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At least 19 recordsLinked to original sources
PubMedDate not supplied

The effect on syringe performance of fluid storage and repeated use: implications for syringe pumps.

Syringe stiction has been reported to cause syringe pump malfunction, hence the effect on syringe performance of syringe use and the formulations used in the syringe were investigated. The force required for syringe plunger motion (at 2.5 mm min-1), when filled with soybean oil emulsion (SBOE) and with water, and the extraction of silicone oil from syringes by these fluids, were measured for Primo, Talus and Terumo 10 mL, and Terumo 50 mL syringes. The breakloose, average extrusion and maximum force required to maintain plunger motion increased after storage of SBOE for 7 days in all syringes tested (p < 0.05). The storage of water increased the breakloose force of all syringes, but only increased the maximum force of Talus syringes, and both the average extrusion and maximum forces of Terumo 10 mL syringes. The mechanism for this is most likely swelling of the elastomer of the piston due to sorption of fluid. The force was found to increase logarithmically with repeated syringe use. Electrothermal atomization atomic absorption spectroscopy was used to measure the silicone oil content of syringe extractions. Three extractions were performed: repeated flushing, vigorous washing, and storage for 7 days with occasional agitation. Up to 69.4% of the silicone oil present in the syringes was extracted with both water and SBOE when they were stored or washed. In contrast to water, SBOE also extracted the lubricant when the syringe was filled and flushed immediately. If syringes are refilled, stored filled before use, or used over a prolonged period, particularly with a SBOE formulation, syringe striction may occur during infusion with a syringe pump.

Drug Storage↗
PubMed1998

Access to sterile syringes in Maine: pharmacy practice after the 1993 repeal of the syringe prescription law.

In October 1993, the Maine legislature repealed the prescription law regulating the sale of syringes. The new law allowed but did not require licensed pharmacists to dispense syringes without a prescription to anyone 18 years of age or older. From November 1995 to January 1996, we conducted a telephone survey of 208 Maine pharmacists to evaluate the sale of syringes with and without a prescription and to assess pharmacists' willingness to sell syringes without a prescription. We found that 94% of pharmacists were willing, in all cases or at the discretion of the pharmacist, to sell syringes without a prescription. However, when asked specifically about willingness to sell syringes without a prescription to suspected injection drug users (IDUs) > or =18 years of age, 47% were willing, 40% were not willing, and 13% did not know or declined to answer. Pharmacists reported other requirements for the purchase of syringes without a prescription, such as the requirement for the customer to provide a reasonable justification for the purchase. In all, there were 31 (15%) pharmacists in the sample willing to sell syringes to without a prescription with no additional requirements for purchase to suspected IDUs as permitted by law. There were few negative incidents reported involving IDUs and the sale of syringes without a prescription since amendment of the law. Although sales of syringes without a prescription were reported, the numbers sold fell short of the estimated number of syringes required for IDUs in Maine to use a new syringe for every injection. Despite the change in the prescription law intended to increase access to syringes, the data suggest barriers such as drug paraphernalia laws and pharmacy policies may prevent IDUs from purchasing syringes and contribute to ongoing transmission of HIV. Amendment of the drug paraphernalia and syringe possession laws, clarification of the legitimate medical purpose of access to sterile syringes for IDUs, and offering pharmacists continuing education on the prevention of blood-borne disease appear to be necessary steps in the effort to decrease the transmission of HIV among IDUs in Maine.

Adult↗
PubMed1998

Syringe use and reuse: effects of syringe exchange programs in four cities.

We determined the effect of syringe exchange programs (SEPs) on syringe reuse patterns. Five methods were employed to estimate injections per syringe made by exchange clients in four cities. In San Francisco, Chicago, and Baltimore, self-reported data on the number of injections per syringe were obtained. In New Haven, self-reported injection frequencies were combined with syringe tracking data to derive two methods for estimating the mean injections per syringe. The average number of injections per syringe declined by at least half after establishment of SEPs in New Haven, Baltimore, and Chicago, all cities where such an analysis could be made. There were significant increases in the percentages of exchangers reporting once-only use of their syringes in San Francisco, Baltimore, and Chicago, all cities where the data were amenable to this form of analysis. Self-report and syringe tracking estimates were in agreement that SEP participation was associated with decreases in syringe reuse by drug injectors. SEP participation was associated with increases in the once-only use of syringes. These findings add to earlier studies supporting the role of SEPs in reducing the transmission of syringe-borne infections such as HIV and hepatitis.

