injectability of cross-linked hyaluronic acid (HA) dermal fillers is influenced by polymer concentration, polymer cross-linking type and degree, the presence of lidocaine or other functional excipients, types of syringes, and injection techniques. Finished product injectability constitutes a critical quality attribute for clinical injectors, as it strongly influences product applicability and ease of use in aesthetic medicine. While injectable product extrusion force specifications are provided by the respective device manufacturers, the qualitative informative value of such datasets is low for injectors wishing to compare product brands and technologies from an injectability standpoint. Therefore, the present study comparatively assessed 28 cross-linked HA dermal fillers (JUVÉDERM®, Restylane®, BELOTERO®, TEOSYAL RHA®, and STYLAGE® brands) using various injectability benchmarking setups for enhanced clinical-oriented relevance. Manual product injections were performed by three specialized and experienced clinicians, whereas automatic product extrusion was performed using a Texture Analyzer instrument. The various hydrogel products were injected into ex vivo human skin and into SimSkin® cutaneous equivalents to appropriately account for injection-related counterpressure. The injectability results revealed important variability between and within product brands, with a strong influence of the local anesthetic lidocaine, HA contents, and needle gauge size. Critical appraisals of the investigated products were performed, notably from manufacturing process-based and clinical ease of application-based standpoints, centered on respective experimental injectability quality levels. Generally, it was confirmed that each HA-based dermal filler product requires specific expertise for optimal injection, mainly due to differing viscoelastic characteristics and injectability attributes. Overall, the present study set forth evidence-based and clinical-oriented rationale elements confirming the importance for injectors to work with injectable products with which they are experienced and comfortable to optimize clinical results.

Strategi Pengelolaan Limbah Medis Padat Pada UPTD Puskesmas Lampahan yang Berdampak Pencemaran Lingkungan

The aim of the research is to get an overview of the types, determine management factors, get recommendations to determine the right strategy in order to reduce environmental pollution due to solid medical waste at the UPTD of the Lampahan Community Health Center and in the community environment. Data analysis was carried out using several parameters through statistical tests and discussed quantitatively descriptively. The results of the research showed that to identify types of solid medical waste, syringes, Nald heating, gauze, infusion bottles, handscoons, medicine bottles, masks, abocaths, needles, used plasters, urine catheters, urine bags and basturi were identified. Several factors include the knowledge of officers regarding the management and handling of solid medical waste which still varies greatly, especially in the field of health services, such as in the ER, inpatient rooms, drug distribution (pharmacies) and midwives who do not yet understand how to actually manage medical waste. Another risk factor occurs in community groups regarding their ability to act regarding the presence of solid medical waste originating from the Puskesmas environment, including actions in handling it. The strategy that will be used as a recommendation in managing solid medical waste is through increasing the capacity of human resources, increasing support for budget allocations, increasing monitoring of officer compliance in using PPE, and proposals for procuring waste management facilities as well as strengthening cooperation with third parties, licensing related to storage. , packaging, labeling and providing waste symbols.

SAT167 Risk Of Life Threatening Hypoglycemia When Using U-100 Insulin Syringes To Administer R U-500 Insulin

