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the syringe driver

Lachlan Frawley, Bridget Devaney, Theo Tsouras, Geoff Frawley
BACKGROUND: The BBraun Perfusor Space™ syringe driver is already in use by ambulance services and retrieval teams but has not previously been assessed for hyperbaric chamber use. METHODS: Pump flow accuracy was tested at rates between 1 and 40 ml· h⁻¹ using three different brands of 50 ml syringe. Function of the occlusion alarms was assessed using the same syringes. The hyperbaric profile involved pressurisation to 284 kPa at 30 kPa· min⁻¹, 30 min at 284 kPa and decompression at 30 kPa· min⁻¹...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Tashuna Albritton, Isabel Martinez, Crystal Gibson, Meghan Angley, Valen R Grandelski
Health care budgets and policies are chief drivers in the delivery and access to health services. Place is also a factor that affects patient and provider experiences within the health care system. We examine the impact of policy changes and subsequent budget cuts on rural HIV/AIDS care, support services, and prevention. We interviewed 11 social workers, case managers, and outreach workers who serve rural people living with HIV/AIDS. We conducted telephone interviews inquiring about the effect of economics and policies on direct practice with rural clients...
March 6, 2017: Social Work in Public Health
Karemah François, Elizabeth Lobb, Sarah Barclay, Liz Forbat
OBJECTIVES: Conflict is a significant and recurring problem in healthcare. This study aimed to understand staff and relatives' perspectives on the characteristics of conflict and serious disagreement in adult palliative care, including triggers, risk factors and the impact on themselves and clinical care. METHODS: Qualitative study of 25 staff and seven bereaved relatives using individual interviews, recruited from a multidisciplinary specialist palliative care setting in Australia...
February 24, 2017: Patient Education and Counseling
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
Roland A Snijder, Johannes T A Knape, Toine C G Egberts, Annemoon M D E Timmerman
A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0...
April 1, 2017: A & A Case Reports
Isabel Fernández-Arias, Hae Kyung Kim
INTRODUCTION AND OBJECTIVE: To capture the experience of haemophilia A patients with their devices for coagulation factor reconstitution, the barriers for treatment adherence; and to determine their preferences, presenting a new double-chamber syringe (DCS). METHOD: A cross-sectional research through a supervised survey and a DCS testing session. RESULTS: Seventy-four (74) patients participated, 50% of them on prophylaxis treatment, and 7 years (median) with their usual treatment (IQR 17...
November 1, 2016: Farmacia Hospitalaria
Marc C Torjman, Robert Machnicki, Jennifer Lessin, Channy Loeum, Douglas Steinberger, Sarah Mycroft, Jeffrey I Joseph
OBJECTIVES: Introduction of a wearable device for subcutaneous delivery of larger volume bolus injections would encourage patient compliance and reduce the burden on healthcare services. With one such wearable device commercially available, this study examined the safety and functionality of an investigational device in volunteers. METHODS: Four devices were applied to the subject's abdomen: 1) Investigational Device, 2) Investigational Device: subject movement, 3) Control Device: FDA-cleared syringe driver with FDA-cleared infusion set, 4) Control Device: FDA-cleared syringe driver attached to investigational device...
January 2017: Expert Opinion on Drug Delivery
Naveed Zafar Janjua, Zahid Ahmad Butt, Bushra Mahmood, Arshad Altaf
AIM: To summarize the available information about injection use and its determinants in the South Asian region. METHODS: We searched published and unpublished literature on injection safety in South Asia published during 1995-2016 using the keywords "injection" "unsafe injection" and "immunization injection" and combined these with each of the countries and/or their respective states or provinces in South Asia. We used a standardized questionnaire to abstract the following data from the articles: the annual number of injections per capita, the proportion of injections administered with a reused syringe or needle, the distribution of injections with respect to prescribers and providers and determinants of injection use...
July 7, 2016: World Journal of Gastroenterology: WJG
Phillip L Marotta, Charlotte A McCullagh
Although many studies have found an association between harm reduction interventions and reductions in incidence rates of Human Immunodeficiency Virus (HIV) infection, scant research explores the effects of harm reduction cross-nationally. This study used a year- and country-level fixed effects model to estimate the potential effects of needle-and-syringe programs (NSPs) and methadone maintenance therapy (MMT) on incidence rates of HIV in the general population and among people who inject drugs (PWID), in a sample of 28 European nations...
June 2016: International Journal on Drug Policy
Katie Alexandra Stone
BACKGROUND: There is an estimate of three to five million people who inject drugs living in Asia. Unsafe injecting drug use is a major driver of both the HIV and hepatitis C (HCV) epidemic in this region, and an increase in incidence among people who inject drugs continues. Although harm reduction is becoming increasingly accepted, a largely punitive policy remains firmly in place, undermining access to life-saving programmes. The aim of this study is to present an overview of key findings on harm reduction in Asia based on data collected for the Global State of Harm Reduction 2014...
2015: Harm Reduction Journal
Steffanie A Strathdee, Jaime Arredondo, Teresita Rocha, Daniela Abramovitz, Maria Luisa Rolon, Efrain Patiño Mandujano, Maria Gudelia Rangel, Horcasitas Omar Olivarria, Tommi Gaines, Thomas L Patterson, Leo Beletsky
INTRODUCTION: Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre-post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown...
