What’s in the Palliative Care Syringe: Identifying Evaluation and Treatment Trends in Protocol-Driven Outpatient Palliative Care Consultations (SCI945)
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The accuracy of mixing two types of insulin in one syringe was studied in 41 insulin-dependent diabetic patients who prepared a mixture of two fluids (saline and sterile water) with either a disposable, 1-ml plastic syringe with a fixed needle, i.e., with a small dead space, or one equipped with a separate needle. Syringes with fixed needles delivered the two components very accurately and were associated with only slight wastage of insulin of 0.011 ml per injection. The syringe with a separate needle delivered 0.033–0.065 ml more than the intended dose of the “first insulin” and correspondingly less of the intended dose of the “second insulin,” since the total dose delivered was approximately correct. The magnitude of the insulin wastage of two daily injections was calculated to be 64 ml per patient annually, which could be reduced to 8 ml per patient if fixed needles were used. It is therefore recommended that patients preparing mixtures of two insulins in the same syringe abandon syringes with separate needles.
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Palliative care that provides specialized attention to pain and symptom management is important for patients with cancer. Palliative care aims to reduce pain and other symptoms through an interdisciplinary approach involving physicians, nurses, social workers, and other members of the healthcare team. Families are included in care planning. Patients and families benefit from the availability of palliative care services early in the disease process, particularly when symptoms impact quality of life. One way to implement early palliative interventions is the establishment of an ambulatory care clinic dedicated to palliative care. This article describes the experience of an outpatient palliative care clinic at a large teaching hospital by using case studies to highlight the benefits of ambulatory palliative care and concluding with recommendations for research.
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ABSTRACT The friction force of 5-ml, 2-ml, and 1-ml syringes used for manual aspiration of cortex material in extracapsular cataract extraction (ECCE) were compared. It was found that for a 5-ml syringe the force was 500 g, for a 2-ml syringe it was 250 g, and for a 1-ml tuberculin-type syringe it was only 50 g. The ease and duration of cortex aspiration in 30 cases of ECCE were compared using each of the above syringes partially filled with fluid, connected to a 25-gauge Gill's type cannula, and a closed anterior chamber technique. It was found that with the help of a 1-ml tuberculin syringe, cortex material was removed faster and with less finger fatigue than with the 5-ml or 2-ml syringe.
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In Brief The Episure™ AutoDetect™ syringe, a spring-loaded syringe, is a new loss-of-resistance syringe with an internal compression spring that applies constant pressure on the plunger. In this pilot study, we compared the spring-loaded syringe with the standard glass syringe for identification of the epidural space during initiation of epidural analgesia in parturients. The primary outcome was the incidence of failed epidural analgesia. Three-hundred and twenty-five women were enrolled. Eight residents performed 291 procedures (90%) and two attendings performed 34 procedures (10%). Epidural analgesia failed in five subjects in the glass syringe group and in no subject in the spring-loaded syringe group (P = 0.025). IMPLICATIONS: The Episure™ AutoDetect™ syringe, a spring-loaded syringe, was compared with the glass syringe for identification of the epidural space in 325 parturients. There was no failed epidural analgesia and no inadvertent dural punctures with the AutoDetect syringe.
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Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers.The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA.Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release.Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products.In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.
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Objective:To investigate clinical result of hypodermal injection of insulin by two different syringes on diabetic mellitus(DM)nephropathy patients.Method:43 DM nephropathy patients who used to received insulin injection by 1ml traditional syringe now by specially made syringe for DM.Result:This specially made syringe can alleviate injection pain,avoid over use of insulin,easy to spread and easy for preserve.Conclusion:Application of specially made insulin syringe can improve therapeutic result.
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We measured fluctuation of injection pressure by several types of commercially available syringe pumps in order to investigate the effect of syringe volumes (Terumo syringe) and speed settings on the irregularity of injection speeds. We recorded the injection pressure continuously with various speed settings, except that one of the pumps injected irregularly at the settings of 2 and 1 ml.h-1. With 50 ml syringes, only two of the six pumps injected precisely at all the speed settings. With the other four types, a steep increase in pressure was recorded at the speed setting of 1 ml.h-1. However irregular infusion was never observed by using a syringe of a high resistant type (TOP syringe). With 30 ml syringes, injection pressures fluctuated in most of the six syringe pumps at a speed lower than 5 ml.h-1. In conclusion, changes in injection pressures depend on types of syringes, syringe volumes and speed settings. We urge not to use a 30 ml syringe to infuse vasoactive drugs with syringe pumps.
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