Abstract Disclosure: T. Rizwan: None. M. Alchalabi: None. G. Arora: None. U.N. Qureshi: None. F. Qureshi: None. Background: Humulin R U-500 is a concentrated human insulin indicated to improve glycemic control in adults and children with diabetes mellitus requiring more than 200 units of insulin per day. R U-500 insulin is five times more concentrated than U-100 insulin. Clinical Case: A 42-Year-old woman with medical history of depression, hidradenitis, morbid obesity, hypertension, hyperlipidemia, chronic headache, and type 2 diabetes mellitus was on R U-500 insulin, Jardiance, and Victoza. Patient presented with low blood glucose levels. Patient reported that her home insulin regimen is 20 units of R U-500 insulin with meals. Her home glucose diary showed blood glucose levels as low as 30-50 mg/dL. Recent hemoglobin A1c was 6.5%. Of note, the patient was unaware of hypoglycemic symptoms. Upon taking detailed history, and discussing insulin injection technique, it was apparent that the patient was administering insulin correctly. Upon further inquiry, the patient reported not being aware of the specialized R U-500 syringe. Patient expressed unfamiliarity after being shown images of the correct R U-500 syringe. It became apparent that the patient was using a U-100 insulin syringe to draw from R U-500 insulin vial which means she was receiving an incorrect dosage. Filling the U-100 syringe to the 20-unit mark with R U-500 insulin will deliver 100 units of R U-500 insulin which puts the patient at risk of severe hypoglycemia. During hospital stay, U-500 R insulin, Victoza, and Jardiance were stopped, the patient was started on basal and bolus insulin regimen, and blood glucose levels were monitored with meals and at bedtime. Blood glucose levels improved to 140-180 mg/dL. Upon hospital discharge, the patient was encouraged to switch to R U-500 KwikPen as this will be more accurate and safe. Conclusion: The U.S. Food and Drug Administration approved a dedicated syringe for the administration of Humulin R U-500 insulin, which is now the only device approved for use with U-500 insulin vial. Do not switch between types of syringes because it may increase the risk of dosing errors. Presentation: Saturday, June 17, 2023

Comparison of arterial blood gas results obtained using two types of Heparinized Syringes

Objective: The objective of this study was to compare the arterial blood gas results obtained using syringes heparinized with liquid heparin and syringes containing lyophilized balanced heparin. Study Design: Comparative cross sectional. Place and Duration: This study was conducted in the Chemical Pathology department at Combined Military Hospital, Lahore for a period of six months from November 2022 to March 2023. Methodology: A total of 100 arterial blood samples were taken from 50 patients admitted in ICU using a regular plastic syringe flushed with 5000 IU/ mL liquid heparin and another containing lyophilized heparin. Samples were analyzed immediately after collection on Roche Cobas b121 ABG analyzer. Three of the measured parameters (pH, pCO2 and pO2) were then compared among both syringe groups. pH, pO2 and pCO2 were compared using mean difference. Results: The difference of means for pH was insignificant (p- Value >0.05). But pCO2 and pO2 showed significant difference in means with p- Values <0.05 (0.007 and 0.037, respectively). Bland Altman plots were also plotted for all three parameters. 12% of the pH values, 8% pco2 and 6% pO2 values exceeded the total allowable error. Conclusion: Arterial blood pH was comparable between the two types of syringes used. The pCO2 and pO2 differed significantly and where found to be lower in blood samples collected in the liquid heparin syringes. Keywords: Liquid Heparin, Lyophilized Heparin, Arterial Blood Gas, pH, pO2, pCO2. How to Cite This: Mahmood A, Sattar A, Shaheen S, Ahmad S, Hafeez A. Comparison of arterial blood gas results obtained using two types of Heparinized Syringes. Isra Med J. 2022; 14(4): 161-164. DOI: https://doi.org/10.55282/imj.oa1379

Differences in the incidence of aflibercept-related sterile endophthalmitis according to types of disposable syringes used.

To evaluate the difference between the incidences of sterile endophthalmitis after administration of intravitreal aflibercept injection using two different types of syringes. We administered a total of 498 intravitreal aflibercept injections between September 2017 and August 2021. The disposable syringe used was changed from a 1-mL disposable syringe (Profi syringe, Shinchang Medical., Ltd. Korea) to a 1-mL Becton Dickenson Luer-Lok syringe (BD, Franklin, NJ, USA) in September 2019. Thus, the patients who received injections before and after September 1, 2019, were classified into group 1 and group 2, respectively. The incidence of aflibercept-related sterile endophthalmitis between the two groups was compared. In group 1, six (2.791%) out of 215 cases were diagnosed with sterile endophthalmitis and prescribed topical or oral steroids. In group 2, one (0.353%) out of 283 cases was diagnosed with sterile endophthalmitis and prescribed a steroid eye drop. The incidence of sterile endophthalmitis was significantly different between the two groups (P = 0.046). The BD Luer-Lok syringe is associated with a lower incidence of aflibercept-related sterile endophthalmitis than the conventional polypropylene syringe. Differences in immunogenicity associated with silicone oil lubricants within the syringes might be one of the potential reasons behind the difference in the incidence of the sterile endophthalmitis.

