2010 2011 MEDICAL EQUIPMENT REVIEW

New Medical Job CPNS KLH 2010

2010-10-09T03:14:00.000-07:00

Jefferson Radiology Adds Automated Breast Ultrasound To Improve Early Detection Of Cancer In Women With Dense Breast Tissue

PENGUMUMAN PENERIMAAN CALON PEGAWAI NEGERI SIPIL (CPNS) FORMASI TAHUN 2010 KEMENTERIAN LINGKUNGAN HIDUPNomor : 001/SES/LH/10/20 1 0
Diumumkan bahwa Kementerian Lingkungan Hidup membuka kesempatan bagi yang berminat menjadi CPNS di lingkungan Kementerian Lingkungan Hidup untuk mengisi lowongan formasi Tahun Anggaran 20 10 , dengan ketentuan sebagai berikut :
1. Formasi Jabatan dan Kualifikasi Pendidikan
NO
FORMASI JABATAN CPNS KLH

2. Persyaratan Pelamar
a. Persyaratan Umum :
1) Warga Negara Indonesia ;
2) Bertakwa kepada Tuhan Yang Maha Esa;
3) Memiliki Integritas yang tinggi terhadap Negara Kesatuan Republik Indonesia;
4) Tidak berkedudukan sebagai Calon/PNS, Calon/Anggota TNI/Polri;
5) Tidak berkedudukan sebagai anggota atau pengurus partai politik;
6) Tidak pernah diberhentikan dengan hormat tidak atas permintaan sendiri atau tidak dengan hormat sebagai PNS/TNI/Polri atau diberhentikan tidak dengan hormat sebagai pegawai swasta;
7) Tidak pernah dihukum penjara atau kurungan berdasarkan putusan pengadilan;
8 ) Memenuhi persyaratan jenjang pendidikan dan keahlian/program studi yang sesuai dengan kebutuhan;
9) Berkelakuan baik;
10) Sehat jasmani dan rohani;
11) Melengkapi persyaratan lamaran berikut lampiran yang telah ditentukan.
b. Persyaratan Khusus :
1) Indeks Prestasi Kumulatif (IPK) minimal 2,75 (dua koma tujuh lima );
2) Berusia setinggi-tingginya 35 tahun per 1 Nopember 20 1 0;
3) Bersedia ditempatkan di seluruh Indonesia (termasuk ditempatkan di PPLH Regional).
3. Ketentuan Pengajuan Lamaran :
a. Surat Lamaran :
1) Surat lamaran harus ditulis tangan dan ditandatangani pelamar dengan menggunakan tinta hitam , ditujukan kepada Sekretaris Menteri Negara Lingkungan Hidup selaku Ketua Panitia Pengadaan Calon Pegawai Negeri Sipil Kementerian Lingkungan Hidup Tahun 20 1 0 dengan melampirkan :
• Foto copy Surat Tanda Tamat Belajar/Ijazah ;
• Foto copy transkrip nilai akademik ;
• Pas photo berwarna ukuran 3 X 4 sebanyak 2 lembar (terbaru);
• Daftar Riwayat Hidup (DRH) dengan mencantumkan alamat lengkap;
• Surat Pernyataan bersedia ditempatkan di seluruh Indonesia dengan dibubuhi materai Rp.6.000,-
• Satu buah amplop ukuran folio yang telah ditulis nama, alamat lengkap pelamar, dan telah dibubuhi perangko secukupnya .
b. Pendaftaran :
Surat lamaran beserta lampirannya disusun rapi dan dimasukkan ke dalam amplop coklat ukuran folio/kuarto dikirim PO BOX 7777 JAT 13000 dan pada pojok kanan amplop ditulis dengan jelas jabatan dan Kode Jabatan yang dilamar . Selambat-lambatnya tanggal 23 Oktober 20 1 0 sudah diterima oleh Panitia Pengadaan Calon Pegawai Negeri Sipil Kementerian Lingkungan Hidup.
4. Seleksi Administrasi :
• Berkas lamaran yang telah diterima oleh Tim Pengadaan CPNS Kementerian Lingkungan Hidup akan dilakukan seleksi administrasi;
• Jumlah peserta test sebanyak 15 X jumlah lowongan, berdasarkan IPK atau nilai rata-rata Ijazah/STTB yang tertinggi;
• Bagi pelamar yang dinyatakan lulus seleksi administrasi dipanggil melalui pos /dapat dilihat melalui Website : www.menlh.go.id;
• Bagi pelamar yang tidak lulus seleksi administrasi, berkas lamaran akan dikembalikan melalui pos.
- 4 -
5. Lain-lain :
a. Pelamar/peserta ujian tidak dipungut biaya;
b . Keputusan P a nitia Pengadaan CPNS Kementerian Lingkungan Hidup Tahun 20 1 0 bersifat mutlak dan tidak dapat diganggu gugat.
Jakarta, Oktober 20 1 0
SEKRETARIS MENTERI NEGARA LINGKUNGAN HIDUP
SELAKU KETUA PANITIA PENGADAAN CALON PEGAWAI NEGERI SIPIL
KEMENTERIAN NEGARA LINGKUNGAN HIDUP TAHUN 20 1 0
IR. ARIEF YUWONO, M.A.
dHAMAdHAMA

New Information Medical Job Fair :PENERIMAAN CPNS KEMENKES RI 2010, BIDANG KESEHATAN

2010-09-28T21:31:00.000-07:00

New Information Medical Job Fair www.ropeg.depkes.or.id www.ropeg-depkes.com www.ropekdepkes.co.id.gi.id
PENERIMAAN CPNS KEMENKES RI 2010, BIDANG KESEHATAN,SYARAT, FORMULIR, DOWNLOAD PENGUMUMAN

r 2010
PENERIMAAN CPNS KEMENKES RI TAHUN 2010
1. Pengumuman Penerimaan CPNS Kemenkes RI Tahun 2010
2. Ketentuan Legalisir Ijazah
3. Warna Map Pelamar
4. Surat Pernyataan Besedia Ditempatkan Dimana Saja

DOWNLOAD PDF READER
http://www.ropeg-depkes.or.id/news/2010/cpns/PengumumanCPNS2010.pdf

Conditions that the Device Treats An automated external defibrillator is used in cases of life threatening cardiac arrhythmias which lead to cardiac arrest. The rhythms that the device will treat are usually limited to: Pulseless Ventricular tachycardia (shortened to VT or V-Tach)Ventricular fibrillation (shortened to VF or V-Fib) In each of these two types of shockable cardiac arrhythmia, the heart is active, but in a life-threatening, dysfunctional pattern. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole. AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator. Effect of Delayed Treatment Uncorrected, these cardiac conditions (ventricular tachycardia, ventricular fibrillation, asystole) rapidly lead to irreversible brain damage and death. After approximately three to five minutes,[3] irreversible brain/tissue damage may begin to occur. For every minute that a person in cardiac arrest goes without being successfully treated (by defibrillation), the chance of survival decreases by 10 percent.[4] Requirements for Use AEDs are designed to be used by laypersons who ideally should have received AED training. This is in contrast to more sophisticated manual and semi-automatic defibrillators used by health professionals, which can act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator able to read electrocardiograms. Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference Placement and Availability An AED at a railway station in Japan. Automated external defibrillators are generally either held by trained personnel who will attend events or are public access units which can be found in places including corporate and government offices, shopping centres, airports, restaurants, casinos, hotels, sports stadiums, schools and universities, community centers, fitness centers, health clubs, workplaces and any other location where people may congregate. The location of a public access AED should take in to account where large groups of people gather, regardless of age or activity. Children as well as adults may fall victim to sudden cardiac arrest (SCA)

Nitrous oxyde and Oxygen

2010-09-22T00:14:00.000-07:00

Gas and air redirects here, for the 1923 film, see Gas and Air (film)
A mix of nitrous oxide 50% and oxygen 50% is a medical anaesthesia gas, commonly known as Entonox (a registered trademark of BOC) or Nitronox,[1] or colloquially as 'gas and air',[2] and is frequently used in pre-hospital care, childbirth and emergency medicine situations by medical professionals such as doctors, nurses, midwives and paramedics.[3]
Contents[hide]
1 History
2 Composition
3 Administration
4 Action on the patient
5 Contraindications and cautions
6 References
7 External links
//
[edit] History
Nitrous oxide as a single gas was first used as a medical analgesic in 1844 by American dentist Horace Wells, growing in popularity in the late 1800s.[4] Negative side effects were found from the hypoxia caused by a lack of oxygen, and the requirement to have at least 21% oxygen content in the gas was discovered (the same percentage as in air).[4]
In 1911, the anaesthetist Arthur Ernest Guedel first described the use of self-administration of a nitrous oxide and oxygen mix.
It was not until 1961 that the first paper was published by Michael Tunstall et al. describing the administration of a pre-mixed 50:50 nitrous oxide and oxygen mix, which led to the commercialisation of the product.[4]
[edit] Composition

Distinct blue and white cap of an Entonox cylinder

Typical schrader valve attachment, making the gas usable only with demand based giving sets
The gas is made of a mixture of fifty percent nitrous oxide (N2O or laughing gas) and fifty percent oxygen (O2).[1][3] The ability to combine nitrous oxide and oxygen at high pressure while remaining in the gaseous form is due to the Poynting effect (after John Henry Poynting, an English physicist).[3]
The Poynting effect involves the dissolution of gaseous O2 when bubbled through liquid N2O, with vaporisation of the liquid to form a gaseous O2/N2O mixture.[3]
Inhalation of pure nitrous oxide over a continued period would render a human hypoxic,[5] and the 50% oxygen content prevents this from occurring. The two gases will separate at low temperatures (<4 °C), which would permit administration of hypoxic mixtures. Therefore, it is not given from a cold cylinder without being shaken (usually by cylinder inversion) to remix the gases.
[edit] Administration
The gas is self administered though a demand valve, using a mouthpiece, bite block or face mask.[1] Self-administration of Entonox remains safe because if enough is inhaled to start to induce anaesthesia, the patient becomes unable to hold the valve, and so will drop it and soon exhale the residual gas. This means, that unlike with other anesthetic gases, it does not require the presence of an anaesthetist for administration. The 50% oxygen in Entonox ensures the patient will have sufficient oxygen in their system for a short period of apnoea to be safe.
[edit] Action on the patient
Nitrous oxide is itself active (does not require any changes in the body to become active), and so has an onset in roughly the lung-brain circulation time. This gives it a peak action 30 seconds after the start of administration;[3] Entonox should thus be used accordingly, e.g. use should begin 30 seconds before a contraction becomes painful in labour. It is removed from the body unchanged via the lungs, and does not accumulate under normal conditions, explaining the rapid offset of around 60 seconds.[3]
Nitrous oxide is more soluble than oxygen and nitrogen, so will tend to diffuse into any air spaces within the body. This makes it dangerous to use in patients with pneumothorax or who have recently been scuba diving, and there are cautions over its use with any bowel obstruction.
Its analgesic effect is strong (equivalent to 15 mg of subcutaneous route morphine[3]) and characterised by rapid onset and offset (i.e. it is very fast-acting and wears off very quickly).
[edit] Contraindications and cautions
Nitrous oxide should not be used in patients with bowel obstruction, pneumothorax, middle ear or sinus disease,[3] and should also not be used on any patient who has been scuba diving within the preceding 24 hours or in violently disturbed psychiatric patients.[1] There are also clinical cautions in place for the first 2 trimesters of pregnancy and in patients with decreased levels of consciousness.[3]

