Multiple use of disposable insulin syringe-needle units

Fourteen insulin-dependent diabetics were asked to use their insulin syringe-needle units three times in succession to determine the efficacy and safety of this practice. The mean duration of time each patient participated in the study was 20.4 weeks, and a total of 2,000 injections were taken. No signs of infections at the injection site were observed. Multiple use of disposable insulin syringe-needle units appears to be safe and cost beneficial.

U100 insulin and the general practitioner

On August 1 1980, U100 insulins (100 units/mL) will be introduced and other strengths will be phased out over four months. During that period all insulin-dependent diabetics will need to be seen and helped to adjust to their new dosage volume. The new system is decimal, and provided the new appropriate syringes are used, much more simple. Experience has shown that mistakes in dosage are much fewer with U100 insulins. General practitioners will be in the forefront of the campaign to educate patients.

Consequence of syringe-plunger contamination

Any microorganisms, which might be placed onto the sides of a syringe plunger by finger contact while withdrawing the plunger, can be transferred to the inside of the barrel and enter the fluid pathway if the plunger is drawn in and out several times. Tests are described to show which of several brands of syringes allow this contamination to occur.

[Technology of preparing gauges for calibration of medical syringe cylinders]

Thermal treatment substantially influences the resistance of calibres used in mollification (vacuum calibrating) of glass cylinders for medical syringes, the highest resistance of calibres made of the XH32T alloy and the 12X18H10T steel being achieved through their preliminary annealing in the argon atmosphere. The quality of manufactured syringes is affected also by wrong calibres shape and, formostly, by their out-of-roundness, whose degree in individual cases reaches 2--3 micrometer.

False-positive blood cultures. Association with nonsterile blood collection tubes

A substantial increase in blood cultures positive for a Serratia marcescens strain unusually sensitive to antibiotics was noted in two large hospitals within six months. Because the patients' illnesses seemed incompatible with Serratia bacteremia, contamination of blood cultures was suspected. Investigation suggested that pediatric-sized vacuum tubes containing ethylenediamine tetraacetic acid (EDTA) were the source of the organisms, and the epidemic strain of Serratia was recovered from 41 (35%) of the 116 tubes cultured. Mock trials showed that reflux from tube to syringe can occur while vacuum tubes are being filled. Because contaminated EDTA tubes were sometimes inoculated before blood culture bottles in these hospitals, cross-contamination occurred. Most evacuated specimen tubes are not guaranteed sterile by the manufacturer. False-positive blood cultures stemming from the use of nonsterile tubes can be eliminated by inoculating blood culture bottles before other specimen tubes. Because false-positive blood cultures may lead to unnecessary antibiotic therapy, health-care workers should guard against the potential hazard associated with use of these tubes.

Use of disposable products in surgical practice

Disposable products today are an important part of the multibillion dollar health devices industry. A few heavy-usage and low-usage examples of disposable products used by surgeons are chosen to demonstrate that in a 1,000-bed hospital, economy is rarely, if ever, a reason for converting from reusables to disposables. The actual reasons are more closely related to individual preference, availability, convenience, dependability, safely, and, in some cases, manufacturer's promotion. In a 24-hospital study of surgical apparel, it was found that only caps, masks, shoe covers, and other small items approached partly in cost between disposable and reusable items, where as the per-use cost of reusable larger items such as gowns and drapes was still much lower than that of their disposable counterparts. However, each hospital must make its own decisions based on all factors, not on economy alone.