Accuracy of Oral Liquid Measuring Devices Used Among Caregivers at Hospital Dungun

Oral liquid medications are common type of dosage form prescribed to children. Caregiver responsible to choose appropriate measuring device to measure intended dose and minimize dosing error. Objectives of this study were 1) To identify types of measuring devices used at home; 2) To determine dose error deviation across all the measuring devices. This cross-sectional study involved caregivers visiting outpatient pharmacy with oral liquid prescription that fulfilled inclusion and exclusion criteria. The caregivers were instructed to measure 4.8ml and 15.0ml liquid by using suitable devices provided, which were 4 types of syringes and 2 types of dosing cups. The measured liquid was read by investigator and any dose error deviation was calculated and reported as percentages. Data was analyzed descriptively using SPSS version 21. Out of 120 caregivers involved, 60% were female (n=72), aged between 31-40 years old (49.1%, n=59), and employed (62.5%, n=75). 82 caregivers (68.3%) received secondary education level. Most caregivers use standardized measuring devices at home, particularly syringes and dosing cups. For smaller dose, less dose error was detected if using syringe (13.3%) as compared to dosing cup (39.3%); while for larger dose, both syringe and dosing cups are acceptable (11.7% and 7.4% respectively). Syringe shows less dose error as compared to dosing cup for smaller dose. Pharmacist should participate in decision making of choosing right measuring device to improve accuracy of medication administration.

Can Cross-Linked Siliconized PFS Come to the Rescue of the Biologics Drug Product?

Silicone can present a challenge during the development of a biologics drug product particularly in pre-filled syringe (PFS). Due to silicone related challenges, substantial changes in components and manufacturing of the PFS are being sought. Cross-linking of the silicone being one of them, can help reduce mobilization of the silicone into drug product whilst retaining its functionality of lubrication during injection. In this work, we systematically compare the stability of a fusion protein and monoclonal antibody formulation in conventionally siliconized and cross-linked siliconized PFS available from commercial manufacturers. The two types of syringes did not influence the aggregation profile of proteins as determined by HP-SEC. Compared to conventionally siliconized PFS, a cross-linked siliconized PFS can have a favorable or indifferent impact (depending on vendor) on the sub-visible particles profile as assessed by light obscuration and microflow imaging. The different PFS after 24 months of long-term storage showed comparable functionality attributes like break-loose/gliding force and silicone oil distribution. Cross-linked siliconized PFS can offer an incremental advantage over conventionally siliconized PFS for the moderately concentrated protein solutions, however the differences in the quality of these PFS amongst manufacturers is an important aspect that needs to be considered as shown in this study.

Method to Determine Syringe Silicone Oil Layer Heterogeneity and Investigation of its Impact on Product Particle Counts

Prefilled syringes (PFSs) are commonly used for parenteral delivery of protein therapeutics. In PFSs, the inner surface of the syringe barrel is typically coated with silicone oil for lubrication. The total amount of silicone oil as well as its distribution can impact syringe functionality and particle formation. However, methods to non-destructively characterize the silicone oil distribution are limited. In this paper, we developed a method to visualize and quantify the relative distribution of silicone oil in unfilled syringes using a custom-built multi-color interferometric imaging system. We then applied the system in a preliminary study to investigate the impact of the silicone oil distribution on the number of particles formed in solution after filling and extrusion for two different types of syringes. The syringe type with significantly lower particle counts also exhibited significantly more homogeneous silicone oil distributions. Within syringe types, no significant association was found between silicone oil distribution and particle formation. Our method can be used in further studies that investigate the impact of syringe siliconization on PFS functionality and particle formation.