Baltimore↗
PubMed1995

Impact of increased legal access to needles and syringes on community pharmacies' needle and syringe sales--Connecticut, 1992-1993.

In May 1992, the Connecticut legislature passed new laws aimed at increasing injecting drug users' (IDUs) access to sterile needles and syringes (syringes); as of July 1992, pharmacists were permitted to sell and individuals were permitted to possess up to 10 syringes without medical prescriptions (nonprescription syringes). We evaluated the impact of the new laws by conducting (1) prospective surveillance of syringe sales and policies at selected community pharmacies (pharmacies) and (2) a telephone survey of pharmacy managers' reports of syringe sales and policies at a statewide stratified random sample of pharmacies. Our data provide direct evidence that most, but not all, Connecticut pharmacies sold nonprescription syringes when permitted to do so by the new laws. For example, using the telephone survey data, we estimate that during November, 1993, 83% [95% CI: 77-89%] of all Connecticut pharmacies sold nonprescription syringes and 56,000 [95% CI: 44,000-68,000] nonprescription syringes were sold, during November 1993. Our data provide indirect evidence that IDUs were purchasing nonprescription syringes at pharmacies. For example, in five Hartford pharmacies located in neighborhoods where injection drug use was prevalent, the total number of nonprescription syringes sold per month increased significantly from 460 in July 1992 to 2,482 in June 1993 (p = 0.0001). The data suggest that the new laws increased IDUs' access to sterile syringes in Connecticut.

Centers for Disease Control and Prevention, U.S.↗
PubMed1994

[Fluctuation of injection pressure of syringe pumps; the effect of syringe volumes and speed settings].

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.

Infusion Pumps↗
PubMedDate not supplied

Pharmacy access to sterile syringes for injection drug users: attitudes of participants in a syringe exchange program.

OBJECTIVE: To examine attitudes of participants of a van-based syringe exchange program (SEP) toward the hypothetical prospect of pharmacy-based syringe access. DESIGN: One-time, cross-sectional survey. SETTING: Baltimore, Maryland. PARTICIPANTS: 206 injection drug users who participate in the Baltimore SEP. INTERVENTIONS: Face-to-face interviews. MAIN OUTCOME MEASURES: Location preferred for obtaining syringes, drug and syringe use, past experience with pharmacies, and willingness to pay. RESULTS: The sample was 67% men, 95% African American, and 95% unemployed; mean age was 39.8 years. A total of 19% of respondents had bought syringes at a pharmacy during the prior six months. Some 37% reported having been turned down when asking for syringes at a pharmacy, most commonly due to lack of identification to prove diabetic status (50%). If legal restrictions were lifted, 92% of respondents would obtain syringes from pharmacies, and would be willing to pay a mean price of $0.80 (median = $1.00) per syringe. Women were more likely than men to report the intention to switch from van-based SEP to pharmacy (57% versus 38%, p = .045). CONCLUSION: If current legal restrictions were lifted, pharmacies would be a viable syringe source appealing particularly to women, suggesting gender-specific access issues that should be addressed. The per-syringe price that study participants would be willing to pay exceeds typical retail prices, suggesting that pharmacists could charge enough per syringe to recoup operational costs.

Adult↗
PubMed1998

A sterile syringe for every drug user injection: how many injections take place annually, and how might pharmacists contribute to syringe distribution?

Our objectives were to estimate the annual number of injections by injection drug users (IDUs) in the United States of America, and to describe the potential role of pharmacists in providing IDUs with a sterile syringe for every injection. We estimated the number of annual injections by IDUs for the United States, selected U.S. states, and selected U.S. cities according to the following formula: number of injections per year = (number of IDUs) x (average number of injections per IDU per day) x 365. Data were obtained from published articles, personal communications with local experts, and selected national databases. We also reviewed published and unpublished studies of pharmacy kits, pharmacist attitudes, and pharmacist practices in the United States and abroad. Between 920 million and 1.7 billion injections by IDUs take place each year in the United States. We estimated 12 million injections per year in San Francisco and >80 million in New York City. A similar number of syringes would be needed to satisfy the goal of a sterile syringe for every injection. Pharmacy-based strategies, including the sale of kits for injection drug use, have provided sterile syringes to IDUs in Europe, Australia, and New Zealand. Modification of laws restricting syringe purchase and possession has led to marked increases in purchase of syringes from pharmacies and reductions in needle-sharing. In conclusion, large numbers of syringes would be required to provide a sterile syringe for every injection, but significant numbers of pharmacists seem to be willing to play a central role in syringe sale and distribution. Outreach programs should emphasize that using a sterile syringe for every injection is the optimal HIV prevention practice for IDUs who cannot or will not stop injecting. Pharmacy-based syringe sale or distribution has the potential to augment current efforts to prevent HIV infection in IDUs, their sex partners, and their children.