Long Spine Board

2010-08-24T21:45:00.000-07:00

Long spine board (LSB), or the panel, is a medical device used to immobilize and transport patients with suspected spinal injuries. Panels are used to prevent movement of the spine that can cause permanent injury. They are most often used by prehospital care providers such as ambulance and paramedic. backboards are usually made of wood or plastic, although there was a strong movement away from wooden boards because of their higher level of maintenance required to keep them in working condition and protect against cracking and other imperfections that could harbor bacteria. There are also short backboards, but the short spine board is rarely used because of the presence of a superior technology, such as walking the patient to the hospital with a cervical collar around the neck. Panels are designed to be slightly wider and longer than the average human body to accommodate the straps capital, and have handles for transporting the patient. Most panels are designed to be completely transparent to X-rays so as not to interfere with the examination while patients are attached to them. Panels are almost always used in conjunction with the following features: a cervical collar with occipital padding, if necessary; side head supports, like a rolled blanket or head blocks made specifically for this purpose, used to prevent lateral rotation of the head; straps to secure the patient to long spine board, and tape to secure the head

Kendrick Extrication Device Equipment

2010-03-27T19:44:00.000-07:00

Schematic Kendrick extrication device The Kendrick extrication device (KED) is a device that is used in the extrication of the vehicle to remove a patient from a motor vehicle. A KED is generally used only on stable patients, unstable patients are shot with rapid extrication techniques without applying a KED. A KED is used in conjunction with a neck brace to help immobilize the patient's head, neck and spine in the normal anatomical position (neutral position). This position helps prevent further injury to these regions during extrication from vehicles. An envelope KED a person's head, back, shoulders, torso in a corset and semi-rigid, immobilizing the head, neck and spine. Generally there are two head straps, three straps, torso, legs and straps that are used to adequately secure the KED for the patient. Unlike a board, the KED uses a series of bars of wood or polymer in a nylon jacket, which immobilizes the spine stakeholders of the patent and neck, and remove the vehicle / confined space. KEDS can also be used to completely immobilize pediatric patients. Once the KED is slipped behind the patient a mnemonic is often used to ensure the straps are fixed in a specific order.

New Face Shield Medical Equipment

2010-03-27T19:38:00.000-07:00

A mask is a device used to protect the entire face of the wearer (or part) of the impact hazard such as flying objects and road debris, chemical splash (in industry), or potentially infectious fluid (in medicine). In a medical mask refers to a variety of devices used to protect a health professional during a procedure that could expose the worker to blood or other potentially infectious fluids. An example is the use of a CPR mask in artificial respiration or CPR scene. Another example is the use of personal protective equipment to guard the face against splashing, spraying or splashing of blood or other potentially infectious materials. From Wikipedia, the free encyclopedia Jump to: navigation, search

Medical equipment asset management: aim for better facilities

2009-12-19T20:45:00.000-08:00

It becomes a boon for the health of people if there are ample facilities in the field of medicines. Since any health conditions can be easily dealt with new machines and equipments, it is important to give priority to such devices which are life-savers. In spite of all this, it can somewhat be not ignored that these devices too need upgrading and also servicing, etc on a timely basis. Who will decide when? Medical equipment asset management can be undertaken so as to make sure that no compromises have to be made. Medical equipments are very important requirements for any health care centers, etc. Also, those medical equipments that have already been working for the purpose too need a servicing so that they do not fail at the wrong time and prove dangerous. Timely intervention is therefore necessary for equipment and is done so by the medical equipment asset management programs that are undertaken. Under the management of medical equipments, any changes that are required are made suitably. Also, servicing of this equipment has also to be done which is another task under management of these instruments. Another very important requirement is the updating of medical equipments according to the need. Whether new investments have to be made is also required to be judged and accordingly, new financial investments are made with complete care and forethought and only after careful scrutiny and planning. Replacement of medical equipments after their effective lives also has to be done. The services are now easily available and also very much important since the matter relates directly to health issues. Also, tracking of these devices and their specific locations can also be traced whenever they are needed with the help of tracking devices. Medical equipment asset management is the right way to keep track of all medical assets, their location, usability, working condition, effective life, notifications etc. Any financial investments that are to be made are also done after thorough planning.
John Elliott is an expert in international asset protection strategies. He specializes with a honor degree in wealth protection. For more information about medical equipment asset management and other services, you need to visit www.safeasset.org/
by John Elliott

Combitube

2009-12-01T18:22:00.000-08:00

The Combitube is a blind insertion airway device (BIAD) often utilized in the pre-hospital, emergency setting. It is designed to facilitate the intubation of a patient in respiratory distress. It consists of a cuffed, double-lumen tube that is inserted into a the patient's airway facilitating ventilation. Inflation of the cuff allows the device to function similarly to an endotracheal tube and usually closes off the esophagus, allowing ventilation and preventing reflux of gastric contents.
The simplicity of placement is the main advantage of the Combitube over endotracheal intubation. When intubating with a traditional endotracheal tube, care must be taken to visually ensure that the tube has been placed in the trachea while the dual-lumen design of the Combitube allows for ventilation to proceed regardless of esophageal or tracheal placement. Generally, the tube enters the esophagus and ventilation is provided through tube number one. In the rare instance where the Combitube intubates the trachea, ventilation is provided through tube number two while tube one is clamped.
The Combitube's ease of use makes it ideal for use in the pre-hospital, emergency setting where advanced level providers capable of placing an endotracheal tube tube are often not immediately available. The drawbacks of Combitube use center around an inability to perform deep (subglottic) suctioning assuming esophageal placement.
While it has been suggested as an option by the American Heart Association and European Resuscitation Council, it is seldom used outside of the pre-hospital, emergency setting. Alternatives to the Combitube include the laryngeal mask airway (LMA), the endotracheal tube, and other BIAD's such as the King Airway.
The Combitube was invented by Austrian researchers M.Frass M.D., R. Frenzer, and J. Zahler M.D.

Cervical collar

2009-11-28T06:15:00.000-08:00

A fourteen month old infant wearing a neckbrace after sustaining a skull fracture, at the Children's Hospital of Orange County on September 23, 2007.A cervical collar (also neck brace) is an orthopedic piece of medical equipment used to support the cervical portion of a patient's spinal cord, and their head. It is also used by emergency medical services personnel for victims of traumatic head or neck injuries, [1] and can be used to treat chronic medical conditions.

Whenever patients have a traumatic head or neck injury, there is a danger of spinal cord injury, which could lead to paralysis or death. In order to prevent this, patients may have a collar placed by medical professionals.[2] The cervical collar only stabilizes the top 7 vertebrae, C1 through C7. Other immobilizing devices such as a Kendrick Extrication Device, or a backboard must be used in order to stabilize the remainder of the spinal column.[3] Additional testing such as X-rays will later determine if a cervical spine fracture exists. A common scenario for this injury would be a patient suspected of having whiplash due to a car accident.[4]

A cervical collar can also be therapeutic. It can help realign one's spinal cord and relieve pain,[5] though it is usually not worn for long periods of time.[6] Another use of the cervical collar is for strains, sprains or whiplash.[4][2] If pain is persistent, the collar might be required to remain attached to help in the healing process.[2][5] A patient might also need a cervical collar, or may require a halo to support their neck during recovery after surgeries such as cervical spinal fusion.[7]

Bag valve mask

2009-11-20T21:38:00.000-08:00

Bag valve mask
A disposable BVM ResuscitatorA bag valve mask (also known as a BVM or Ambu bag) is a hand-held device used to provide positive pressure ventilation to a patient who is not breathing or who is breathing inadequately. The device is a normal part of a resuscitation kit for trained professional, such as ambulance crew. The BVM is frequently used in hospitals, and is an essential part of a crash cart. The device is used extensively in the operating room to ventilate an anaesthetised patient in the minutes before a mechanical ventilator is attached. The device is self-filling with air, although additional oxygen (O2) can be added. Use of the BVM to ventilate a patient is frequently called "bagging" the patient.[1] Bagging is regularly necessary in medical emergencies when the patient's breathing is insufficient (respiratory failure) or has ceased completely (respiratory arrest). The BVM resuscitator is used in order to manually provide mechanical ventilation in preference to mouth-to-mouth resuscitation (either direct or through an adjunct such as a pocket mask).
Components
The Ambu Resuscitator bag or BVM, this version shows is a hybrid MkIII body, Mark IV head and with an old obsolete latex inflatable seal on the mask. The part labelled 1 is a flexible mask designed to seal to the patient's face, and the part labelled 3 is a self-filling bag, i.e. re-fills as an action of the elastic re-coil of the bag after compression.The BVM consists of a flexible air chamber, about the size of a rugby ball, attached to a face mask via a shutter valve. When the air chamber or "bag" is squeezed, the device forces air through into the patient's lungs; when the bag is released, it self-inflates, drawing in ambient air or a low pressure oxygen flow supplied from a regulated cylinder, whilst the patient's lungs deflate to the air through the one way valve.
Bag and valve combinations can also be attached to an alternate airway adjunct, such as an endo-tracheal tube or laryngeal mask airway, instead of the mask with which it is supplied. Often a small HME filter is also used (Heat & Moisture exchanger or simple put - a Humidifying / bacterial filter - see diagram on the right) A bag valve mask can be used without being attached to an oxygen tank to provide air to the patient, but supplemental oxygen is recommended since it increases the partial pressure of oxygen in the air, helping to increase perfusion in the patient. Most devices also have a reservoir which can fill with oxygen while the patient is exhaling (a process which happens passively), in order to increase the amount of oxygen that can be delivered to the patient to nearly 100%.Bag valve masks come in different sizes to fit infants, children, and adults.
Most types of the device are now disposable and therefore single use, while others are designed to be cleaned and reused. Many users have moved away from the reusable bags to reduce the possibility of cross-contamination.
Method of operation
The BVM directs the gas inside it via a one-way valve when compressed by a rescuer; the gas is then delivered through a mask and into the patient's trachea, bronchus and into the lungs. In order to be effective, a bag valve mask must deliver between 500 and 800 milliliters of air to the patient's lungs, but if oxygen is provided through the tubing and if the patient's chest rises with each inhalation (indicating that adequate amounts of air are reaching the lungs), 400 to 600 ml may still be adequate.[1] Squeezing the bag once every 5 seconds for an adult or once every 3 seconds for an infant or child provides an adequate respiratory rate (12 respirations per minute in an adult and 20 per minute in a child or infant).[3]
Professional rescuers are taught to ensure that the mask portion of the BVM is properly sealed around the patient's face (that is, to ensure proper "mask seal"); otherwise, air escapes from the mask and is not pushed into the lungs. In order to maintain this protocol, some protocols use a method of ventilation involving two rescuers: one rescuer to hold the mask to the patient's face with both hands and ensure a mask seal, while the other squeezes the bag.[4] However, as most ambulances have only two members of crew, the other crew member is likely to be doing compressions in the case of CPR, or may be performing other skills such as cannulation. In this case, or if no other options are available, the BVM can also be operated by a single rescuer who holds the mask to the patient's face with one hand, in the anaesthetists grip, and squeezes the bag with the other.
When using a BVM, as with other methods of positive pressure ventilation, there is a risk of over-inflating the lungs. This can lead to pressure damage to the lungs themselves, and can also cause air to enter the stomach, causing gastric distention which can make it more difficult to inflate the lungs and which can cause the patient to vomit. This can be avoided by care on behalf of the rescuer. Alternatively, some models of BVM (usually Paediatric) are fitted with a valve which prevents over inflation, by venting the pressure when a pre-set pressure is reached.
An endotracheal tube (ETT) can be inserted by a trained practitioner and can substitute for the mask portion of the BVM. This provides a more secure fit and is easier to manage during emergency transport, since the ET tube is sealed with an inflatable cuff in the trachea, so that any regurgitation cannot enter the lungs. Such material can severely damage the lung tissue, and in the absence of an ET tube, could choke the patient by obstructing the airway. Inhalation of stomach contents can be fatal; the after effects can cause Mendelson's syndrome or aspiration pneumonia. Some rescuers may also choose to use a different form of resuscitation adjunt, such as an oropharyngeal airway or Laryngeal mask airway, which would be inserted and then used with the BVM. In a hospital, long-term mechanical ventilation is provided by using more complex devices such as an intensive care ventilator, rather than by a BVM, which requires at least one person to operate it constantly. A flow-restricted, oxygen-powered ventilation device (FROPVD) is similar to a BVM in thatoxygen is pushed through a mask into the patient's lungs, but unlike a BVM, in the FROPVD the pressure needed to push air into the patient's lungs is generated by oxygen via a pressure regulator from a cylinder rather than by squeezing a bag.
Ambu bag
One proprietary brand of a self-inflating BVM resuscitator is called the Ambu bag. The concept for the original Ambu bag was developed in 1953 by the German engineer, Dr. Holger Hesse, and his partner, Danish anaesthetist Henning Ruben. In 1956, the world's first non-electric, self-inflating resuscitator was ready for production by their company, Ambu A/S, which still produces a wide range of single-patient and multi-use resuscitators. The Ambu name has become an example of a Genericized trademark, as all manual bag resuscitators in medical settings are now often referred to generically as "Ambu bags," even though Ambu brand resuscitator bags are still produced and other companies are not allowed to use the Ambu trademark.
From Wikipedia, the free encyclopedia

