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Diving and Hyperbaric Medicine Mar 2023Critically ill patients require continuation of their care when receiving hyperbaric oxygen treatment. This care may be facilitated via portable electrically powered... (Review)
Review
INTRODUCTION
Critically ill patients require continuation of their care when receiving hyperbaric oxygen treatment. This care may be facilitated via portable electrically powered devices such as intravenous (IV) infusion pumps and syringe drivers, which may create risks in the absence of a comprehensive safety evaluation. We reviewed published safety data for IV infusion pumps and powered syringe drivers in hyperbaric environments and compared the evaluation processes to key requirements documented in safety standards and guidelines.
METHODS
A systematic literature review was undertaken to identify English language papers published in the last 15 years, describing the safety evaluations of IV pumps and/or syringe drivers for use in hyperbaric environments. Papers were critically assessed in relation to the requirements of international standards and safety recommendations.
RESULTS
Eight studies of IV infusion devices were identified. There were deficiencies in the published safety evaluations of IV pumps for hyperbaric use. Despite a simple, published process for evaluating new devices, and available guidelines for fire safety, only two devices had comprehensive safety assessments. Most studies focused only on whether the device functioned normally under pressure and did not consider implosion/explosion risk, fire safety, toxicity, oxygen compatibility or risk of pressure damage.
CONCLUSIONS
Intravenous infusion (and other electrically powered) devices require comprehensive assessment before use under hyperbaric conditions. This would be enhanced by a publicly accessible database hosting the risk assessments. Facilities should conduct their own assessments specific to their environment and practices.
Topics: Humans; Syringes; Infusion Pumps; Hyperbaric Oxygenation; Oxygen; Infusions, Intravenous
PubMed: 36966521
DOI: 10.28920/dhm53.1.42-50 -
Talanta Feb 2022Dispersive liquid-liquid microextraction (DLLME) has recently been widely used in the separation and preconcentration of various chemical species. Among the various... (Review)
Review
Dispersive liquid-liquid microextraction (DLLME) has recently been widely used in the separation and preconcentration of various chemical species. Among the various approaches using DLLME are systems that use a syringe as an extraction environment. In this review, details of some methods that use this approach are presented. The ways to promote dispersion, analytical characteristics, and the advantages and disadvantages of the methods, among other aspects, are discussed critically. Finally, some trends in the use of in-syringe microextraction systems are described.
Topics: Liquid Phase Microextraction; Syringes
PubMed: 34857335
DOI: 10.1016/j.talanta.2021.123002 -
BMJ Supportive & Palliative Care Sep 2021
Topics: Humans; Infusion Pumps; Risk Assessment; Syringes; Terminal Care
PubMed: 33468505
DOI: 10.1136/bmjspcare-2020-002735 -
Lab on a Chip Dec 2021Manipulation of fluid flow is paramount for microfluidic device operation. Conventional microfluidic pumps are often expensive, bulky, complicated, and not amenable in...
Manipulation of fluid flow is paramount for microfluidic device operation. Conventional microfluidic pumps are often expensive, bulky, complicated, and not amenable in limited resource settings. Here, we introduce a Fully self-sufficient, RobUst, Gravity-Assisted, Low-cost (FRUGAL) microfluidic pump. The pump consists of a syringe, a syringe holder and loading masses. The system is easy to assemble, inexpensive, portable, and electrical power-free. Inside the syringe, the fluid is driven by the pressure from the weight of the loading masses. During operation, the exerted pressure is dynamically controllable and stable for hours. These features are useful for optimization of microfluidics assays and dynamic temporal studies. We demonstrate the application of this system to control the formation of water-in-oil droplet emulsion. Benefitting from its simplicity and versatility, the frugal microfluidic pump will enable global adoption of microfluidic technology in chemistry and biomedical applications, especially in limited resource environments.
Topics: Electricity; Gravitation; Lab-On-A-Chip Devices; Microfluidics; Syringes
PubMed: 34751689
DOI: 10.1039/d1lc00691f -
Scientific Reports Feb 2021Previous studies have reported silicone oil (SO) applied to needles and syringes in the vitreous of patients after intravitreal injections. We evaluated four syringes...