August 10, 2015: BMJ Open
Pauline Voon, Kanna Hayashi, Lianping Ti, Karyn Kaplan, Paisan Suwannawong, Evan Wood, Thomas Kerr
BACKGROUND: Syringe sharing continues to be a major driver of the HIV pandemic. In light of efforts to enhance access to sterile syringes and promote secondary prevention among HIV-positive individuals, we sought to identify the prevalence and correlates of used syringe lending among self-reported HIV-positive people who inject drugs (PWID) in Bangkok, Thailand. FINDINGS: We used bivariable statistics to examine factors associated with self-reported syringe lending among self-reported HIV-positive PWID participating in the Mitsampan Community Research Project, a serial cross-sectional study of PWID in Bangkok, between June 2009 and October 2011...
2015: Harm Reduction Journal
Ian L Millar
In an emergency, life support can be provided during recompression or hyperbaric oxygen therapy using very basic equipment, provided the equipment is hyperbaric-compatible and the clinicians have appropriate experience. For hyperbaric critical care to be provided safely on a routine basis, however, a great deal of preparation and specific equipment is needed, and relatively few facilities have optimal capabilities at present. The type, size and location of the chamber are very influential factors. Although monoplace chamber critical care is possible, it involves special adaptations and inherent limitations that make it inappropriate for all but specifically experienced teams...
March 2015: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
S C Reston, P Basanagoudar, A D McNair, A H Deakin, A W G Kinninmonth
UNLABELLED: There are concerns about the risk of iatrogenic infection when employing local anaesthetic techniques with post-operative intra-articular infusions in total knee arthroplasty. This study aimed to determine the efficacy of intact epidural filters in preventing transit of bacteria and to develop a technique of administration which would prevent membrane rupture. Filter efficacy was assessed using a standardised test suspension of Pseudomonas aeruginosa. Twenty millilitres of suspension was injected through isolated epidural filters (n=10) or filters with 40cm of catheter tubing attached (n=30)...
January 2016: Knee
Claire Magee, Jonathan Koffman
OBJECTIVES: Offering genuine choice to patients over place of care and death requires the provision of high-quality palliative care 24/7. This study examines the confidence of out-of-hours general practitioners (GPs) in symptom control and end of life prescribing, and identifies their educational needs and preferences in order to inform recommendations for future education. METHODS: A self-completion postal survey was designed and sent to 1005 GPs working for an independent provider of out-of-hours services across England...
September 2016: BMJ Supportive & Palliative Care
Tabitha Thomas, Stephen Barclay
Syringe drivers are widely used in palliative care, and this article reviews the challenges and outstanding questions associated with their use. Misperceptions among the lay public and some health professionals can be addressed by sensitive communication with patients and families and clear thinking in clinical teams concerning the drugs and doses used, particularly in non-malignant disease. Good levels of knowledge concerning syringe driver use has been found among GPs and community nurses, although this is not the case in some nursing home teams...
February 2015: International Journal of Palliative Nursing
Gregory M Lucas, Sunil S Solomon, Aylur K Srikrishnan, Alok Agrawal, Syed Iqbal, Oliver Laeyendecker, Allison M McFall, Muniratnam S Kumar, Elizabeth L Ogburn, David D Celentano, Suniti Solomon, Shruti H Mehta
BACKGROUND: Injecting drug use has historically been the principal driver of the HIV epidemic in the northeast states of India. However, recent data indicate growing numbers of people who inject drugs (PWIDs) in north and central Indian cities. METHODS: We conducted face-to-face surveys among PWIDs in seven northeast and eight north/central Indian cities using respondent-driven sampling. We used a rapid HIV-testing protocol to identify seropositive individuals and multiassay algorithm to identify those with recent infection...
March 13, 2015: AIDS
Sheila Payne, Mary Turner, David Seamark, Carol Thomas, Sarah Brearley, Xu Wang, Susan Blake, Christine Milligan
OBJECTIVE: To explore how bereaved family members recall managing end of life medications when delivering care to a patient dying at home in England. DESIGN: Qualitative study. SETTING: Domestic homes in two contrasting areas in England. PARTICIPANTS: 59 bereaved family carers who have delivered care to a patient who spent a minimum of 2 weeks at home prior to their death from cancer or other non-malignant condition...
June 2015: BMJ Supportive & Palliative Care
Philip Bruggmann, Jason Grebely
People who inject drugs (PWID) represent the core of the hepatitis C virus (HCV) epidemic in many countries. HCV transmission continues among PWID, despite evidence demonstrating that high coverage of combined harm reduction strategies, such as needle syringe programs (NSP) and opioid substitution treatment (OST), can be effective in reducing the risk of HCV transmission. Among infected individuals, HCV-related morbidity and mortality continues to grow and is accompanied by major public health, social and economic burdens...
February 2015: International Journal on Drug Policy
Douglas McG Clarkson, Romain Barbosa
The value of compliance of disposable elements such as infusion lines and syringes can significantly affect the performance characteristics of infusion devices. In a technique used to determine the compliance of infusion lines, the item under test is placed in a semi sealed water filled enclosure and the volume of fluid displaced is measured on an analytical weighing balance as set pressures are applied to the test item. Thermal drift of the measurement chamber was minimised by inclusion of discs of Invar alloy...
November 2014: Medical Engineering & Physics
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