Automated External Defibrillator

2009-11-07T14:55:00.001-08:00

A defibrillator is a machine that can restart the heart by giving a electric shock in some cases of cardiac arrest.An automated external defibrillator (AED) is a type of defibrillator that detects the electrical activity in the heart and gives automated instructions to the rescuer on what to do.
An automated external defibrillator, open and ready for pads to be attached An automated external defibrillator or AED is a portable electronic device that automaticallydiagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,[1] and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm. AEDs are designed to be simple to use for the layman, and the use of AEDs is taught in many first aid, first responder and basic life support (BLS) level CPR classes.[2]
Conditions that the Device Treats
An automated external defibrillator is used in cases of life threatening cardiac arrhythmias which lead to cardiac arrest. The rhythms that the device will treat are usually limited to: Pulseless Ventricular tachycardia (shortened to VT or V-Tach)Ventricular fibrillation (shortened to VF or V-Fib) In each of these two types of shockable cardiac arrhythmia, the heart is active, but in a life-threatening, dysfunctional pattern. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole.
AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator.
Effect of Delayed Treatment
Uncorrected, these cardiac conditions (ventricular tachycardia, ventricular fibrillation, asystole) rapidly lead to irreversible brain damage and death. After approximately three to five minutes,[3] irreversible brain/tissue damage may begin to occur. For every minute that a person in cardiac arrest goes without being successfully treated (by defibrillation), the chance of survival decreases by 10 percent.[4]
Requirements for Use
AEDs are designed to be used by laypersons who ideally should have received AED training. This is in contrast to more sophisticated manual and semi-automatic defibrillators used by health professionals, which can act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator able to read electrocardiograms.
Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference
Placement and Availability
An AED at a railway station in Japan.
Automated external defibrillators are generally either held by trained personnel who will attend events or are public access units which can be found in places including corporate and government offices, shopping centres, airports, restaurants, casinos, hotels, sports stadiums, schools and universities, community centers, fitness centers, health clubs, workplaces and any other location where people may congregate.
The location of a public access AED should take in to account where large groups of people gather, regardless of age or activity. Children as well as adults may fall victim to sudden cardiac arrest (SCA)
In many areas, emergency vehicles are likely to carry AEDs, with some ambulances carrying an AED in addition to manual defibrillators. Police or fire vehicles often carry an AED for first responder use. Some areas have dedicated community first responders, who are volunteers tasked with keeping an AED and taking it to any victims in their area. AEDs are also increasingly common on commercial airlines, cruise ships, and other transportation facilities.
In order to make them highly visible, public access AEDs often are brightly colored, and are mounted in protective cases near the entrance of a building. When these protective cases are opened or the defibrillator is removed, some will sound a buzzer to alert nearby staff to their removal, though this does not necessarily summon emergency services; trained AED operators should know to phone for an ambulance when sending for or using an AED. In September 2008, the International Liaison Committee on Resuscitation issued a 'universal AED sign' to be adopted throughout the world to indicate the presence of an AED, and this is shown at right.[6]
A trend that is developing is the purchase of AEDs to be used in the home, particularly by those with known existing heart conditions.The number of devices in the community has grown as prices have fallen to affordable levels. There has been some concern among medical professionals that these home users do not necessarily have appropriate training, and many advocate the more widespread use of community responders, who can be appropriately trained and managed. Typically, an AED kit will contain a face shield for providing a barrier between patient and first aider during rescue breathing; a pair of nitrile rubber gloves; a pair of trauma shears for cutting through a patient's clothing to expose the chest; a small towel for wiping away any moisture on the chest, and a razor for shaving those with very hairy chests.
Preparation for operation
Most manufacturers recommend checking the AED before every period of duty or on a regular basis for fixed units. Some units need to be switched on in order to perform a self check; other models have a self check system built in with a visible indicator.All manufacturers mark their pads with an expiry date, and it is important to ensure that the pads are in date. This is usually marked on the outside of the pads. Some models are designed to make this date visible through a 'window', although others will require the opening of the case to find the date stamp.
Mechanism of operation
The use of easily visible status indicator and pad expiration date on one model of AED
An AED is external because the operator applies the electrode pads to the bare chest of the victim, as opposed to internal defibrillators, which have electrodes surgically implanted inside the body of a patient.
Automatic refers to the unit's ability to autonomously analyse the patient's condition, and to assist this, the vast majority of units have spoken prompts, and some may also have visual displays to instruct the user.
When turned on or opened, the AED will instruct the user to connect the electrodes (pads) to the patient. Once the pads are attached, everyone should avoid touching the patient so as to avoid false readings by the unit. The pads allow the AED to examine the electrical output from the heart and determine if the patient is in a shockable rhythm (either ventricular fibrillation or ventricular tachycardia). If the device determines that a shock is warranted, it will use the battery to charge its internal capacitor in preparation to deliver the shock. This system is not only safer (charging only when required), but also allows for a faster delivery of the electrical current.
When charged, the device instructs the user to ensure no one is touching the victim and then to press a button to deliver the shock; human intervention is usually required to deliver the shock to the patient in order to avoid the possibility of accidental injury to another person (which can result from a responder or bystander touching the patient at the time of the shock). Depending on the manufacturer and particular model, after the shock is delivered most devices will analyze the victim and either instruct that CPR be given, or administer another shock.
Many AED units have an 'event memory' which store the ECG of the patient along with details of the time the unit was activated and the number and strength of any shocks delivered. Some units also have voice recording abilities[citation needed] to monitor the actions taken by the personnel in order to ascertain if these had any impact on the survival outcome. All this recorded data can be either downloaded to a computer or printed out so that the providing organisation or responsible body is able to see the effectiveness of both CPR and defibrillation.
AEDs available to the public may be semi-automatic or fully automatic. Fully automatic units are likely to have few buttons, often activating as soon as the case is opened, and possibly just one button to shock, or in some cases this will be performed automatically. The user has no input in the operation of the unit apart from attaching the pads and following the prompts. Health care professionals and other trained responders may use a semi-automatic defibrillator, which is likely to have an ECG readout display, and the possibility to override the rhythm analysis software. This allows trained personnel to provide a higher level of care.
The first commercially available AEDs were all of a monophasic type, which gave a high-energy shock, up to 360 to 400 joules depending on the model. This caused increased cardiac injury and in some cases second and third-degree burns around the shock pad sites. Newer AEDs (manufactured after late 2003) have tended to utilise biphasic algorithms which give two sequential lower-energy shocks of 120 - 200 joules, with each shock moving in an opposite polarity between the pads. This lower-energy waveform has proven more effective in clinical tests, as well as offering a reduced rate of complications and reduced recovery time.[10]
Simplicity of use
Usual placement of pads on chest Unlike regular defibrillators, an automated external defibrillator requires minimal training to use. It automatically diagnoses the heart rhythm and determines if a shock is needed. Automatic models will administer the shock without the user's command. Semi-automatic models will tell the user that a shock is needed, but the user must tell the machine to do so, usually by pressing a button. In most circumstances, the user cannot override a "no shock" advisory by an AED. Some AEDs may be used on children - those under 55 lbs (25 kg) in weight or under age 8. If a particular model of AED is approved for pediatric use, all that is required is the use of more appropriate pads. Some organizations, such as the American Heart Association, recommend that if pediatric AED pads are not available, adult pads should be used to determine if the child is in a shockable rhythm. There is insufficient evidence to suggest that a child, in a shockable cardiac arrest, can be "hurt" by an adult defibrillation energy setting.[citation needed]
All AEDs approved for use in the United States use an electronic voice to prompt users through each step. Because the user of an AED may be hearing impaired, many AEDs now include visual prompts as well. Most units are designed for use by non-medical operators. Their ease of use has given rise to the notion of public access defibrillation (PAD), which experts agree has the potential to be the single greatest advance in the treatment of out-of-hospital cardiac arrest since the invention of CPR.[11]
Liability
Automated external defibrillators are now easy enough to use that most states in the United States include the "good faith" use of an AED by any person under the Good Samaritan laws.[12] "Good faith" protection under a Good Samaritan law means that a volunteer responder (not acting as a part of one's occupation) cannot be held civilly liable for the harm or death of a victim by providing improper or inadequate care, given that the harm or death was not intentional and the responder was acting within the limits of their training and in good faith. In the United States, Good Samaritan laws provide some protection for the use of AEDs by trained and untrained responders.[13] AEDs create little liability if used correctly;[14] NREMT-B and many state EMT training and many CPR classes incorporate or offer AED education as a part of their program. In addition to Good Samaritan laws, Ontario, Canada also has the "Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 (Bill 171 – Subsection N)", passed in June, 2007,[15] which protects individuals from liability for damages that may occur from their use of an AED to save someone's life at the immediate scene of an emergency unless damages are caused by gross negligence.