Previous studies have reported silicone oil (SO) applied to needles and syringes in the vitreous of patients after intravitreal injections. We evaluated four syringes (SR 1-mL insulin, Saldanha-Rodrigues; BD 1-mL Tuberculin Slip Tip, Becton-Dickinson; BD Ultra-Fine 0.3 mL, HSW Norm-Ject Tuberculin, Henke Sass Wolf) and 10 needles (BD PrecisionGlide 27- and 30-gauge (G); BD Eclipse and JBP Nanoneedle 27-, 30-, 33- and 34-G; TSK Invisible Needle and 27 and 30-G Steriject Control Hub). The protein-free buffer samples injected into the syringes and needles under study were collected in an Eppendorf tube and taken to Flow imaging microscopy, that characterized the concentration and morphology of the microsized particles. The number of particles was analyzed. The coefficients of variation (CV) were the primary outcome. The Feltz and Miller test compared the CVs. The significance level was 5%. Numerous particles and high CVs were associated with both devices, needles and syringes; the comparisons among them did not reach significance. The BD Ultrafine 0.3 mL syringe (149.7%) had the highest CV and the SO-free HSW Norm-Ject (66.4%) syringe the lowest, and the TSK Invisible needle (149.5%) had the highest and the BD Precision Glide 30G needle (35.9%) needle the lowest. In conclusion, particle release, including those with SO morphology, varied greatly among instruments, even from the same lots, which is relevant considering that fewer particles are injected into some eyes compared with others.
Topics: Needles; Reproducibility of Results; Silicon; Silicone Oils; Syringes
PubMed: 33633285
DOI: 10.1038/s41598-021-84158-0 -
Bulletin of the World Health... 1998In many developing countries use of unsterilized or improperly sterilized needles and syringes is common and causes millions of cases of viral hepatitis B and C as well...
In many developing countries use of unsterilized or improperly sterilized needles and syringes is common and causes millions of cases of viral hepatitis B and C as well as contributing to the spread of human immunodeficiency virus (HIV) and other bloodborne pathogens. To combat this problem, WHO has stimulated the development of the "auto-destruct" syringe and encourages all donors, international agencies, and health departments to include a supply of such syringes with all vaccines supplied for emergency purposes. In addition, health providers and the public need to be educated about the risk of inappropriate and unsterile injections.
Topics: Blood-Borne Pathogens; Developing Countries; Disposable Equipment; Equipment Contamination; Humans; Practice Guidelines as Topic; Sterilization; Syringes; World Health Organization
PubMed: 9615502
DOI: No ID Found -
European Journal of Hospital Pharmacy :... Mar 2020Opioid-free anaesthesia is a treatment strategy of pain management based on the use of drugs such as lidocaine, ketamine and dexmedetomidine that do not interact...
OBJECTIVES
Opioid-free anaesthesia is a treatment strategy of pain management based on the use of drugs such as lidocaine, ketamine and dexmedetomidine that do not interact significantly with opioid receptors. In particular, these drugs are used by anaesthesiologists to ensure adequate levels of analgesia during surgical procedures for burn patients such as daily wound dressings and graft surgeries. Furthermore, for hypothermia prevention and wound-healing purposes, ambient temperature must be kept high for these patients, usually between 27°C and 30°C. To facilitate the use of this technique, clinicians want to mix lidocaine and ketamine in the same syringe. No stability data is available to determine the feasibility of this admixture and at this temperature. The objective was to study the physicochemical stability of lidocaine 20 mg/mL with ketamine 2.5 mg/mL diluted with 0.9% sodium chloride (0.9% NaCl) stored at 28°C in polypropylene syringe for 48 hours.
METHODS
Physical stability was evaluated by visual examination and by measuring turbidity with a spectrophotometer. Chemical stability was determined after preparation and after 6, 24 and 48 hours of conservation with a high performance liquid chromatography and pH measurements. The method was validated according to International Conference on Harmonisation Q2(R1) guidelines.
RESULTS
Both lidocaine (99.98%±1.44%) and ketamine (100.70%±0.95%) retained more than 95% of their initial concentration after 48 hours storage. pH measurements remained stable over the course of the study (less than 0.21 point of variation). No signs of physical instability were observed after visual and subvisual inspections.
CONCLUSIONS
The physicochemical stability of lidocaine 20 mg/mL and ketamine 2.5 mg/mL diluted with 0.9% NaCl in a polypropylene syringe stored at 28°C protected from light was demonstrated for 48 hours. This infusion technique is therefore feasible from a pharmaceutical point of view in burn-unit settings.