Heroin type, injecting behavior, and HIV transmission. A simulation model of HIV incidence and prevalence.

Background and aimsUsing mathematical modeling to illustrate and predict how different heroin source-forms: “black tar” (BTH) and powder heroin (PH) can affect HIV transmission in the context of contrasting injecting practices. By quantifying HIV risk by these two heroin source-types we show how each affects the incidence and prevalence of HIV over time. From 1997 to 2010 PH reaching the United States was manufactured overwhelmingly by Colombian suppliers and distributed in the eastern states of the United States. Recently Mexican cartels that supply the western U.S. states have started to produce PH too, replacing Colombian distribution to the east. This raises the possibility that BTH in the western U.S. may be replaced by PH in the future.DesignWe used an agent-based model to evaluate the impact of use of different heroin formulations in high- and low-risk populations of persons who inject drugs (PWID) who use different types of syringes (high vs. low dead space) and injecting practices. We obtained model parameters from peer-reviewed publications and ethnographic research.ResultsHeating of BTH, additional syringe rinsing, and subcutaneous injection can substantially decrease the risk of HIV transmission. Simulation analysis shows that HIV transmission risk may be strongly affected by the type of heroin used. We reproduced historic differences in HIV prevalence and incidence. The protective effect of BTH is much stronger in high-risk compared with low-risk populations. Simulation of future outbreaks show that when PH replaces BTH we expect a long-term overall increase in HIV prevalence. In a population of PWID with mixed low- and high-risk clusters we find that local HIV outbreaks can occur even when the overall prevalence and incidence are low. The results are dependent on evidence-supported assumptions.ConclusionsThe results support harm-reduction measures focused on a reduction in syringe sharing and promoting protective measures of syringe rinsing and drug solution heating.

Comparing the Liquid Heparin Syringe with Dry Bound Heparin Syringe for Blood Gas Analysis

Abstract Background Blood gas (BG) analysis is routine today for patient management in intensive care units. Accurate analysis of different parameters in the BG is essential for managing critical patients. Errors in BG analysis can happen at many levels, with one of them being at sampling and heparinization. We compared self-prepared heparinized syringes rinsed with liquid heparin (LH) and the standard commercially available syringes with dry bound heparin (DBH) for arterial BG analysis of postoperative cardiac surgical patients. Methods This prospective observational study was conducted in 100 consecutive adult cardiac surgical patients in the cardiac surgical intensive care unit. Paired samples were collected, analyzed immediately, and statistically compared for pH, partial pressure of arterial oxygen (pO2), partial pressure of arterial carbon dioxide (pCO2), oxyhemoglobin saturation (SaO2), HCO, Na+, K+, Cl–, Ca2+, Mg2+, base excess (BE), hemoglobin (Hb), hematocrit, glucose, and lactate. Paired parameters were compared and agreement was evaluated using Bland–Altman difference plots. The 95% limits of absolute agreement (LOA) were compared with total allowable error (TEa). Results The BG parameters analyzed by two types of heparinized (LH and DBH) syringes were found to be comparable with a negligible mean difference and had an agreement outside the TEa of 8% for pO2, pCO2, and hematocrit, 7% for BE, 6% for Mg2+, 5% for K+, Ca2+, and lactate, 4% for HCOand Na+, 3% for pH, Cl–, Hb, and glucose, and zero for SaO2. The two types of syringes did not show clinically relevant discrepancies among many different parameters as per LOA and TEa limits. Conclusion In this study, we found that the BG parameters—respiratory, metabolic, and electrolytes—were comparable between the two types of syringes used for sampling. Unlike some previous studies, we did not find statistically significant differences among these analytes, which might have been due to appropriate self-preparation of heparin syringes.

Site-Specific Cytosol Sampling from a Single Cell in an Intact Tumor Spheroid Using an Electrochemical Syringe.