Auto Pulse Review

2009-11-07T14:46:00.000-08:00

AutoPulse is an automated cardiopulmonary resuscitation machine created by Revivant and subsequently purchased by ZOLL. It is a circumferential chest compression device composed of a constricting band and half backboard that is intended to be used as an adjunct to CPR during advanced cardiac life support by paramedics. The 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation give load-distributing band CPR (LDB-CPR) a Class IIb recommendation.
Froipedia, the free encyclopedia
Device operation
The patient's head, shoulders and upper back lay upon the base unit, with the controls for the AutoPulse beside the patient's left ear. It can be augmented for cervical spinal support. The unit contains the control computer, the rechargeable battery, and the motors that operate the LifeBand. The LifeBand is an adjustable strap that covers the entire rib cage. When the patient (who must be disrobed) is strapped in and the start button is pressed, the LifeBand pulls tight around the chest and proceeds to rhythmically constrict the entire rib cage, compressing and pumping the heart at a rate of 80 beats per minute equivalent. The LifeBand can be placed over AED pads but must be taken off to use standard paddle defibrillators. The LifeBand is disposable, and designed to be used on a single patient for sanitary reasons.
Studies and clinical trials
The gold standard for resuscitation research is survival to hospital discharge. Although common sense suggests that short-term and intermediate outcomes like return of spontaneous circulation (ROSC) or survival to hospital admission are promising, experienced scientists know that anything less than a neurologically intact survivor walking out of the hospital is ultimately irrelevant
Several animal studies have shown that automated CPR machines are more effective at providing circulatory support than manual CPR. One study showed that use of the AutoPulse produced blood flow to the heart and brain that was comparable to pre-arrest levels.In another study, an adapted AutoPulse was shown to be highly effective in support of cardiac arrest in animals, whereas manual CPR was tenuous in its effectiveness. Pigs were used in the study, and were left in cardiac arrest for eight minutes to simulate average ambulance response time. 73% of the pigs that were put into the AutoPulse were revived, and 88% of the surviving pigs showed no neurological damage. None of the pigs that received manual CPR survived.
The device has shown less promise with human research. Although some studies showed improved coronary perfusion pressure and more spontaneous return of circulation with the AutoPulse, one large, multi-centered, randomized clinical trial was canceled early by the Institutional Review Board (IRB) when it was determined that patients who received manual CPR were more likely to walk out of the hospital, suggesting that enthusiasm for the device "is premature, given that the effectiveness of the device likely depends on still-to-be-defined factors independent of the mechanical capabilities of the device."AutoPulse in the news
ABC World News Tonight on May 19, 2005, did a story on automated CPR machines, and profiled the story of Caralee Welch, who survived thirty minutes of cardiac arrest during which the AutoPulse was used. She had a heart attack in front of a theatre, but even after a half-hour of no heartbeat, with AutoPulse's help she ultimately recovered with no apparent brain damage.
References
^ 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 6: CPR Techniques and Devices Circulation 2005;112:IV-47 – IV-50. Accessed February 13, 2007.
^ ACLS: Principles and Practice. p. 62. Dallas: American Heart Association, 2003. ISBN 0-87493-341-2.
^ Halperin HR, Paradis N, Ornato JP, et al. "Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest: improved hemodynamics and mechanisms." J Am Coll Cardiol 2004; 44(11): 2214-20. PMID 15582320
^ Ikeno F, Lyons J, Kaneda H, Hongo Y, Emami S, Chiistine N, Rezaee M. Improved survival with a novel chest compression device in a porcine model of cardiac arrest. Circulation. 2003; 108: IV–381. Abstract.
^ Timmerman S, Cardoso LF, Ramires JA, et al. "Improved hemodynamic performance with a novel chest compression device during treatment of in-hospital cardiac arrest." Resuscitation 2004; 61(3): 273-80. PMID 15172705
^ Ornato JP et al. " Improvement in field return of spontaneous circulation using circumferential chest compression cardiopulmonary resuscitation." Prehosp Emerg Care 2005; 9(1): 104.
^ Casner M, Andersen D, and Isaacs SM. "The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest." Prehosp Emerg Care 2005; 9(1): 61-7. PMID 16036830
^ Hallstrom A, Rea TD, Sayre MR et al. "Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial." JAMA 2006; 295: 2620-2628. PMID 16772625
^ Lewis RJ and Niemann JT. "Manual vs Device-Assisted CPR: Reconciling Apparently Contradictory Results." JAMA 2006; 295: 2661-2664. PMID 16772632
[edit] External links
AutoPulse Official Website
CPR Machine Proves More Effective Than Paramedics from ABCNews.com (It does not mention AutoPulse by name, but her story is also profiled on the AutoPulse website.)
LUCAS An alternative method for providing mechanical chest compressions.
Retrieved from "http://en.wikipedia.org/wiki/AutoPulse"

AutoPulse

2009-10-31T01:24:00.000-07:00

From Wikipedia, the free encyclopedia
Jump to: navigation, search
The AutoPulse is an automated cardiopulmonary resuscitation machine created by Revivant and subsequently purchased by ZOLL. It is a circumferential chest compression device composed of a constricting band and half backboard that is intended to be used as an adjunct to CPR during advanced cardiac life support by paramedics. The 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation give load-distributing band CPR (LDB-CPR) a Class IIb recommendation.[1]

Class I Definitely recommended. Supported by excellent evidence.
Class IIa Acceptable and useful. Good to very good evidence provides support.
Class IIb Acceptable and useful. Fair to good evidence provides support.
Class III Unacceptable, no documented benefit, may be harmful.
Contents [hide]
1 Device operation
2 Studies and clinical trials
3 AutoPulse in the news
4 References
5 External links

[edit] Device operation
The patient's head, shoulders and upper back lay upon the base unit, with the controls for the AutoPulse beside the patient's left ear. It can be augmented for cervical spinal support. The unit contains the control computer, the rechargeable battery, and the motors that operate the LifeBand. The LifeBand is an adjustable strap that covers the entire rib cage. When the patient (who must be disrobed) is strapped in and the start button is pressed, the LifeBand pulls tight around the chest and proceeds to rhythmically constrict the entire rib cage, compressing and pumping the heart at a rate of 80 beats per minute equivalent. The LifeBand can be placed over AED pads but must be taken off to use standard paddle defibrillators. The LifeBand is disposable, and designed to be used on a single patient for sanitary reasons.

[edit] Studies and clinical trials
The gold standard for resuscitation research is survival to hospital discharge. Although common sense suggests that short-term and intermediate outcomes like return of spontaneous circulation (ROSC) or survival to hospital admission are promising, experienced scientists know that anything less than a neurologically intact survivor walking out of the hospital is ultimately irrelevant.[2]

Several animal studies have shown that automated CPR machines are more effective at providing circulatory support than manual CPR. One study showed that use of the AutoPulse produced blood flow to the heart and brain that was comparable to pre-arrest levels.[3] In another study, an adapted AutoPulse was shown to be highly effective in support of cardiac arrest in animals, whereas manual CPR was tenuous in its effectiveness. Pigs were used in the study, and were left in cardiac arrest for eight minutes to simulate average ambulance response time. 73% of the pigs that were put into the AutoPulse were revived, and 88% of the surviving pigs showed no neurological damage. None of the pigs that received manual CPR survived.[4]

The device has shown less promise with human research. Although some studies showed improved coronary perfusion pressure[5] and more spontaneous return of circulation[6][7] with the AutoPulse, one large, multi-centered, randomized clinical trial[8] was canceled early by the Institutional Review Board (IRB) when it was determined that patients who received manual CPR were more likely to walk out of the hospital, suggesting that enthusiasm for the device "is premature, given that the effectiveness of the device likely depends on still-to-be-defined factors independent of the mechanical capabilities of the device."[9]

[edit] AutoPulse in the news
ABC World News Tonight on May 19, 2005, did a story on automated CPR machines, and profiled the story of Caralee Welch, who survived thirty minutes of cardiac arrest during which the AutoPulse was used. She had a heart attack in front of a theatre, but even after a half-hour of no heartbeat, with AutoPulse's help she ultimately recovered with no apparent brain damage.

[edit] References
1.^ 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 6: CPR Techniques and Devices Circulation 2005;112:IV-47 – IV-50. Accessed February 13, 2007.
2.^ ACLS: Principles and Practice. p. 62. Dallas: American Heart Association, 2003. ISBN 0-87493-341-2.
3.^ Halperin HR, Paradis N, Ornato JP, et al. "Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest: improved hemodynamics and mechanisms." J Am Coll Cardiol 2004; 44(11): 2214-20. PMID 15582320
4.^ Ikeno F, Lyons J, Kaneda H, Hongo Y, Emami S, Chiistine N, Rezaee M. Improved survival with a novel chest compression device in a porcine model of cardiac arrest. Circulation. 2003; 108: IV–381. Abstract.
5.^ Timmerman S, Cardoso LF, Ramires JA, et al. "Improved hemodynamic performance with a novel chest compression device during treatment of in-hospital cardiac arrest." Resuscitation 2004; 61(3): 273-80. PMID 15172705
6.^ Ornato JP et al. " Improvement in field return of spontaneous circulation using circumferential chest compression cardiopulmonary resuscitation." Prehosp Emerg Care 2005; 9(1): 104.
7.^ Casner M, Andersen D, and Isaacs SM. "The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest." Prehosp Emerg Care 2005; 9(1): 61-7. PMID 16036830
8.^ Hallstrom A, Rea TD, Sayre MR et al. "Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial." JAMA 2006; 295: 2620-2628. PMID 16772625
9.^ Lewis RJ and Niemann JT. "Manual vs Device-Assisted CPR: Reconciling Apparently Contradictory Results." JAMA 2006; 295: 2661-2664. PMID 16772632

Vaporizer

2009-10-31T01:23:00.001-07:00

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Not to be confused with humidifier.
For the device used in surgery, see anaesthetic vaporiser.
This article is missing citations or needs footnotes. Please help add inline citations to guard against copyright violations and factual inaccuracies. (March 2009)

A Volcano forced-air Vaporizer. After filling, the balloon (top) may be unfastened and inhaled from.A vaporizer (or vapouriser) is a device used to extract and deliver via inhalation the active ingredients of plant material, commonly cannabis, tobacco, or any of many other herbs or blends (phyto-inhalation; see also: aromatherapy). Vaporization is an alternative to smoking. Rather than burning the herb, which produces irritating, toxic, and carcinogenic by-products, a vaporizer heats the material in a partial vacuum so that the active compounds contained in the plant boil off into a vapor. No combustion occurs, so no smoke or taste of smoke is evident. The vapor ideally contains virtually zero particulate matter or tar, and significantly lower concentrations of noxious gases such as carbon monoxide. Also, less chance of flames occur. The vapor is extracted in various forms of extraction chambers then inhaled directly through a hose or pipe including vapor-specific vaporization water tools for highest activity, or stored for subsequent inhalations in a container such as a bag or jar. With little to no smoke produced, cooler temperatures, and less material required to achieve a given level of effect, the irritating/harmful effects of smoking are greatly reduced or eliminated,[1][2][3][4][5] along with second hand smoke, by using a vaporizer.

In comparison to other drug delivery methods such as ingestion, vaporization offers the advantages of rapid onset of pharmacological effect, direct delivery into the bloodstream (via the lungs), and more precise titration such that the desired level is reached and not exceeded, enabling consistent and appropriate dosage.

Vaginal ring

2009-10-31T01:21:00.000-07:00

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This article needs additional citations for verification.
Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (December 2007)

NuvaRingVaginal rings (also known as intravaginal rings, or V-Rings) are 'doughnut-shaped' polymeric drug delivery devices designed to provide controlled release of drugs to the vagina over extended periods of time. Several vaginal ring products are currently available, including:

Estring - a low-dose estradiol-releasing ring, manufactured from silicone elastomer, for the treatment of vaginal atrophy.
Femring - a low-dose estradiol-acetate releasing ring, manufactured from silicone elastomer, for the relief of hot flashes and vaginal atrophy associated with menopause.
NuvaRing - a low-dose contraceptive vaginal ring, manufactured from poly(ethylene-co-vinyl acetate), and releasing etonogestrel (a progesterone) ethinyl estradiol (an estrogen).
A number of vaginal ring products are also in development.

[edit] Methods of use
General - Vaginal rings are easily inserted and removed. Vaginal walls hold them in place. Although their exact location within the vagina is not critical for clinical efficacy, rings commonly reside next to the cervix. Rings are typically left in place during intercourse, and most couples report no interference or discomfort. In many cases, neither partner feels the presence of the ring. [1] Rings can be removed prior to intercourse, but in the case of the contraceptive Nuvaring only for one to three hours in order to maintain efficacy of birth control.

