单向活瓣式医用橡胶瓶塞的研制与应用

现有的各种医用橡胶瓶塞都是一体化的结构，使用时需用注射器针头刺穿瓶塞才能抽出瓶中的药液。由于注射器针头是一种空心的管状结构，在穿刺瓶塞的过程中不可避免的会有橡胶微粒堵塞针头或污染药液，引起过敏反应或输液反应，造成患者或家属的紧张、恐惧．甚至引起医疗纠纷。为此．我们研制了一种不会产生橡胶微粒污染的单向活瓣式医用橡胶瓶塞，避免了橡胶微粒污染药液．达到了安全输液的目的，现报道如下。     

单向活瓣式医用橡胶瓶塞的研制与应用

现有的各种医用橡胶瓶塞都是一体化的结构,使用时需用注射器针头刺穿瓶塞才能抽出瓶中的药液[1]。由于注射器针头是一种空心的管状结构,在穿刺瓶塞的过程中不可避免的会有橡胶微粒堵塞针头或污染药液[2],引起过敏反应或输液反应[3],造成患者或家属的紧张、恐惧,甚至引起医疗纠纷。为此,我们研制了一种不会产生橡胶微粒污染的单向活瓣式医用橡胶瓶塞,避免了橡胶微粒污染药液,达到了安全输液的目的,现报道如下。制作方法本实用新型单向活瓣式医用瓶塞,可用橡胶材料制作,也可采用丁基材料制作(图1、图2),在普通橡胶瓶塞主体的中间增加活瓣结构(…     

两种静脉输注液体加药方法的比较

静脉输注微粒污染主要为输液前准备工作中的污染，如切割安瓿、开瓶塞、反复穿刺溶液瓶，橡胶塞及输液环境不洁净等。传统加药法是使针头垂直橡胶瓶塞加药，经常遇到针头堵塞，溶液瓶内有橡胶瓶塞进入，不仅加药浪费时间，又易造成溶液微粒污染，输液时又易造成病人紧张。为此，我科护理人员自2004年7月开始不断摸索，找出一种切实可行的方法，现报告如下。     

不同型号针头穿刺胶塞形成微粒情况的研究

多年来 ,临床配药时 ,由于针口刃面对橡胶塞的垂直切割 ,不可避免的造成橡胶塞屑脱落 ,形成微粒 ,对人体危害极大。有报道 ,针头每刺入胶塞一次 ,就有橡胶屑脱落 ,致使大量的橡胶微粒混于药液中 ,有时肉眼可见到。[1] 为此作者对 3种型号的针头穿刺胶塞形成微粒的情况进行了研究。现介绍如下。1　材料与方法1.1　材料有胶塞瓶装 0 .9%生理盐水 (0 .9%氯化钠 )注射液 2 40瓶 ,规格为 10 0ｍｌ/瓶 ,微粒分析仪 (由天津天河医疗器械研制中心制造 )、普通斜面金属针头 8# 、12 # 、16 # 各 1枚 ,净化台。1.2　方法在净化台上用 8# 、12 # 、16 #…     

两种静脉输注液体加药方法的比较

静脉输注微粒污染主要为输液前准备工作中的污染,如切割安瓿、开瓶塞、反复穿刺溶液瓶,橡胶塞及输液环境不洁净等[1]。传统加药法是使针头垂直橡胶瓶塞加药,经常遇到针头堵塞,溶液瓶内有橡胶瓶塞进入,不仅加药浪费时间,又易造成溶液微粒污染,输液时又易造成病人紧张。为此,我科护理人员自2004年7月开始不断摸索,找出一种切实可行的方法,现报告如下。1材料与方法1.1材料本组分别选取待加溶液400瓶,均为本院制剂室生产的普通玻璃瓶装的500mL葡萄糖液体,其中需加药品:红花180例,生脉60例,醒脑静160例,均为20mL待加药液。采用同一厂家生产的20m…     

一次性配药用注射器的改良设计

配制药液是临床工作中的一项常规操作。配药时一般用30ml注射器配制,针头一般是12号,孔径较大,由于反复抽吸,难免有少许橡胶塞,玻璃碎屑等微粒污染液体。现我们自制了一款避免药液污染的一套装置,经多次使用效果良好。现     