Australia↗
PubMed1982

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.

Blood Gas Analysis↗
PubMed1999

Use of SoloShot autodestruct syringes compared with disposable syringes, in a national immunization campaign in Indonesia.

Autodestruct syringes can reduce the improper reuse of syringes, which present a significant risk in the transmission of bloodborne pathogens in developing countries, especially during immunization campaigns owing to the high number of injections given per session. SoloShot is an autodestruct syringe, distributed by UNICEF, which has been shown to be safer and easier to use than standard syringes. This study analyses the accuracy and dose-efficiency of SoloShot, compared with disposable syringes, during a national tetanus toxoid immunization campaign on the Indonesian island of Lombok. Observation and dose measurements revealed that SoloShot syringes delivered more precise and consistent doses and 15% more doses per vial than disposable syringes. Vaccine savings may partially be offset by the higher price of SoloShot. Vaccinators preferred SoloShot, describing it as easier to use, faster, and more accurate than the disposable syringe. The study indicates that SoloShot is highly appropriate for use in immunization campaigns by reducing vaccine wastage and improving injection safety.

Adult↗
PubMed1992

Effect of two different syringes on syringe driver function.

A laboratory investigation into the effect of two different syringes on the performance of a syringe driver was undertaken in order to assess accuracy of delivery, occlusion-alarm delay time and the effect of incorrectly coding the device for the syringe in use. Results indicated that accuracy of delivery was of the order of -1%/h for both syringe types at an infusion rate of 5 ml/h. Clinically and statistically significant differences in the occlusion-to-alarm time were found between syringes and between infusion rates. At 99.9 ml/h lag time was about 30 seconds for both syringes, whereas at 5 ml/h this was 667 seconds for one syringe and 903 seconds for the other. Incorrect coding of the driver for the syringe in use, resulted in a significant change in the accuracy of delivery at an infusion rate of 5 ml/h. Similarly, incorrect coding resulted in changes in the occlusion-alarm time. These results carry significant pharmacological implications for the clinical situation.

Humans↗
PubMed1986

Microbial contamination potential of solutions in prefilled disposable syringes used with a syringe pump.

The sterility of trypticase soy broth (TSB) that was frozen and thawed in disposable plastic syringes and infused via syringe pump was studied to determine whether ambient air or personnel-transferred contaminants compromised the sterility of the solution. Samples of TSB (10, 20, 30 mL) were prepared aseptically in syringes of three different brands--150 samples for each volume (50 for each manufacturer). The syringes were placed in zip-lock bags, stored for 24 hours at -15 to -20 degrees C, and thawed for three hours. Both positive and negative controls were used. For the test samples, infusion sets were connected to the syringes under aseptic conditions, and the solution was infused via syringe pump in ambient air into polyvinyl chloride minibags before incubation. The remaining samples were prepared in the same manner as the test solutions except that they were intentionally challenged with Bacillus subtilis introduced distal to the plunger. All samples were inspected visually for turbidity after a 14-day incubation period. There was no growth in any of the test infusion samples or in samples that were intentionally contaminated. The negative controls showed no growth; all of the positive controls showed growth. The sterility of solutions frozen in disposable plastic syringes does not appear to be compromised by touch contamination of the plunger shaft or by airborne microorganisms settling on the infusion system.

Bacteria↗
PubMed1997

Changing the environment of AIDS risk: findings on syringe exchange and pharmacy sales of syringes in Hartford, CT.