Femring - Femring is inserted into the vagina and left in place for three months, after which it is removed and replaced with a fresh ring.
NuvaRing - NuvaRing is inserted into the vagina and left in place for three weeks, after which it is removed for a 'ring-free' week to allow menstruation to occur.

Issues have been raised about the biodegradability of the product given the recent concern about pollution and use of plastics, especially of the poly(ethylene-co-vinyl+) archetypes.[citation needed]

[edit] References
1.^ FAQs on nuvaring.com
[edit] External links
Estring
Femring
Nuvaring
[show]v • d • e

Transfersome

2009-10-31T01:20:00.000-07:00

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This article may be confusing or unclear to readers. Please help clarify the article; suggestions may be found on the talk page. (December 2006)

Transfersome is a term registered as a trademark by the German company IDEA AG, and used by it to refer to its proprietary drug delivery technology. The name means “carrying body”, and is derived from the Latin word 'transferre', meaning ‘to carry across’, and the Greek word ‘soma’, for a ‘body’. A Transfersome carrier is an artificial vesicle designed to be like a cell vesicle or a cell engaged in exocytosis, and thus suitable for controlled and, potentially targeted, drug delivery.

Contents [hide]
1 Discovery
2 Composition and mechanism of action
3 Characterisation
4 Usage
5 Peripheral tissue targeting
6 Manufacturing
7 References
8 Further reading

[edit] Discovery
The term Transfersome and the underlying concept were introduced in 1991 by Gregor Cevc. Numerous groups have since been working with similar carriers, frequently under different names (elastic vesicle, flexible vesicle, Ethosome, etc.) to describe them.

In broadest sense, a Transfersome is a highly adaptable and stress-responsive, complex aggregate. Its preferred form is an ultradeformable vesicle possessing an aqueous core surrounded by the complex lipid bilayer. Interdependency of local composition and shape of the bilayer makes the vesicle both self-regulating and self-optimising. This enables the Transfersome to cross various transport barriers efficiently, and then act as a Drug carrier for non-invasive targeted drug delivery and sustained release of therapeutic agents.

[edit] Composition and mechanism of action
The carrier aggregate is composed of at least one amphiphat (such as phosphatidylcholine), which in aqueous solvents self-assembles into lipid bilayer that closes into a simple lipid vesicle. By addition of at least one bilayer softening component (such as a biocompatible surfactant or an amphiphile drug) lipid bilayer flexibility and permeability are greatly increased. The resulting, flexibility and permeability optimised, Transfersome vesicle can therefore adapt its shape to ambient easily and rapidly, by adjusting local concentration of each bilayer component to the local stress experienced by the bilayer. In its basic organization broadly similar to a liposome), the Transfersome thus differs from such more conventional vesicle primarily by its "softer", more deformable, and better adjustable artificial membrane.

Another beneficial consequence of strong bilayer deformability is the increased Transfersome affinity to bind and retain water. An ultradeformable and highly hydrophilic vesicle always seeks to avoid dehydration; this may involve a transport process related to but not identical with forward osmosis. For example, a Transfersome vesicle applied on an open biological surface, such as non-occluded skin, tends to penetrate its barrier and migrate into the water-rich deeper strata to secure its adequate hydration. Barrier penetration involves reversible bilayer deformation, but must not compromise unacceptably either the vesicle integrity or the barrier properties for the underlying hydration affinity and gradient to remain in place.

Since it is too large to diffuse through the skin, the Transfersome needs to find and enforce its own route through the organ. The Transfersome vesicles usage in drug delivery consequently relies on the carrier’s ability to widen and overcome the hydrophilic pores in the skin or some other (e.g. plant cuticle) barrier. The subsequent, gradual agent release from the drug carrier allows the drug molecules to diffuse and finally bind to their target. Drug transport to an intra-cellular action site may also involve the carrier’s lipid bilayer fusion with the cell membrane, unless the vesicle is taken-up actively by the cell in the process called endocytosis.

[edit] Characterisation
The mechanical properties and transport ability of a vesicle can be studied by measuring stress- or deformation-dependent vesicle bilayer elasticity and permeability changes. In a single experiment the objective may be reached by determining the pressure dependent area density of the Transfersome suspension flux through a nano-porous filter, with pores at least 50% smaller than the average vesicle size. For the proper Transfersome vesicles, the experiment derived proportionality function, so-called “Penetrability”, increases non-linearly with the flux driving force (head pressure), often sigmoidally). The bulk suspension viscosity governs the highest achievable penetrability; a suspension of ideal Transfersome vesicles, experiencing no friction in the barrier, therefore yields similar maximum penetrability value as the comparably tested vesicles-suspending fluid. On the other hand, the characteristic pressure needed to enforce a significant transport rate with the vesicles suspension mainly depends on the explored bilayer adaptability. Analysis of experimental Penetrability vs. Driving pressure curves can therefore yield the characteristic bilayer elasticity and permeability values, based on theoretical description of material flow as an activated transport process.

[edit] Usage
Transfersome technology is best suited for non-invasive delivery of therapeutic molecules across open biological barriers. The Transfersome vesicles can transport across the skin, for example, molecules that are too big to diffuse through the barrier. Examples include systemic delivery of therapeutically meaningful amounts of macromolecules, such as insulin or interferon, across intact mammalian skin. Other applications include the transport of small molecule drugs which have certain physicochemical properties which would otherwise prevent them from diffusing across the barrier.

[edit] Peripheral tissue targeting
Another attraction of the Transfersome technology is the carriers ability to target peripheral, subcutaneous tissue. This ability relies on minimisation of the carrier-associated drug clearance through cutaneous blood vessels plexus: the non-fenestrated blood capillary walls in the skin together with the tight junctions between endothelial cells preclude vesicles getting directly into blood, thus maximising local drug retention and propensity to reach the peripheral tissue targets. The Non-steroidal anti-inflammatory drug (NSAID) ketoprofen in a Transfersome formulation gained marketing approval by the Swiss regulatory agency (SwissMedic) in 2007; the product is expected to be marketed under the trademark Diractin. Further therapeutic products based on the Transfersome technology, according to IDEA AG, are in clinical development.

[edit] Manufacturing
Transfersome vesicles are prepared in a similar manner as liposomes, except that no separation of the vesicle-associated and free drug is required. Examples include sonicating [1], extrusion, low shear rates mixing (multilamellar liposomes), or high high-shear homogenisation unilamellar liposomes) of the crude vesicle suspension.

[edit] References
1.^ Stryer S. (1981) Biochemistry, 213
G. Gompper, D.M. Kroll (October 1995). "Driven transport of fluid vesicles through narrow pores" (abstract page). Physical Review E 52 (4): 4198–4208. doi:10.1103/PhysRevE.52.4198. http://link.aps.org/abstract/PRE/v52/p4198.
G. Cevc, A. Schätzlein, H. Richardsen (2002-08-19). "Ultradeformable Lipid Vesicles can Penetrate the Skin and other Semi-Permeable Barriers Intact. Evidence from Double Label CLSM Experiments and Direct Size Measurements". Biochim. Biophys. Acta 1564: 21–30. PMID 12100992.
G. Cevc, A. Schätzlein, H. Richardsen, U. Vierl (2003). "Overcoming semi-permeable barriers, such as the skin, with ultradeformable mixed lipid vesicles, Transfersomes, liposomes or mixed lipid micelles". Langmuir 19 (26): 10753–10763. doi:10.1021/la026585n.
G. Cevc, D. Gebauer (February 2003). "Hydration-driven transport of deformable lipid vesicles through fine pores and the skin barrier.". Biophysical Journal 84 (4): 1010–1024. doi:10.1016/S0006-3495(03)74917-0. http://www.biophysj.org/cgi/content/abstract/84/2/1010.
G. Cevc (2004). "Lipid vesicles and other colloids as drug carriers on the skin". Advanced Drug Delivery Reviews 56 (5): 675–711. doi:10.1016/j.addr.2003.10.028. PMID 15019752.
[edit] Further reading
"Science". IDEA AG. http://www.idea-ag.de/web/en/science/index.html. — IDEA's own detailed explanation of what Transfersomes are and what they do.
"What is the difference between liposomes and Transfersomes?". Scientific FAQ. IDEA AG. http://www.idea-ag.de/web/en/faq/index-transfersome.html.
Medical trial that started in 2005
"Trans(Dermal) Delivery, Present and Future Perspectives" (PDF). http://www.drugdeliveryreport.com/articles/ddcr_s2003_article3.pdf.
Retrieved from "http://en.wikipedia.org/wiki/Transfersome"
Categories: Cell biology Nanotechnology Medical research Drug delivery devices

Transdermal implant

2009-10-31T01:19:00.000-07:00

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Transdermal implants are a form of body modification used both in a medical and aesthetic context. In either case, they consist of an object placed partially below and partially above the skin, thus transdermal. The skin around it generally heals as if it were a piercing.

Medically, transdermal implants are used to create "ports". An example of this is a transdermal implant which is done at the navel and is essentially a tube with a valve in it leading into the intestines; this is done on patients who are unable to eat food normally.

In the body piercing community, these types of modification are generally called fairly "heavy" due to the complexity of the procedure and the social implications. Two types of implants can be used.

When the procedure is done using a post-like implant, an incision is made a small distance from the site. The skin is then lifted and the implant is passed through. Then, a hole is opened at the site for it to pass through, and it is moved so that the top part fills the hole. The implants used for this are generally small and not textured in any way except rounding.

If a more graphic implant is desired, it is generally done in two parts. First, the base is inserted the same way a single-part would be, except that the base implant is threaded. It may either stick out like a bolt, or be inward like a nut. When this is done, the top half is screwed on. This type is usually done for spikes and/or horns.

In any case, the part of the implant which passes under the skin generally is somewhat large and has holes. The skin will grow into them, making it more permanent.

[edit] See also
Microdermal implants
Subdermal implant
Body piercing materials
Body modification
Body piercing
Retrieved from "http://en.wikipedia.org/wiki/Transdermal_implant"
Categories: Implants Body modification Drug delivery devices

Thin film drug delivery

2009-10-31T01:18:00.001-07:00

From Wikipedia, the free encyclopedia
Jump to: navigation, search
"Drug film" and "Drug films" redirect here. For movies featuring prescription drug abuse or use of illicit substances, see List of drug films.
This article only describes one highly specialized aspect of its associated subject.
Please help improve this article by adding more general information. (September 2009)
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Thin film drug delivery is a process of delivering drugs to the systemic circulation via a thin film that dissolves when in contact with liquid, often referred to as a dissolving film or strip. Thin film drug delivery has emerged as an advanced alternative to the traditional tablets, capsules and liquids often associated with prescription and OTC medications. Similar in size, shape and thickness to a postage stamp, thin film strips are typically designed for oral administration, with the user placing the strip on or under[citation needed] the tongue or along the inside of the cheek. As the strip dissolves, the drug can enter the blood stream enterically, buccally or sublingually.

The first commercial non-drug product to use thin films was the Listerine PocketPaks breath freshening strips. Since then, thin film products for other breath fresheners, as well as a number of cold, cough, flu and anti-snoring medications, have entered the marketplace. There are currently several projects in development that will deliver prescription drugs utilizing the thin film dosage form.[1]

Targeted drug delivery

2009-10-31T01:11:00.000-07:00

Targeted drug delivery is a method of delivering medication to a patient in a manner that increases the concentration of the medication in some parts of the body relative to others.