配药技术对静脉输液中不溶性微粒污染的安全控制研究

[目的]探讨配药技术对静脉输液过程中的不溶性微粒污染的控制情况.[方法]检测0.9%无菌氯化钠注射液在净化工作台上穿刺加药前、加青霉素后及穿刺空药瓶后微粒数并比较;比较治疗室和净化操作台下穿刺空药瓶后再穿刺0.9%无菌氯化钠注射液中橡胶微粒产生的情况;比较一次性9号针头和12号针头分别直刺和斜刺方法下橡胶微粒产生的情况.[结果]在净化工作台上操作产生的微粒数明显低于治疗室环境(P<0.05),加药可导致微粒数剧增(P<0.01);一次性9号针头较一次性12号针头、斜刺较直刺显著减少橡胶微粒的产生(P<0.01).[结论]采用小型号针头注射器配药产生的不溶性微粒数明显少于大型号针头注射器;直刺时容易对橡胶塞造成切割,使橡胶微粒增加,而斜角进针可减少橡胶微粒的产生.同时,穿刺本身、粉针剂药物及空气中所含微粒数也对液体微粒数产生重要影响.     

一种西林瓶专用配药针头的设计及应用

通过设计一种西林瓶专用配药针头,克服一次性配药针头容易产生橡胶微粒污染、药物抽吸困难等问题。本研究设计了一种可以减少橡胶微粒污染、更易操作的西林瓶专用配药针头。该针头具有使用简单、省力,可以一定程度上减少橡胶微粒污染等优点。经过临床使用后发现该针头经济、实用,值得在临床使用推广。     

配药技术对静脉输液中不溶性微粒污染的安全控制研究

[目的]探讨配药技术对静脉输液过程中的不溶性微粒污染的控制情况。[方法]检测0．9％无菌氯化钠注射液在净化工作台上穿刺加药前、加青霉素后及穿刺空药瓶后微粒数并比较；比较治疗室和净化操作台下穿刺空药瓶后再穿刺0．9％无菌氯化钠注射液中橡胶微粒产生的情况；比较一次性9号针头和12号钟头分别直刺和斜刺方法下橡胶微粒产生的情况。[结果]在净化工作台上操作产生的微粒数明显低于治疗室环境（P〈0.05），加药可导致微粒数剧增（P〈0．01）；一次性9号针头较一次性12号针头、斜刺较直刺显著减少橡胶微粒的产生（P〈0.01）。[结论]采用小型号针头注射器配药产生的不溶性微粒数明显少于大型号针头注射器；直刺时容易对橡胶塞造成切割．使橡胶微粒增加．而斜角进针可减少橡胶微粒的产生。同时．穿刺本身、粉针剂药物及空气中所含微粒数也对液体微粒数产生重要影响。     

溶药时不同进针角度致橡胶塞微粒污染的研究

临床静脉溶药微粒污染主要是橡胶塞微粒。在临床实际操作中，通过变换针头斜面与瓶塞刺入角度（分别为60°、90°、120°）对液体中像胶的微粒污染。影响进行了实验研究，结果表明溶药时针头斜面与瓶塞呈90°角进针时效果佳P＜0．01，其次是60°、120°角效果差，不宜应用。     

减少橡胶微粒污染输液液体的研究

目的：调查橡胶塞微粒的来源及相关因素。方法：采用了一次性12号针头（斜面针），一次性输液器（斜面针），一次性输液器（侧孔针），采取不同的穿刺方法，即直刺与斜刺，观察哪种方法可减少橡胶塞微粒数，结果：一次性12号针（斜面针），一次性输液器（斜面针）直刺与斜刺比较，经t检验，P＜0．05，有显著性差异，说明斜刺比直刺的橡胶微较少；一次性输液器（侧孔针），直刺与斜刺比较，经t检验，P＞0．05，无显著性差异，说明直刺与斜刺都一样，结论：一次性针（斜面针）很锋利，直刺时容易对橡胶塞造成切割，使橡胶微粒增多，斜角进针，可减少橡胶塞微粒和其他杂质落入瓶中。     