A multicellular tumor aggregate, known as a spheroid, is an indispensable tool to study cancer biology. Owing to its three-dimensional organization, a spheroid exhibits an inherent gradient of nutrients, oxygen, and metabolites within itself. The spheroid provides culture conditions that resemble the microenvironment of certain cancer cells and causes these cells to acquire characteristics relevant to tumors in our body. However, site-specific gene expression analysis in an intact spheroid with single-cell resolution has not been explored. Recently, some types of electrochemical syringes were developed to extract cellular materials from living single cells for transcriptomic analysis. Here, we investigated whether an electrochemical syringe could be used to evaluate site-specific gene expression in a spheroid. A small amount of cytosol (roughly 540-1480 fL, less than the volume of a single cell) was successfully collected from the first, second, and third layers of the spheroid using an electrochemical syringe without causing damage to the spheroid architecture. We found that the CCNB1 and CCNA2 expression levels were different between the surface and the average of the entire spheroid, indicating that there are heterogeneous cellular functions across different regions of the spheroid. This method provides opportunities to improve our understanding of spatial gene expression of single cells in a three-dimensional environment.

Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.

Botulinum Toxin Therapy

Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference. Which syringe type is most efficient in minimizing product waste and most cost-effective for the patient and provider? We performed a single-center, open-label, analytical study using BT therapy and 2 types of syringes for analytics of cost-effectiveness. OnabotulinumtoxinA was the neuromodulator used in this report. Vials (100 U) of BT A were each reconstituted with 2.5 mL of 0.9% sodium chloride, for a final concentration of 4 U/0.1 mL. High-dead-space syringes are compared with low-dead-space syringes: 1-mL tuberculin (TB) luer slip syringe with detachable 25-gauge needle and 1-mL ultrafine insulin syringe with an attached 31-gauge needle, respectively. After each syringe was evacuated, the TB syringe was noted to contain 0.05 mL of the remaining product in the hub. Providers are discarding approximately 2 U of BT per TB syringe product injection. If the physician uses 30 syringes per day, 3 days a week, for 1 year, it equals to a lost revenue of approximately $155,500 per year. To individualize the cost-effective analysis, average quantity of syringes used per patient and overall patient volume must be considered, with corresponding adjustment of cost and units discarded. The American Society of Plastic Surgeons reported that the use of neuromodulators has increased by approximately 797% from 2000 to 2016. During that period, the price of neuromodulators has also increased by approximately 85%. Considering these statistics, the type of syringe used for BT neuromodular injection is a thought-provoking concept but surrounded by a paucity of data. Overall, our data suggest that the use of ultrafine insulin syringes for injection of BT reduces product waste and is cost-effective for the patient and the provider.

Drug preparation, injection, and sharing practices in Tajikistan: a qualitative study in Kulob and Khorog.

BackgroundSharing injection equipment remains an important rout of transmission of HIV and HCV infections in the region of Eastern Europe and Central Asia. Tajikistan is one of the most affected countries with high rates of injection drug use and related epidemics.The aim of this qualitative study was to describe drug use practices and related behaviors in two Tajik cities – Kulob and Khorog.MethodsTwelve focus group discussions (6 per city) with 100 people who inject drugs recruited through needle and syringe program (NSP) outreach in May 2014. Topics covered included specific drugs injected, drug prices and purity, access to sterile equipment, safe injection practices and types of syringes and needles used. Qualitative thematic analysis was performed using NVivo 10 software.ResultsAll participants were male and ranged in age from 20 to 78 years. Thematic analysis showed that cheap Afghan heroin, often adulterated by dealers with other admixtures, was the only drug injected. Drug injectors often added Dimedrol (Diphenhydramine) to increase the potency of “low quality” heroin. NSPs were a major source of sterile equipment. Very few participants report direct sharing of needles and syringes. Conversely, many participants reported preparing drugs jointly and sharing injection paraphernalia. Using drugs in an outdoor setting and experiencing withdrawal were major contributors to sharing equipment, using non-sterile water, not boiling and not filtering the drug solution.ConclusionQualitative research can provide insights into risk behaviors that may be missed in quantitative studies. These finding have important implications for planning risk reduction interventions in Tajikistan. Prevention should specifically focus on indirect sharing practices.

