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Brazilian Journal of Anesthesiology... 2020The purpose of the Brazilian Society of Anesthesiology (SBA)’s Regional Anesthesia Safety Recommendations Update is to provide new guidelines based on the current...
The purpose of the Brazilian Society of Anesthesiology (SBA)’s Regional Anesthesia Safety Recommendations Update is to provide new guidelines based on the current relevant clinical aspects related to safety in regional anesthesia and analgesia. The goal of the present article is to provide a broad overview of the current knowledge regarding pre-procedure asepsis and antisepsis, risk factors, diagnosis and treatment of infectious complications resulting from anesthetic techniques. It also aims to shed light on the use of reprocessed materials in regional anesthesia practice to establish the effects of aseptic handling of vials and ampoules, and to show cost-effectiveness in the preparation of solutions to be administered continuously in regional blockades. Electronic databases were searched between January 2011 (final date of the literature search for the past SBA recommendations for safety in regional anesthesia) and September 2019. A total of 712 publications were found, 201 of which were included for further analysis, and 82 new publications were added into the review. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to assess the quality of each study and to classify the strength of evidence. The present review was prepared by members of the SBA Technical Standards Committee.
Topics: Anesthesia, Conduction; Brazil; Humans; Infections; Nerve Block; Practice Guidelines as Topic; Risk Factors
PubMed: 32636024
DOI: 10.1016/j.bjan.2020.02.005 -
Acta Crystallographica. Section E,... Jul 2012The vanadium oxide arsenate with formula K₂V₂O₂(AsO₄)₂, dipotassium divanadium(IV) dioxide diarsenate, has been synthesized by solid-state reaction in an...
The vanadium oxide arsenate with formula K₂V₂O₂(AsO₄)₂, dipotassium divanadium(IV) dioxide diarsenate, has been synthesized by solid-state reaction in an evacuated silica ampoule. Its structure is isotypic with K₂V₂O₂(PO₄)₂. The framework is built up from corner-sharing VO₆ octa-hedra and AsO₄ tetra-hedra, creating an infinite [VAsO₈](∞) chain running along the a- and c-axis directions. The K⁺ cations are located in hexa-gonal tunnels, which are delimited by the connection of the [VAsO₈](∞) chains.
PubMed: 22807696
DOI: 10.1107/S1600536812027183 -
American Journal of Infection Control Aug 2004Several infection control practices and procedures crucial to the prevention of disease transmission in the health care setting are reviewed and discussed. Emphasis is... (Review)
Review
Several infection control practices and procedures crucial to the prevention of disease transmission in the health care setting are reviewed and discussed. Emphasis is placed on the importance of infection control to gastrointestinal endoscopy. Recommendations that minimize the risk of nosocomial infection during the preparation, handling, and administration of intravenous medications, particularly propofol, are provided. These recommendations include the labeling of predrawn syringes; use of sterile single-use syringes, needles, and administration sets for each patient; and, whenever feasible, administration of intravenous medications promptly after opening their prefilled syringes or after opening their ampoules or vials and filling the sterile syringes.
Topics: Cross Infection; Endoscopy, Gastrointestinal; Equipment Contamination; Humans; Infection Control; Infusions, Intravenous; Pharmaceutical Preparations; Sterilization; Syringes
PubMed: 15292893
DOI: 10.1016/j.ajic.2003.10.014 -
Bulletin of the World Health... Jul 2021To assess the cost and effectiveness of the two-site, 1-week, intradermal rabies post-exposure prophylaxis regimen recommended by the World Health Organization (WHO) in...
OBJECTIVE
To assess the cost and effectiveness of the two-site, 1-week, intradermal rabies post-exposure prophylaxis regimen recommended by the World Health Organization (WHO) in 2018.
METHODS
We compared the number of rabies vaccine and rabies immunoglobulin ampoules consumed at The Indus Hospital in Karachi, Pakistan and their cost before and after implementing WHO's 2018 recommendations. In 2017, patients with suspected rabies-infected bites were treated using the two-site, 4-week, Thai Red Cross regimen, which involved administering four rabies vaccine doses intradermally over 4 weeks and infiltrating immunoglobulin into serious wounds, with the remainder injected into a distant muscle. In 2018, patients received three vaccine doses intradermally over 1 week, with a calculated amount of immunoglobulin infiltrated into wounds only. Remaining immunoglobulin was saved for other patients. The survival of patients bitten by apparently rabid dogs was used as a surrogate for effectiveness.