In traditional drug delivery systems such as oral ingestion or intravascular injection, the medication is distributed throughout the body through the systemic blood circulation. For most therapeutic agents, only a small portion of the medication reaches the organ to be affected. Targeted drug delivery seeks to concentrate the medication in the tissues of interest while reducing the relative concentration of the medication in the remaining tissues. This improves efficacy of the while reducing side effects.

Targeted drug delivery can be used to treat many diseases, such as the cardiovascular diseases and diabetes. However, the most important application of targeted drug delivery is to treat cancerous tumors.

There are two kinds of targeted drug delivery, active targeted drug delivery, such as some antibody medications; and passive targeted drug delivery, such as the Enhanced Permeability and Retention effect (EFR-effect).

Syringe

2009-10-06T06:50:00.002-07:00

A typical medical syringe with needleA syringe is a simple piston pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed along inside a cylindrical tube (the barrel), allowing the syringe to take in and expel a liquid or gas through an orifice at the open end of the tube. The open end of the syringe may be fitted with a hypodermic needle, a nozzle, or tubing to help direct the flow into and out of the barrel. Syringes are often used to administer injections, apply compounds such as glue or lubricant, and measure liquids.

The word "syringe" is derived from the Greek συριγξ syrinx = "tube" via back-formation of a new singular from its Greek-type plural "syringes" (συριγγες syringes)

Syrette

2009-10-06T06:50:00.001-07:00

Instructions for using the Syrette from the FM-21-11 Basic Field Manual –First Aid for Soldiers, April 7th 1943The Syrette is a device for injecting liquid through a needle. It is similar to a syringe except that it has a closed flexible tube (like that used for toothpaste) instead of a rigid tube and piston. It was developed by Squibb, now the Bristol-Myers Squibb Company.

Similar devices, often with similar names, have been made by other companies. [1][2]

The morphine syrette used in World War II had a wire loop pin with a guard in the end of the hollow needle that was used to break a seal where the needle was attached to the tube. It was similar to a Superglue tube. After breaking the seal the wire loop pin was removed and the hollow needle was inserted under the skin at a shallow angle and the tube flattened between the thumb and fingers. (See subcutaneous injection.) After injection the used tube was pinned to the receiving soldier's collar to inform others of the dose administered.

The US Military also distributed atropine in syrettes. Chemical treatment was subsequently distributed in Autoinjector form.

Suppository

2009-10-06T06:47:00.001-07:00

Suppository casting mouldA suppository is a drug delivery system that is inserted into the rectum (rectal suppository), vagina (vaginal suppository), or urethra (urethral suppository), where it dissolves.
They are used to deliver both systemically-acting and locally-acting medications.
The alternative term for delivery of medicine via such routes is pharmaceutical pessary.
The general principle is that the suppository is inserted as a solid, and will dissolve inside the body to deliver the medicine.
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Softgel

2009-10-06T06:45:00.000-07:00

A typical softgelA softgel is an oral dosage form for medicine similar to capsules. They consist of a gelatin based shell surrounding a liquid fill. Softgel shells are a combination of gelatin, water, and a plasticiser such as glycerin and/or sorbitol(s).

Softgels are produced in a process known as encapsulation using the Rotary Die Encapsulation process invented by Robert Pauli Scherer. The encapsulation process has been described as a form/fill/seal process. Two flat ribbons of shell material are manufactured on the machine and brought together on a twin set of rotating dies. The dies contain recesses in the desired size and shape, which cut out the ribbons into a two dimensional shape, and form a seal around the outside. Concomitantly, a dosing pump delivers a precise dose of fill material down through a nozzle incorporated into a filling wedge whose tip sits between the two ribbons in between two die pockets at the point of cut out. The wedge is heated to facilitate the sealing process. The wedge injection causes the two flat ribbons to expand into the die pockets, giving rise to the 3 dimensional finished product. After encapsulation, the softgels are dried for 2 days to 2 weeks depending on the product.

In recent years, manufacturers have been able to replace gelatin in the shell with other polymers based on, for example, starch and carrageenan.
Advil Liqui-Gels
It has been suggested that this section be split into a new article entitled Advil Liqui-Gels. (Discuss)

Advil Liqui-Gels are composed of a Gelatin outer casing filled with solubilized ibuprofen.[2] Ibuprofen normally is in a crystallized form that is grown 2 times and wet granulated to for the base material. The crystalline structure is one reason certain people my have reactions to Ibuprofen products.

The patent for solubilization of Ibuprofen in softgels was granted to the RPScherer Corporation (technology now owned by Catalent Pharma Solutions).[3]. The concept behind the invention was that Ibuprofen, being poorly soluble in water, takes time to dissolve in the stomach. The Advil Liquigel formulation provides the Ibuprofen in a solution, which reduces the time it takes for the body to absorb the drug. This is particularly beneficial for patients with occasional headaches or migraines, but less useful, perhaps, in patients with continuous, ongoing pain. The same rapid onset can be achieved in an oral solution (or syrup) but the softgel dosage form is more convenient.

Catalent Pharma Solutions is the current owner of the RPScherer technology [1].
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Self-microemulsifying drug delivery system

2009-07-28T08:45:00.001-07:00

A self-microemulsifying drug delivery system (SMEDDS) is a drug delivery system that uses a microemulsion achieved by chemical rather than mechanical means. That is, by an intrinsic property of the drug formulation, rather than by special mixing and handling. It employs the familiar ouzo effect displayed by anethole in many anise-flavored liquors. Microemulsions have significant potential for use in drug delivery, and SMEDDS (including so-called "U-type" microemulsions) are the best of these systems identified to date.[1] SMEDDS are of particular value in increasing the absorption of lipophilic drugs taken by mouth.

SMEDDS in research or development include formulations of the drugs anethole trithione,[2] oridonin,[3][4][5] curcumin,[6] vinpocetine,[7][8] tacrolimus,[9][10][11] berberine hydrochloride,[12] nobiletin,[13] piroxicam,[14][15] anti-malaria drugs beta-Artemether[16] and halofantrine,[17][18] anti-HIV drug UC 781,[19][20] nimodipine,[21][22] exemestane,[23] anti-cancer drugs 9-nitrocamptothecin (9-NC)[24] paclitaxel,[25][26] and seocalcitol,[27][28] alprostadil (intraurethral use),[29] probucol,[18][30] itraconazole,[31] fenofibrate,[32] acyclovir,[33] simvastatin,[34][35] xibornol,[36] silymarin,[37][38] alpha-asarone,[39] enilconazole,[19] puerarin (an isoflavone found in Pueraria lobata),[40][41][42][43] atorvastatin,[44][45][46] heparin,[47] carvedilol,[48] ketoconazole,[49] gentamicin,[50] labrasol,[51] flurbiprofen,[52] celecoxib,[53] danazol,[54] cyclosporine,[55] and idebenone.[56]

SMEDDS offer numerous advantages: spontaneous formation, ease of manufacture, thermodynamic stability, and improved solubilization of bioactive materials.[1] Improved solubility contributes to faster release rates and greater bioavailability. For many drugs taken by mouth, faster release rates improve the drug acceptance by consumers. Greater bioavailability means that less drug need be used; this may lower cost, and does lower the stomach irritation and toxicity of drugs taken by mouth.

For oral use, SMEDDS may be formulated as liquids or solids, the solids packaged in capsules or tablets. Limited studies comparing these report that in terms of bioavailability liquid SMEDDS are superior to solid SMEDDS,[21] which are superior to conventional tablets.[42][47][21] Liquid SMEDDS have also shown value in injectable (IV and urethral) formulations and in a topical (oral) spray.[36]

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Respimat

2009-07-28T08:44:00.001-07:00

Respimat, or commonly referred to as Respimat SMI, with the SMI acronym to mean, Soft Mist Inhaler.

Respimat SMI is an advanced drug delivery device in comparison to MDIs or DPIs used for the treatment of Asthma, COPD, and other respiratory conditions.

Its developer, Boehringer Ingelheim, is currently conducting Phase III clinical trials in the US with a variety of their products, such as Spiriva and Combivent.
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Pegintron Redipen

2009-07-28T08:41:00.000-07:00

Pegintron Redipen (or Peg-Intron Redipen) is a needle-based injector medical device (drug delivery device) that uses a dual chamber cartridge and is the first and only pen delivery system the U.S. Food and Drug Administration approved for administering pegylated interferon therapy for chronic hepatitis C. This delivery device is an easy-to-use alternative to traditional vial and syringe. Has short thin needle (30 gauge).From Wikipedia, the free encyclopedia
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A metered-dose inhaler

2009-07-24T04:20:00.001-07:00

A metered-dose inhaler consists of three major components; the canister, where the formulation resides; the metering valve, which allows a metered quantity of the formulation to be dispenced with each actuation; and an actuator (or mouthpiece) which allows the patient to operate the device and directs the aerosol into the patient's lungs.[1],[2] The formulation itself is made up of the drug, a liquefied gas propellant and, in many cases, stabilising excipients. The actuator contains the mating discharge nozzle and generally includes a dust cap to prevent contamination.

To use the inhaler the patient by presses down on the top of the canister, with their thumb supporting the lower portion of the actuator. Actuation of the device releases a single metered dose of the formulation which contains the medication either dissolved or suspended in the propellant. Breakup of the volatile propellant into droplets, followed by rapid evaporation of these droplets, results in the generation of an aerosol consisting of micrometer-sized medication particles that are then inhaled.[3]

[edit] Uses
Metered-dose inhalers are only one type of inhaler, but they are the most commonly used type. The replacement of chlorofluorocarbons propellants with hydrofluoralkanes resulted in the redesign of metered-dose inhalers in the 1990s. For one variety of beclomethasone inhaler, this redesign resulted in considerably smaller aerosol particles being produced, and led to an increase of potency by a factor of 2.6[4]; however for the salbutamol inhalers the effectiveness and dose required has, by design, remain unchanged.

Asthma inhalers contain a medication that treats the symptoms of asthma.
Dry powder inhalers involve micronised powder often packaged in single dose quantities in blisters or gel capsules containing the powdered medication to be drawn into the lungs by the user's own breath. These systems tend to be more expensive than the MDI, and patients with severely compromised lung function, such as occurs during an asthma attack, may find it difficult to generate enough airflow to get good function from them.
A nicotine inhaler allows cigarette smokers to get nicotine without using tobacco, much like nicotine gum or a nicotine patch. Nicotine inhalers that are marketed as nicotine replacement therapy should not be confused with electronic cigarettes, which produce vapour and which are marketed mainly as devices that smokers can use in non-smoking areas.

Metered dose transdermal spray

2009-07-24T04:18:00.001-07:00

Metered dose transdermal spray

Working in a similar manner to a transdermal patch, a metered dose transdermal spray (MDTS) delivers a drug to the surface of the skin which is absorbed into the circulation on a sustained basis. The drug is delivered by a device placed gently against the skin and triggered, causing it to release a light spray containing a proprietary formulation of the drug that quickly dries on the skin to form an invisible drug depot. As it would be from a patch, the drug is then absorbed steadily for a predetermined amount of time.

These methods can be used for symptoms of menopause, female androgen insufficiency, severe pain, central nervous system disorders, male androgen insufficiency, urinary incontinence, contraception and smoking cessation.
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HumaPen Memoir

2009-07-24T04:17:00.001-07:00

HumaPen Memoir is the first insulin needle-based injector medical device (drug delivery device) with memory of the last 16 injectors. The HumaPen Luxura HD delivers between 1 and 30 units of the drug in half-unit increments. Insulin pen injector use short needles to deliver precise insulin doses, and are highly portable.