Evaluation of transport conditions for autologous bone marrow-derived mesenchymal stromal cells for therapeutic application in horses.

Background. Mesenchymal stromal cells (MSCs) are increasingly used for clinical applications in equine patients. For MSC isolation and expansion, a laboratory step is mandatory, after which the cells are sent back to the attending veterinarian. Preserving the biological properties of MSCs during this transport is paramount. The goal of the study was to compare transport-related parameters (transport container, media, temperature, time, cell concentration) that potentially influence characteristics of culture expanded equine MSCs.Methods. The study was arranged in three parts comparing (I) five different transport containers (cryotube, two types of plastic syringes, glass syringe, CellSeal), (II) seven different transport media, four temperatures (4 °C vs. room temperature; −20 °C vs. −80 °C), four time frames (24 h vs. 48 h; 48 h vs. 72 h), and (III) three MSC concentrations (5 × 106, 10 × 106, 20 × 106 MSC/ml). Cell viability (Trypan Blue exclusion; percent and total number viable cell), proliferation and trilineage differentiation capacity were assessed for each test condition. Further, the recovered volume of the suspension was determined in part I. Each condition was evaluated using samples of six horses (n = 6) and differentiation protocols were performed in duplicates.Results. In part I of the study, no significant differences in any of the parameters were found when comparing transport containers at room temperature. The glass syringe was selected for all subsequent evaluations (highest recoverable volume of cell suspension and cell viability). In part II, media, temperatures, or time frames had also no significant influence on cell viability, likely due to the large number of comparisons and small sample size. Highest cell viability was observed using autologous bone marrow supernatant as transport medium, and “transport” at 4 °C for 24 h (70.6% vs. control group 75.3%); this was not significant. Contrary, viability was unacceptably low (<40%) for all freezing protocols at −20 °C or −80 °C, particularly with bone marrow supernatant or plasma and DMSO. In part III, various cell concentrations also had no significant influence on any of the evaluated parameters. Chondrogenic differentiation showed a trend towards being decreased for all transport conditions, compared to control cells.Discussion. In this study, transport conditions were not found to impact viability, proliferation or ability for trilineage differentiation of MSCs, most likely due to the small sample size and large number of comparisons. The unusual low viability after all freezing protocols is in contrast to previous equine studies. Potential causes are differences in the freezing, but also in thawing method. Also, the selected container (glass syringe) may have impacted viability. Future research may be warranted into the possibly negative effect of transport on chondrogenic differentiation.

A phantom model study to identify the most effective manual aspiration thrombectomy for acute deep-vein thrombosis of the lower extremity

To identify the most effective manual aspiration thrombectomy (MAT) method for the initial endovascular management of acute deep-vein thrombosis (DVT) in the lower extremity using a phantom model. An acute DVT phantom model was created by infusing a bovine acute thrombus in a 20-mm diameter, 120-cm long plastic tube with banding of the distal portion. A total of 32 types of aspiration methods using combinations of two aspiration catheters (8 and 10 Fr), four syringes (10, 20, 40, and 50ml), and four different aspiration methods (I, II, III, and IV) were performed. Each method was performed 10 times. The total weight of the aspirated thrombus was measured and compared among the 32 aspiration methods. The aspiration methods were classified based on the length of the dynamic catheter withdrawal (0cm [method I], 15cm [II], 30cm [III], or >45cm [IV]) while maintaining continuous negative pressure using a syringe. Analysis of variance and Student's t-test were used for statistical analysis. There were no statistically significant differences in the total amount of aspirated thrombus among the various types of aspiration catheters and syringes; however, different aspiration methods showed significantly different results. Acute thrombus was most effectively aspirated by method IV irrespective of the catheter and syringe used. The longer the length of dynamic catheter withdrawal, the greater the amount of total thrombi that could be aspirated, irrespective of the type of aspiration catheter and syringe used (IV>III>II>I; p<0.05). MAT can be performed most effectively using method IV. Effective MAT relies on the length of the dynamic catheter withdrawal while maintaining continuous negative pressure using a syringe in the initial endovascular management of acute DVT in the lower extremity.