FINDINGS
Despite treating 8.5% more patients in 2018 (5370 patients) than 2017 (4948 patients), 140 fewer ampoules of rabies vaccine and 436 fewer ampoules of rabies immunoglobulin were used, at a cost saving of 4202 United States dollars. Of 56 patients bitten by apparently rabid dogs, 50 were alive at 6-month follow-up. The remaining six patients could not be contacted but did not present to any hospital with rabies.
CONCLUSION
The new regimen was more economical than the two-site, 4-week regimen and was equally effective. This regimen is recommended for preventing rabies in countries where the disease is endemic and rabies vaccine and immunoglobulin are in short supply.
Topics: Adolescent; Animals; Bites and Stings; Child; Child, Preschool; Cost-Benefit Analysis; Dogs; Female; Humans; Infant; Infant, Newborn; Male; Pakistan; Post-Exposure Prophylaxis; Rabies; Rabies Vaccines; Tertiary Healthcare
PubMed: 34248223
DOI: 10.2471/BLT.20.275453 -
Case Reports in Dermatological Medicine 2021Since its discovery in the 19th century, cutaneous leishmaniasis has been a major public health problem, especially with the appearance of more and more unusual cases of...
Since its discovery in the 19th century, cutaneous leishmaniasis has been a major public health problem, especially with the appearance of more and more unusual cases of cutaneous lesions due to this parasite. Indeed, the present study joins the previous studies and describes a typical case of a nasal lesion due to infection. This is a 20-year-old young man, with no particular pathological history, from an epidemic focus who presented with inflammatory nasal swelling similar to a mucocutaneous form. However, the X-ray data showed that no lysis of the bones proper to the nose was detected and no damage to the underlying mucosa was observed. Nevertheless, the parasitological diagnosis confirmed the presence of amastigotes, and the results of the molecular study showed that the electrophoretic profile was comparable to that of . After diagnosis and confirmation, treatment with meglumine antimonate at the rate of two ampoules/injection (one ampoule = 5 ml) of antimony salt for one month was administered intramuscularly with favorable outcome. Atypical forms of cutaneous leishmaniasis constitute a rare and unusual entity often leading to diagnostic delay. For this, the clinical examination must take into account both exceptional presentations of infection, in particular in subjects living or having stayed in an endemic area, in order to ensure appropriate and early treatment.
PubMed: 34987871
DOI: 10.1155/2021/3801949 -
Acta Crystallographica. Section E,... Feb 2023Quaternary (Sn,Pb,Bi)Pt was synthesized by melting of the elements in an evacuated silica glass ampoule. The crystal structure was established by single-crystal X-ray...
Quaternary (Sn,Pb,Bi)Pt was synthesized by melting of the elements in an evacuated silica glass ampoule. The crystal structure was established by single-crystal X-ray diffraction and adopts an atomic arrangement of the NiAs type with additional occupation of the voids. Decisive for the refinement was the composition of the crystals as determined by energy dispersive X-ray spectroscopy (EDXS), resulting in a formula of (SnPbBi)Pt.
PubMed: 36909991
DOI: 10.1107/S2056989023000956 -
Cureus Jan 2020Human factors and systems factors can affect surgical performance, including the operating room (OR) environment, teamwork and communication, technology and equipment,...
Human factors and systems factors can affect surgical performance, including the operating room (OR) environment, teamwork and communication, technology and equipment, tasks and workload factors, and organizational variables. Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical errors that often lead to adverse healthcare events. We are highlighting a potential error and hazardous situation, which may occur due to the difficulty in reading the embossed letters of some ampoules because of the typeface of these ampoules. This problem is particularly important in the ORs, which require special sterile conditions. We are adding a simple step to help in the differentiation between plastic, embossed ampoules. This simple and easy-to-do step makes it possible for accurate and correct identification, without jeopardizing the safety of the patients and health care professionals.
PubMed: 31929959
DOI: 10.7759/cureus.6592 -
American Journal of Pharmaceutical... Nov 2019To determine whether direct observational scores were predictive of the potency of pharmacy students' compounded sterile preparations (CSPs) and to identify any...