Glide SDI

2009-07-16T06:31:00.001-07:00

This article is an orphan, as few or no other articles link to it. Please introduce links to this page from other articles related to it. (February 2009)
GLIDE SDI is a needle-free injector medical device (drug delivery device) which, instead of accelerating a liquid jet across the skin like other needle-free injectors, uses a solid dose. The dose itself is the delivery vehicle. Thus, a solid dosage in the form of a tiny rod with a pointed end is pushed into the skin using a spring-loaded, handheld actuator which resembles a pen injector.

EpiPen

2009-07-16T06:29:00.000-07:00

A 0.3 mg EpiPen auto-injector.EpiPen is a registered trademark for a commonly used autoinjector of epinephrine (a.k.a. adrenaline), used in medicine to treat anaphylactic shock.
Anaphylaxis is an acute systemic (multi-system) and severe type I hypersensitivity allergic reaction in humans and other mammals. The term comes from the Greek words ανα ana (against) and φύλαξις phylaxis (protection).[1] Minute amounts of allergens may cause a life-threatening anaphylactic reaction. Anaphylaxis may occur after ingestion, skin contact, injection of an allergen or, in some cases, inhalation.[2]

Anaphylactic shock, the most severe type of anaphylaxis, occurs when an allergic response triggers a quick release from mast cells of large quantities of immunological mediators (histamines, prostaglandins, leukotrienes) leading to systemic vasodilation (associated with a sudden drop in blood pressure) and edema of bronchial mucosa (resulting in bronchoconstriction and difficulty breathing). Anaphylactic shock can lead to death in a matter of minutes if left untreated.

Due in part to the variety of definitions, an estimated 1.24% to 16.8% of the population of the United States is considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens, especially penicillin and insect stings. Most of these people successfully avoid their allergens and will never experience anaphylaxis. Of those people who actually experience anaphylaxis, up to 1% may die as a result.[3] Anaphylaxis results in approximately 1,500 deaths per year in the U.S.[4] (one out of every 1,600 of the 2.4 million deaths from all causes each year in the U.S.;[5]). The most common presentation includes sudden cardiovascular collapse (88% of reported cases of severe anaphylaxis).

Researchers typically distinguish between "true anaphylaxis" and "pseudo-anaphylaxis" or an "anaphylactoid reaction." The symptoms, treatment, and risk of death are identical, but "true" anaphylaxis is always caused directly by degranulation of mast cells or basophils that is mediated by immunoglobulin E (IgE), and pseudo-anaphylaxis occurs due to all other causes.[6] The distinction is primarily made by those studying mechanisms of allergic reactions.

Easypod

2009-07-07T21:27:00.000-07:00

From Wikipedia, the free encyclopediaeasypod is a needle-based injector, computer-controlled, battery-powered medical device (drug delivery device) for the recombinant human growth hormone somatropin. With features such as preset dosing, assisted needle attachment and dose confirmation, for precise injections.

Dry powder inhaler

2009-07-07T21:20:00.001-07:00

From Wikipedia, the free encyclopedia
A Dry powder inhaler (DPI) is a device that delivers medication to the lungs in the form of a dry powder. DPIs are commonly used to treat respiratory diseases such as asthma, bronchitis, emphysema and COPD although DPIs have also been used in the treatment of diabetes mellitus.[1]

DPIs are an alternative to the aerosol based inhalers commonly called metered-dose inhaler (or MDI). The DPIs may require some procedure to allow a measured dose of powder to be ready for the patient to take. The medication is commonly held either in a capsule for manual loading or a proprietary form from inside the inhaler. Once loaded or actuated, the operator puts the mouthpiece of the inhaler into their mouth and takes a deep inhalation, holding their breath for 5-10 seconds. There are a variety of such devices. The dose that can be delivered is typically less than a few tens of milligrams in a single breath since larger powder doses may lead to provocation of cough.

Most DPIs rely on the force of patient inhalation to entrain powder from the device and subsequently break-up the powder into aerosol particles that are small enough to reach the lungs.[2] For this reason, insufficient patient inhalation flow rates may lead to reduced dose delivery and incomplete deaggregation of the powder, leading to unsatisfactory device performance. Thus, most DPIs have a minimum inspiratory effort that is needed for proper use and it is for this reason that such DPIs are normally used only in older children and adults

Dry powder inhaler

2009-07-07T21:20:00.000-07:00

Drug-Eluting Stent

2009-07-07T21:14:00.000-07:00

From Wikipedia, the free encyclopedia
A drug-eluting stent (DES) is a coronary stent (a scaffold) placed into narrowed, diseased coronary arteries that slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombus), could otherwise block the stented artery, a process called restenosis. The stent is usually placed within the coronary artery by an Interventional cardiologist during an angioplasty procedure.
Drug-eluting stents in current clinical use were approved by the FDA after clinical trials showed they were statistically superior to bare-metal stents (BMS) for the treatment of native coronary artery narrowings, having lower rates of major adverse cardiac events (MACE) (usually defined as a composite clinical endpoint of death + myocardial infarction + repeat intervention because of restenosis
Drug-eluting stents consist of three parts. Stent platform, coating, and drug.
The stent itself is an expandable metal alloy framework. Many DES are based on a bare-metal stent (BMS). The stents have elaborate mesh-like designs to allow expansion, flexibility and in some cases the ability to make/enlarge side openings for side vessels. Cobalt chrome alloy is stronger (and more radio-opaque) than the usual 316L stainless steel so the struts can be thinner which seems to reduce the degree of restenosis. (The L605 CoCr alloy has less nickel than 316L stainless steel and so may cause less allergy.)
A coating, typically of a polymer, holds and elutes (releases) the drug into the arterial wall by contact transfer. The first few DES licenced used durable coatings, but some newer coating are designed to biodegrade after or as the drug is eluted. Coatings are typically spray coated or dip coated. There can be one to three or more layers in the coating eg a base layer for adhesion, a main layer for holding the drug, and sometimes a top coat to slow down the release of the drug and extend its effect.
The drug is mainly to inhibit neointimal growth (due to proliferation of smooth muscle cells) which would cause restenosis. Much of the neointimal hyperphasia seems to be cause by inflammation. Hence immunosuppressive and antiproliferative drugs are used. Both sirolimus and paclitaxel were previously used for other medical applications; new drugs are being evaluated for coronary stents [7] [28].
Examples (approved for clinical use) :
Cypher (J&J, Cordis ) uses a 316L stainless steel BxVelocity stent (140 µm struts) and adds a 12.6 µm 3 layer coating (2 µm Parylene C base coat, 10 µm main coat of PEVA, PBMA and sirolimus, and a 0.6 µm top coat of PBMA).[29] The sirolimus elutes over a period of about 30 days [30].
Taxus (Boston Scientific) uses a 316L stainless steel Express2 stent (132 µm struts) and adds a 16 µm single layer Translute SIBS copolymer coating containing paclitaxel which elutes over a period of about 90 days [30].
Endeavour (Medtronic) uses a cobalt chrome Driver stent (91 µm struts) and adds a 4.3 µm phosphorylcholine coating that includes zotarolimus, on a 1 µm base coat.
Xience V (Guidant, Abbott) uses an L605 cobalt chrome ML Vision stent (81 µm struts) and adds a 7.6 µm fluropolymer multilayer coating with drug everolimus [31].
Examples approved outside the US :
Infinnium (Sahajanand Medical Technologies) Matrix Stent Platform, contains biodegradable polymers as a drug delivery vehicle with Paclitaxel [32]
Axxion (Biosensors Int) Stainless steel stent, Synthetic Glycocalix coating with paclitaxel[33].
BioMatrix (Biosensors Int) S stent platform, bioabsorbable PLA coating with Biolimus A9 drug [34].
ARTAX (Aachen Resonance) double helix stainless steel platform, without polymer, metal coated with paclitaxel drug [35].

[edit] Investigation and Alternative drugs
There are also several other anti-proliferative drugs under investigation in human clinical trials. In general, these are analogues of sirolimus. Like sirolimus, these block the action of mTOR. Medtronic has developed zotarolimus; unlike sirolimus and paclitaxel, this sirolimus analogue designed for use in stents with phosphorylcholine as a carrier. Their ZoMaxx stent is a zotarolimus-eluting, stainless steel and tantalum–based stent; a modified phosphorylcholine slowly releases the zotarolimus [36]. Zotarolimus has been licensed to Medtronic which is researching the effectiveness in a drug-eluting stent of their own. Their Endeavor stent, which is a cobalt alloy,[7] also uses phosphorylcholine to carry the zotarolimus was approved for use in Europe in 2005 is now close to U.S. FDA approval [37].
Clinical trials are currently examining two stents carrying everolimus,[7] an analog of sirolimus. Guidant, which has the exclusive license to use everolimus in drug-eluting stents, is the manufacturer of both stents. The Guidant vascular business was subsequently sold to Abbott [38]. The Champion stent uses a bioabsorbable polylactic acid carrier on a stainless steel stent [39] [40]. In contrast, its Xience stent uses a durable (non-bioabsorbable) polymer on a cobalt alloy stent [41].
One alternative to drug-eluting stents is a stent surface designed to reduce the neointimal proliferation. One such is the Genous bioengineered stent [42].
In place of the stainless steel (and now cobalt chrome) currently used in stents, various biodegradable frameworks are under early phases of investigation. Since metal, as a foreign substance, provokes inflammation, scarring, and thrombosis (clotting), it is hoped that biodegradable or bioabsorbable stents may prevent some of these effects. A magnesium alloy–based stent has been tested in animals, though there is currently no carrier for drug elution. [43] A promising biodegradable framework is made from poly-L-lactide, a polymer of a derivative of L-lactic acid. One of these stents, the Igaki-Tamai stent, has been studied in pigs; tranilast [44] and paclitaxel[45] have been used as eluted drugs

Autoinjector

2009-07-07T20:42:00.000-07:00

An autoinjector (or auto-injector) is a medical device designed to deliver a single dose of a particular (typically life-saving) drug.

Most autoinjectors are spring-loaded syringes. By design, autoinjectors are easy to use and are intended for self-administration by patients. The site of injection depends on the drug loaded, but it typically is administered into the thigh or the buttocks. The injectors were initially designed to overcome the hesitation associated with self-administration of the needle-based drug delivery device.