Glass contamination in parenterally administered medication

AIM: This paper reports a study examining glass particle contamination in two ampoule sizes under three different experimental conditions (n = 18 in each group). BACKGROUND: While existing literature is clear that glass contamination occurs on opening single-dose glass ampoules, the clinical significance of intramuscular administration of glass particles is equivocal. Current nursing practice standards do not adequately address this issue in terms of aspiration or filtration techniques that can minimize risk to patients. METHODS: A computer microscope was used to compare the number and size of glass particles aspirated into a syringe between two needle sizes [18 gauge (G) (130 microm lumen diameter) and 21 gauge (90 microm lumen diameter)] without filters and 19G (110 microm lumen diameter) filtered needles. Data were collected in 2002. RESULTS: At least one glass particle was found in 22% of the 1-mL ampoules, and 56% and 39% of the 2-mL ampoules, using 18G and 21G needles, respectively, had glass contaminants. Many of the 2-mL ampoules produced multiple glass particles on opening. Use of 19G filtered needles resulted in no glass particles. There was a significant difference in mean particle size between the 18G and 21G groups of 2-mL ampoules. CONCLUSION: Our results support the existing literature in that larger bore unfiltered needles increased the risk of aspirating more glass and other particles than smaller bore or filter needles. These data add further support to the use of filtered needles in administering IM medications to patients who receive ongoing scheduled IM injections.     

Two methods of single-dose ampule opening and their influence upon glass particulate contamination

Contamination of glass ampules by glass fragments can occur following ampule opening. The intravenous administration of these glass fragments in animal experiments has resulted in insult to the brain, pulmonary, hepatic, renal, and splenic systems of these animals. Thus, it is of clinical importance to determine quantitatively the extent of glass particulate contamination by examining the different methods of glass ampule opening. Twenty, 2-mL single-dose glass ampules were examined for glass fragments following opening. Ten of the ampules were snapped open by hand while 10 were snapped open with the use of a commercial ampule opener. The contents of the ampules were aspirated into a 5-mL glass syringe, attached to an 18-gauge nonfilter needle. The contents of the syringe were filtered, then examined for glass fragments under a microscope. The size and number of glass particles were recorded using a calibrated ocular micrometer. Analysis of variance for repeated measures and Duncan's test showed no significant difference between the two groups. Thus, no significant difference existed in the number and size of glass particles aspirated when comparing these two ampule opening methods.     

Reuse of disposable syringe-needle units in the diabetic patient

A comparison was made between reuse of plastic disposable needle-syringe units and glass syringes with daily new needles in diabetic patients who take daily insulin injections. Parameters studied were incidence of infection, clarity of syringe readings, ability to use syringe, and sharpness of needle. The plastic disposable units could be reused with safety and patient satisfaction by most patients for at least 3 days. Considerable cost benefit could accrue if disposable units were used more than one time for insulin injections.     

Reuse of disposable syringe-needle units in the diabetic patient

A comparison was made between reuse of plastic disposable needle-syringe units and glass syringes with daily new needles in diabetic patients who take daily insulin injections. Parameters studied were incidence of infection, clarity of syringe readings, ability to use syringe, and sharpness of needle. The plastic disposable units could be reused with safety and patient satisfaction by most patients for at least 3 days. Considerable cost benefit could accrue if disposable units were used more than one time for insulin injections.     

Exploring the effectiveness of a regional nurse practitioner led,long-acting injectable buprenorphine-based model of care for opioid use disorder

The introduction of long-acting injectable buprenorphine preparations for opioid use disorder has been widely heralded as a breakthrough treatment, with several studies indicating positive results when using these medications. In many locations, nurse practitioners prescribe, administer, and monitor long-acting injectable preparations. The objective of this paper is to explore whether a reduction in dispensed needles and syringes is attributable to increased nurse practitioner prescribing of LAIB. We used a retrospective audit of needles dispensed through the health service needle and syringe program vending machine, and individuals treated with long-acting injectable buprenorphine by the nurse practitioner led model. In addition, we examined potential factors that may influence changes in the number of needles dispensed. Linear regression found that each individual with opioid dependence treated with long-acting injectable buprenorphine was associated with 90 fewer needles dispensed each month (p < 0.001). The nurse practitioner led model of care for individuals with opioid dependence appears to have influenced the number of needles dispensed at the needle and syringe program. Although all confounding factors could not be discounted entirely, such as substance availability, affordability, and individuals obtaining injecting equipment elsewhere, our research indicates that a nurse practitioner led model of treating individuals with opioid use disorder influenced needle and syringe dispensing in the study setting.     