This paper reports findings from a National Institute on Drug Abuse-funded study designed to test the hypothesis that environmental changes, such as the enactment of laws to increase the accessibility of sterile syringes, including syringe exchange and pharmacy sale of syringes without a prescription, will lower the frequency of HIV risk and the prevalence of HIV among street drug users. Project COPE, a study of AIDS risk and risk prevention, collected longitudinal data on drug use, HIV risk, serostatus, and source of syringes in a sample of 710 out-of-treatment injection drug users in Hartford, CT. Findings support the hypothesis and the growing research-based conclusion that syringe exchange is an effective AIDS risk reduction modality.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Syringe exchange programs: lowering the transmission of syringe-borne diseases and beyond.

OBJECTIVE: This chapter attempts to describe the factors influencing the transmission of syringe-born viruses, to review the effects of syringe exchange programs (SEPs) in terms of these factors, and to explore the gamut of health-promoting activities of SEPs. RESULTS: The chapter is divided into six sections: biological factors in syringe-borne viral transmission, behavior and viral transmission, quantifying viral transmission, preventing viral transmission, impediments to preventing viral transmission, and research for preventing viral transmission. Understanding how biological and behavioral factors influence transmission of human immunodeficiency virus (HIV) and hepatitis builds a framework to investigate the epidemiology and the impact of SEPs on disease transmission. Even under circumstances in which these programs do not appear to be effective, understanding the implications of the biological and behavioral factors can contribute to our understanding of program benefits and limitations. Furthermore, program benefits may not be restricted to direct effects on disease transmission. Many programs offer services to drug injectors that include risk reduction training, facilitated entry into substance abuse treatment, and medical care. CONCLUSIONS: SEPs can reduce the transmission of syringe-borne viruses without increasing illicit drug use. However, lack of resources, acceptance, and consequently, protection of many of those at risk when they are most vulnerable have hampered program effectiveness. New studies need to be designed to explicate the full measure of program benefit within covered communities and identify the means by which SEPs can expand benefit to individuals at greatest risk.

Community-Institutional Relations↗
PubMed1990

The Ohmeda 9000 syringe pump. The first of a new generation of syringe drivers.

The Ohmeda 9000 syringe pump was developed in response to the need for an infusion apparatus to administer intravenous anaesthetic agents. It incorporates a bolus facility for the rapid, controlled delivery of loading infusions, or incremental dosing over a background maintenance infusion, and may be interfaced with a controller for computer-driven infusions. The Ohmeda 9000 pump has undergone bench testing and detailed evaluation in clinical practice using a variety of syringe sizes and makes. It is capable of accurate delivery over a range of infusion rates provided the recommended manufacturers' syringes are used with the appropriate pump setting. The pump was easy to use and reliable in clinical research and routine clinical practice. It should find its niche as the first genuinely 'anaesthetist-friendly' infusion pump.

Anesthesia, Intravenous↗
PubMedDate not supplied

Zero-Stik-Safety Syringe: an automatic safety syringe.

Needlestick injury (NSI) is an important although rare cause of the transmission of blood-borne viruses to healthcare staff. Many NSIs are avoidable. The use of universal precautions and careful sharps disposal are key factors in the prevention of injury. The availability of safety devices is increasing as it is recognized that action is necessary to prevent NSI. Devices that are easy to use and require no extra effort on behalf of the healthcare worker are preferred. There is evidence that safety devices decrease the rate of NSI. Zero-Stik Safety Syringe, manufactured by New Medical Technology, automatically retracts the needle once the injection is complete. It is simple to use and requires no formal training.

Accidents, Occupational↗
PubMedDate not supplied

[The clean syringe and HIV infection. A clean syringe can be obtained by any drug addict in a bus stationed in places of active drug trading].

The results of the work on the Program "Bus" supported by the Charitable Fund "Vozvrashchenie" and the French organization Doctors of the World [correction of Word] are presented. The Program "Bus", in contrast to a number of other programs aimed at the "decrease of harm", extended the project by providing the possibility of organizing, within this program, contacts between specialists and drug addicts, as well as the possibility of carrying out diagnostic procedures. As revealed in the process of the work, a half of those who applied to the "Bus" for help sought advice, psychological support, etc. 70% of the drug addicts asking for clean syringes had never applied for help. Among 900 persons who underwent testing, 90% were found to have markers of hepatitis C virus and 76%, markers of hepatitis B virus. Among those drug addicts who applied to the "Bus" for help 11% were found to have syphilis and 1 person proved to be HIV-infected. The results of the work on this project are indicative of the expediency of using such programs in other regions.

Adult↗