Solution for Dead Space Problem in Ranibizumab Syringe System

Intravitreal injection of drugs that inhibit the actions of vascular endothelial growth factor bring high economic burden for the health systems. We evaluated the amount of drug volume retained in two different types of syringes with billed and non billed rubber stopper. Difference between two syringe types is 0.037 g. This indicates a significant amount of volume loss due to dead space between syringe and needle. Consequently, a simple change of design of rubber stopper of the plunger as billed form may reduce significant amount of drug loss due to dead space volume.

Assessment of 99mTc-Succimer Residual Activity Using Inert Nonreactive Syringes

It has been widely reported that (99m)Tc-succimer adsorbs to plastic syringes significantly (up to 50%), often resulting in a lower administered dose than intended or inaccurate dosing. This adsorption rate is especially problematic in the pediatric population. To improve (99m)Tc-succimer dosing, we compared the adsorption of (99m)Tc-succimer with 2 types of syringes: silicone-coated syringes with nonlatex rubber on the plunger and inert nonreactive syringes with no silicone coating and no rubber on the plunger. (99m)Tc-succimer kits were compounded according to the manufacturer's instructions. (99m)Tc-succimer doses (37-185 MBq) were drawn into 3-mL (silicone-coated or inert nonreactive) syringes in a 1-mL volume. Thirty min, 1 h, 2 h, and 4 h later, the syringes were assayed in a dose calibrator and assayed again after being emptied and rinsed with saline. In addition, we examined the data collected from 129 (99m)Tc-succimer doses administered in a pediatric department, in which 52 were dispensed in silicone-coated syringes and 77 were dispensed in inert nonreactive syringes. The doses were assayed immediately before and after injection. The syringes were flushed with normal saline. The labeling efficiency of the (99m)Tc-succimer kits was more than 95%. Residual activity left in the inert nonreactive syringes was 0.73% (SD, ±0.18%), which was significantly lower than the activity left in the silicone-coated syringes, 20.9% (SD, ±5.6%; P < 0.0001). The extent of adsorption did not change significantly between 30 min and 4 h of incubation. The clinical data showed that the residual activity was 30.6% (SD, ±12.5%) from doses dispensed in silicone-coated syringes and 6.38% (SD, ±2.95%) from doses dispensed in inert nonreactive syringes (P < 0.001). The inert nonreactive syringes had significantly less residual of (99m)Tc-succimer than silicone-based syringes, making it possible to accurately administer calculated doses of (99m)Tc-succimer to pediatric patients.

Comparative study of application effect of BD preset syringe and regular syringe in arterial blood collection in standardized nursing process

Objective To explore the best practice and normalization of arterial blood collection by comparing performance of BD preset syringe with regular syringes in arterial blood collection in standardized nursing process. Methods The nurses were trained to use BD preset syringe and regular syringes to collect arterial blood sample.Five hundred subjects were randomly divided into the preset syringe group and the regular syringes group,250 subjects in each.Agglutination of blood samples was observed.Time spent in every step of collections was recorded for 23 subjects in each group to calculate workflow efficiency.A questionnaire was used for nurses participated in arterial blood collection for their evaluation of both types of syringes. Results The incidence of micro-clot formation in the preset syringe group was 2 cases,lower than 15 cases in the regular syringes group,the preset syringe group also showed higher workflow efficiency as well as safe and easy-to-use characters.The difference between two groups was statistically significant. Conclusions Using BD preset syringe in nursing process management has lower incidence of micro-clot formation,higher workflow efficiency,safe and easy-to-use character.It should be promoted in clinical practice. Key words: Nursing process; Blood gas analysis; Arterial blood collection; BD preset syringe; Syringe