Effects of syringe material and needle size on the minimum plunger-displacement pressure of arterial blood gas syringes.

We determined the minimum systolic pressures required for blood to enter and begin to displace the plungers of four brands of 3-ml and 5-ml plastic and glass arterial blood gas syringes by combining samples of each syringe size with three sizes of short-beveled needles--25 gauge, 5/8"; 22-gauge, 1"; and 20-gauge, 1 1/2". We measured pressures by use of an arterial-vessel model that incorporated whole human blood and simulated the conditions of a percutaneous arterial puncture. We concluded that all the arterial blood gas syringes that we studied would self-fill in most clinical situations when they were combined with 20- or 22-gauge needles, but that 22-gauge needles with glass syringes were preferable for persons whose systolic pressures were less than 70 mm Hg, for persons in shock, and for persons undergoing CPR. Only glass 3-ml syringes should be used with 25-gauge needles, as two brands of plastic 3-ml syringes with 25-gauge needles required systolic pressures greater than 158 mm Hg and all brands of plastic and glass 5-ml syringes with 25-gauge needles required systolic pressures greater than 247 mm Hg. Because we found no clinical or statistical differences between 20- and 22-gauge needles, we do not recommend use of the larger 20-gauge needle. The syringe-needle combinations that we do recommend should negate the need for, and the potential trauma of, manual aspiration of the syringe plunger.     

Laboratory study of the effectiveness of filters used by heroin injectors

Aims: (a) To compare in the laboratory the effectiveness of various filters at removing particles from heroin injections; (b) To measure the amount of heroin retained by the filters; and (c) To describe the relevance of these preliminary findings to future research.

Design: A laboratory‐based investigation. Injections were prepared with street heroin obtained from the police, copying the methods of injectors. Pieces of cigarette filter, hand‐rolling cigarette filter, cotton wool from buds and commercially produced syringe filters were tested. The Coulter Multisizer (IIe) was used to count and size particles; Capillary Zone Electrophoresis was used to measure the amount of heroin retained in the filters.

Findings: All methods of filtration reduced the amount of particles, with the commercially produced syringe filter producing the largest reduction. The syringe filter retained the most heroin after use; however, less drug material was evident on the spoon, suggesting further work is needed with a range of quantities. The cigarette, hand‐rolling and cotton bud filters all retained some drug with no significant difference detected between the different filters.

Conclusions: This preliminary study suggests all the filters tested may convey health benefits. Further work is needed with varying quantities of drug, acid and water and to establish safety in use. Then future studies can establish the health consequences for injecting drug users from the use of such filters.     

两种方式冲洗注射针头热原检测对比

我院供应室针对注射针头存在热原的问题，对针头冲洗处理工序做了改进。并进行了热原检测。结果显示：临床各科使用后的各型号针头在改进前冲洗工序处理热原阳性率为3.21％，经改进后冲洗工序处理热原阳性率为0．78％．经统计学处理，差异有显著意义，说明改进后的冲洗注射针头除热原工序是一种理想的处理工序。     

Influence of background air on microbial contamination during simulated i.v.-admixture preparation

The effect of the cleanliness of environmental air on the microbial contamination of a simulated i.v.-admixture during its preparation by aseptic transfer was studied under three conditions: (i) in a laminar air flow (LAF) bench situated in a class 1000 clean room, (ii) in an LAF bench in a microbiology laboratory and (iii) on a bench in an ordinary laboratory. Three thousand bottles were manually filled with 10 ml of a nutrient broth under each of the three conditions. The liquid was transferred by means of a syringe and a needle that pierced through the rubber closures of the bottles. The numbers of contaminated bottles under those three conditions were 1, 1 and 2, respectively. Background contamination had no demonstrable effect on the incidence of contamination, provided that preparation of the simulated i.v.-admixture solution was performed by skilled personnel in an LAF cabinet and air contact is avoided.