Topics: Analgesics; Analgesics, Opioid; Anesthesia; Anesthetics, Local; Chemical Phenomena; Chromatography, High Pressure Liquid; Drug Stability; Drug Therapy, Combination; Humans; Ketamine; Lidocaine; Polypropylenes; Syringes
PubMed: 32296511
DOI: 10.1136/ejhpharm-2019-001976 -
The Analyst Apr 2021The development of accelerated methods for pathogen identification (ID) and antimicrobial susceptibility testing (AST) for infectious diseases is necessary to facilitate...
Facile syringe filter-enabled bacteria separation, enrichment, and buffer exchange for clinical isolation-free digital detection and characterization of bacterial pathogens in urine.
The development of accelerated methods for pathogen identification (ID) and antimicrobial susceptibility testing (AST) for infectious diseases is necessary to facilitate evidence-based antibiotic therapy and reduce clinical overreliance on broad-spectrum antibiotics. Towards this end, droplet-based microfluidics has unlocked remarkably rapid diagnostic assays with single-cell and single-molecule resolution. Yet, droplet platforms invariably rely on testing purified bacterial samples that have been clinically isolated after lengthy (>16 h) plating. While plating-based clinical isolation is important for enriching and separating out bacteria from background in clinical samples and also facilitating buffer exchange, it creates a diagnostic bottleneck that ultimately precludes droplet-based methods from achieving significantly accelerated times-to-result. To alleviate this bottleneck, we have developed facile syringe filter-enabled strategies for bacterial separation, enrichment, and buffer exchange from urine samples. By selecting appropriately sized filter membranes, we separated bacterial cells from background particulates in urine samples and achieved up to 91% bacterial recovery after such 1-step filtration. When interfaced with droplet-based detection of bacterial cells, 1-step filtration improved the limit of detection for bacterial ID and quantification by over an order of magnitude. We also developed a facile buffer exchange strategy to prepare bacteria in urine samples for droplet-based AST that achieved up to 10-fold bacterial enrichment during buffer exchange. Our filtration strategies, can be easily integrated into droplet workflows, enable clinical isolation-free sample-to-answer ID and AST, and significantly accelerate the turnaround of standard infectious disease diagnostic workflows.
Topics: Anti-Bacterial Agents; Bacteria; Microbial Sensitivity Tests; Microfluidics; Syringes
PubMed: 33899069
DOI: 10.1039/d1an00039j -
International Journal of Pharmaceutics Nov 2022Understanding the interface motion and hydrodynamic shear induced by the liquid sloshing during the insertion stage of an autoinjector can help improve drug product...
Understanding the interface motion and hydrodynamic shear induced by the liquid sloshing during the insertion stage of an autoinjector can help improve drug product administration. We perform experiments to investigate the interfacial motion and hydrodynamic shear due to the acceleration and deceleration of syringes. The goal is to explore the role of fluid properties, air gap size, and syringe acceleration on the interface dynamics caused by autoinjector activation. We used a simplified autoinjector platform to record the syringe and liquid motion without any view obstruction. Water and silicone oil with the same viscosity are used as the model fluids. Particle Image Velocimetry (PIV) is employed to measure the velocity field. Simultaneous shadowgraph visualization captures the air entrainment. Our in-house PIV and image processing algorithms are used to quantify the hydrodynamic stress and interfacial area to investigate the effects of various autoinjector design parameters and fluid types on liquid sloshing. The results indicate that reducing the air gap volume and syringe acceleration/deceleration mitigate the interface area and effective shear. Moreover, the interfacial area and induced hydrodynamic stress decrease with the Fr=U/aD, where U is the interface velocity, a is the maximum syringe acceleration, and D is the syringe diameter.
Topics: Syringes; Hydrodynamics; Silicone Oils; Rheology; Water
PubMed: 36122618
DOI: 10.1016/j.ijpharm.2022.122210 -
Harm Reduction Journal Feb 2022Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and...
Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and child rights. This article addresses the current legal age restriction on access to needle and syringe programmes (NSPs) in Sweden. Based on legislation and legislative preparatory works, it traces the rationale for retaining an age restriction in the context of a policy priority to improve access for people who inject drugs. Building on threshold theory and child rights literature, the article unpacks the apparent tension between protecting the low threshold nature of service provision, child protection duties of healthcare staff, and the best interests of the child. It explores whether this tension could be alleviated through replacing a legal age restriction for all with best interests assessments for each individual, and discusses the potential ethical and practical challenges involved in such a change.
Topics: Child; Humans; Needles; Sweden; Syringes
PubMed: 35148774
DOI: 10.1186/s12954-022-00597-6