To determine whether direct observational scores were predictive of the potency of pharmacy students' compounded sterile preparations (CSPs) and to identify any misunderstandings students had regarding individual aseptic technique steps. P1 students performed aseptic techniques during three observational encounters separated by two weeks. Students' performances were evaluated using an observation-based rubric and were subject to potency analysis. The encounters were transferring a drug solution from a vial, an ampule, and a reconstituted powder to intravenous (IV) bags. The mean potency of the diphenhydramine (vial) and lidocaine (ampule) met the ±10% goal of expected potency. These results were significantly different from those of the ampicillin (reconstitution) encounter, which was outside the goal. The percentage of students meeting the potency goal was 59.3% for the diphenhydramine, 80.3% for the lidocaine, and 50.4% for the ampicillin encounters. The observation scores were significantly different between all three encounters. There were no correlations between the observational scores and the potency for any encounter regardless of whether or not the student met the goal potency. Although their observation scores were acceptable, up to 50% of students did not meet the potency goal for each of the three encounters. The potency data provided the critical insight that P1 students were not adequately trained to account for pressurization when manipulating vials using aseptic compounding processes. The results suggest that both observation scores and potency analysis should be part of an overall assessment of student ability to compound sterile preparations.
Topics: Clinical Competence; Drug Compounding; Drug Contamination; Education, Pharmacy; Educational Measurement; Humans; Students, Pharmacy
PubMed: 31871356
DOI: 10.5688/ajpe7338 -
Yakugaku Zasshi : Journal of the... Sep 2009The hazardous effects due to the insoluble microparticles generated in the injections have been pointed out. To our knowledge, however, there have been no reports about... (Review)
Review
The hazardous effects due to the insoluble microparticles generated in the injections have been pointed out. To our knowledge, however, there have been no reports about insoluble microparticulate contamination at ampoule opening. Therefore, we performed this study to evaluate the relationship between time and glass particulate sedimentation to examine the effect of swabbing the ampoule neck on particle generation to clarify the relationship between the inner-diameter size of an ampoule and the amount of glass particulate sedimentation to find out the effect of methods for ampule opening, and compare particle contamination in glass ampoule and that of plastic, after ampoule opening and assessed the contribution of material of ampoule to the particle generation. We observed that the glass particulate contamination of accumulation value at a size over 2 mum increased significantly after 60 seconds, the swabbing the neck of the ampoule prior to opening had a negative effect on prevention of glass particulate contamination, the glass particulate contamination was positively influenced by the inner-diameter size of the ampoule, but not by the thickness of the ampoule walls, the particulate contamination derived from glass significantly increased by general method as well as using ampoule open adaptor compared with our method, and the insoluble microparticulate contamination in plastic ampoule was significantly lower than that in glass ampoule. The present findings might provide an useful information to reduce glass particules after ampoule opening performed in clinical practice.
Topics: Dosage Forms; Drug Contamination; Drug Packaging; Glass; Injections; Particle Size; Plastics; Solubility; Time Factors
PubMed: 19721379
DOI: 10.1248/yakushi.129.1041 -
Acta Crystallographica. Section E,... Jan 2009Single crystals of caesium tantalate(V), Cs(10)Ta(29.27)O(78), were obtained as a serendipitous product in a welded tantalum ampoule by a blank reaction of CsBr and...
Single crystals of caesium tantalate(V), Cs(10)Ta(29.27)O(78), were obtained as a serendipitous product in a welded tantalum ampoule by a blank reaction of CsBr and bis-muth subnitrate [Bi(5)O(OH)(9)(NO(3))(4)] with the container material. The crystal structure of the title compound is made up of a three-dimensional framework constituted by two types of layers, viz. (Ta(6)O(15))(n) and (Ta(3)O(9))(n), parallel to (001), which are linked together by TaO(6) octa-hedra (3m. symmetry) along [001]. This framework has cavities where three independent Cs(+) ions (3m. and m2 symmetry, respectively) are located. The compound reveals a Ta deficiency at one trigonal prismatic coordinated site (m2 symmetry). The composition of the title compound was verified by energy-dispersive X-ray analysis of single crystals.
PubMed: 21581740
DOI: 10.1107/S1600536809002967