Morphine is routinely carried by troops on operations and in battle in the case of injuries or severe pain. The wounded soldier is immediately injected to relieve pain, and is then usually taken back or field operated. Morphine in auto-injectors during the World Wars and the Vietnam War was common and was often used as an analgesic during field operations.
Autoinjectors are often used in the military to protect personnel from chemical warfare agents. In the U.S. military, atropine and 2-PAM-Cl (pralidoxime chloride) are used for first aid ("buddy care" or "self care") against nerve agents. An issue item, the Mark I NAAK kit, provides these drugs in the form of separate autoinjectors. A newer model, the ATNAA (Antidote Treatment Nerve Agent Auto-Injector), has both drugs in one syringe, allowing for the simplification of administration procedures. In the Gulf War, accidental and unnecessary use of atropine autoinjectors supplied to Israeli civilians proved to be a major medical problem.
In concert with the Mark I NAAK, diazepam (Valium) autoinjectors, known as CANA, are carried by US servicemembers for use in prevention of the seizures caused by nerve agents. newer variant of the autoinjector is the gas jet autoinjector, which contains a cylinder of pressurised gas and propels a fine jet of liquid through the skin without the use of a needle. This has the advantage that the autoinjector can be reloaded, and a variety of different doses or different drugs can be used, although the only widespread application to date has been for the administration of insulin in the treatment of diabetes.12

Syringe Pumps

2009-06-25T07:42:00.001-07:00

There are two basic classes of pumps. Large volume pumps can pump nutrient solutions large enough to feed a patient. Small-volume pumps infuse hormones, such as insulin, or other medicines, such as opiates.
Within these classes, some pumps are designed to be portable, others are designed to be used in a hospital, and there are special systems for charity and battlefield use.
Large-volume pumps usually use some form of peristaltic pump. Classically, they use computer-controlled rollers compressing a silicone-rubber tube through which the medicine flows. Another common form is a set of fingers that press on the tube in sequence.
Small-volume pumps usually use a computer-controlled motor turning a screw that pushes the plunger on a syringe.
The classic medical improvisation for an infusion pump is to place a blood pressure cuff around a bag of fluid. The battlefield equivalent is to place the bag under the patient. The pressure on the bag sets the infusion pressure. The pressure can actually be read-out at the cuff's indicator. The problem is that the flow varies dramatically with the patient's blood pressure (or weight), and the needed pressure varies with the administration route, making this quite risky for use by an untrained person. Pressures into a vein are usually less than 8 lbf/in² (55 kPa. Epidural and subcutaneous pressures are usually less than 18 lbf/in² (125 kPa).
Places that must provide the least-expensive care often use pressurized infusion systems. One common system has a purpose-designed plastic "pressure bottle" pressurized with a large disposable plastic syringe. A combined flow restrictor, air filter and drip chamber helps a nurse set the flow. The parts are reusable, mass-produced sterile plastic, and can be produced by the same machines that make plastic soft-drink bottles and caps. A pressure bottle, restrictor and chamber requires more nursing attention than electronically-controlled pumps. In the areas where these are used, nurses are often volunteers, or very inexpensive.
The restrictor and high pressure helps control the flow better than the improvised schemes because the high pressure through the small restrictor orifice reduces the variation of flow caused by patients' blood pressures.
An air filter is an essential safety device in a pressure infusor, to keep air out of the patients' veins: doctors estimate that 0.55 cm³ of air per kilogram of body weight is enough to kill (200-300 cm³ for adults) by filling the patient's heart. Small bubbles could cause harm in arteries, but in the veins they pass through the heart and leave in the patients' lungs. The air filter is just a membrane that passes gas but not fluid or pathogens. When a large air bubble reaches it, it bleeds off.
Some of the smallest infusion pumps use osmotic power. Basically, a bag of salt solution absorbs water through a membrane, swelling its volume. The bag presses medicine out. The rate is precisely controlled by the salt concentrations and pump volume. Osmotic pumps are usually recharged with a syringe.
Spring-powered clockwork infusion pumps have been developed, and are sometimes still used in veterinary work and for ambulatory small-volume pumps. They generally have one spring to power the infusion, and another for the alarm bell when the infusion completes.
Battlefields often have a need to perfuse large amounts of fluid quickly, with dramatically changing blood pressures and patient condition. Specialized infusion pumps have been designed for this purpose, although they have not been deployed.
Many infusion pumps are controlled by a small embedded system. They are carefully designed so that no single cause of failure can harm the patient. For example, most have batteries in case the wall-socket power fails. Additional hazards are uncontrolled flow causing an overdose, uncontrolled lack of flow, causing an underdose, reverse flow, which can siphon blood from a patient, and air in the line, which can starve a patient's tissues of oxygen if it floats to some part of a patient's body

Ice pack

2009-06-14T00:04:00.001-07:00

From Wikipedia, the free encyclopedia
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This article is about a sac filled with a coolant. For sea ice, such as Arctic ice packs, see Pack ice

An ice pack
An ice pack with gel leaking out of a hole in the upper left cornerAn ice pack (commonly used therapeutically) is a plastic sac of crushed or cubed ice, refrigerant gel or liquid, or even frozen vegetables. The refrigerant, usually non-toxic, can absorb a considerable amount of heat, since its specific heat capacity is high.

The most common type of ice pack is simply a sack, bag or towel filled with cubed or crushed ice. It is commonly used to alleviate the pain of minor injuries.

Ice packs are used in coolers to keep disease-bearing foods (meats, milk products, eggs, etc.) below 41 °F (5 °C) to keep them safe for eating. If the foods and the ice packs fill the cooler directly from the freezer, then the equivalent of 10 to 20 pounds of ice is needed for each 24 hour period. If the ice pack is filled with a coolant, then the same weight may last longer. If the foods come from the refrigerator then they will not stay cool as long with the same size ice pack. These foods should remain over 41 °F (5 °C) and under 165 °F (74 °C) for no longer than 4 hours accumulated over their entire existence. In that way, ice packs can be considered equivalent to a larger mass of ice.

Gel packs have the added benefit over ice that they do not cross-contaminate foods as ice can do when it turns liquid and mixes with the foods. Gel packs are often made of non-toxic materials that will not liquify, and therefore will not spill or contaminate if the container breaks. Gel packs make be made from hydroxyethyl cellulose (Cellusize™)[1][2] or vinyl-coated silica gel.[3]

Another type of ice pack uses the endothermic reaction of ammonium nitrate and water to cool down quickly. When one breaks a tube inside the pack the ammonium nitrate is released allowing it to mix with the water. Other chemicals which produce a similar effect include calcium chloride and ammonium chloride.[4]

HumaPen

2009-06-13T23:55:00.001-07:00

GLIDE SDI

2009-06-13T23:45:00.001-07:00

GLIDE SDI is a needle-free injector medical device (drug delivery device) which, instead of accelerating a liquid jet across the skin like other needle-free injectors, uses a solid dose. The dose itself is the delivery vehicle. Thus, a solid dosage in the form of a tiny rod with a pointed end is pushed into the skin using a spring-loaded, handheld actuator which resembles a pen injector.

Easypod needle-based injector

2009-06-13T23:32:00.000-07:00

easypod is a needle-based injector, computer-controlled, battery-powered medical device (drug delivery device) for the recombinant human growth hormone somatropin. With features such as preset dosing, assisted needle attachment and dose confirmation, for precise injections.

Dry powder inhaler

2009-06-13T23:30:00.001-07:00

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A Dry powder inhaler (DPI) is a device that delivers medication to the lungs in the form of a dry powder. DPIs are commonly used to treat respiratory diseases such as asthma, bronchitis, emphysema and COPD although DPIs have also been used in the treatment of diabetes mellitus.[1]

DPIs are an alternative to the aerosol based inhalers commonly called metered-dose inhaler (or MDI). The DPIs may require some procedure to allow a measured dose of powder to be ready for the patient to take. The medication is commonly held either in a capsule for manual loading or a proprietary form from inside the inhaler. Once loaded or actuated, the operator puts the mouthpiece of the inhaler into their mouth and takes a deep inhalation, holding their breath for 5-10 seconds. There are a variety of such devices. The dose that can be delivered is typically less than a few tens of milligrams in a single breath since larger powder doses may lead to provocation of cough.

Most DPIs rely on the force of patient inhalation to entrain powder from the device and subsequently break-up the powder into aerosol particles that are small enough to reach the lungs.[2] For this reason, insufficient patient inhalation flow rates may lead to reduced dose delivery and incomplete deaggregation of the powder, leading to unsatisfactory device performance. Thus, most DPIs have a minimum inspiratory effort that is needed for proper use and it is for this reason that such DPIs are normally used only in older children and adults

Drug-eluting stent

2009-06-13T23:28:00.000-07:00

Drug-eluting stent
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An example of a drug-eluting stent. This is the TAXUS Express2 Paclitaxel-Eluting Coronary Stent System, which releases paclitaxel.A drug-eluting stent (DES) is a coronary stent (a scaffold) placed into narrowed, diseased coronary arteries that slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombus), could otherwise block the stented artery, a process called restenosis. The stent is usually placed within the coronary artery by an Interventional cardiologist during an angioplasty procedure.

Drug-eluting stents in current clinical use were approved by the FDA after clinical trials showed they were statistically superior to bare-metal stents (BMS) for the treatment of native coronary artery narrowings, having lower rates of major adverse cardiac events (MACE) (usually defined as a composite clinical endpoint of death + myocardial infarction + repeat intervention because of restenosis) [1] [2] [3].

Autoinjector (or Auto-injector)

2009-06-13T23:19:00.000-07:00

Transdermal patches

2009-06-13T23:18:00.002-07:00

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This category is for transdermal patches (also known as skin patches), medicated adhesive patches that are placed on the skin to deliver a time released dose of medication through the skin and into the bloodstream

Drug delivery devices

2009-06-13T23:18:00.001-07:00

From Wikipedia, the free encyclopedia

Drug delivery devices are specialized tools for the delivery of a drug or therapeutic agent via a specific route of administration. Such devices are used as part of one or more medical treatments.

Twin bloc

2009-06-13T23:17:00.002-07:00

From Wikipedia, the free encyclopedia

A twin bloc is an orthodontic appliance. Its purpose is to posture the lower jaw forward.

Tooth Tunes

2009-06-13T23:17:00.001-07:00

From Wikipedia, the free encyclopedia
Tooth Tunes is a children's toothbrush released by the Tiger Electronics division of Hasbro in 2007. A single toothbrush has a manufacturer's suggested price of USD$9.99. Each brush plays a two-minute song clip from a particular artist to encourage a child to brush their teeth for the dentist-recommended two minutes. A single toothbrush comes with one song.

Once activated, a small CPU in the handle plays the featured song on the chip by transferring vibrations through the bristles, which act as transducers, into the front teeth, through the jawbone, and into the inner ear. The user hears a mix between a natural vocal hum and the song being played.[1][2][3] The intended result was for the music only to be audible to its user, however the music emanating from the toothbrush can be heard by those nearby, with increasing volume as pressure is applied to the brush head.

Andrew Filo, one of the toothbrush's inventors, said that he worked on the project because of his childhood fascination with his ability to hear himself humming.[1]

Toothbrush

2009-06-13T23:16:00.003-07:00

From Wikipedia, the free encyclopedia
The toothbrush is an instrument consisting of a small brush on a handle used to clean teeth through tooth brushing. Toothpaste, often containing fluoride, is commonly added to a toothbrush to aid in cleaning. Toothbrushes are offered with varying textures of bristles, and come in many different sizes and forms. Most dentists recommend using a toothbrush labelled "Soft", since firmer bristled toothbrushes can damage tooth enamel and irritate gums as indicated by the American Dental Association[1]. Toothbrushes are often made from synthetic fibers, although natural toothbrushes are also known in many parts of the world.

Tongue cleaner

2009-06-13T23:16:00.001-07:00

From Wikipedia, the free encyclopedia

Tongue cleaner
Tongue scraper
Tongue brushA tongue cleaner (also called a tongue scraper or tongue brush) is an oral hygiene device designed to clean the bacterial build-up, food debris, fungi, and dead cells from the surface of the tongue. The bacteria and fungi that grow on the tongue are related to many common oral care and general health problems. In addition, decaying bacteria produce volatile sulphur compounds on the rear of the tongue; these molecules are the main cause of halitosis (bad breath).

Sonicare electric toothbrush

2009-06-13T23:15:00.001-07:00

Sonicare is an electric toothbrush manufactured by Philips.In 1987, David Giuliani, an entrepreneur with a background in electrical engineering, met with University of Washington professors Drs. David Engel and Roy Martin. They formed a new company named GEMTech to promote a dental hygiene device using a piezoelectric multimorph transducer. After several years of research and creating prototypes, the Sonicare toothbrush was introduced in November 1992 at a periodontal convention in Florida.

In 1995, GEMTech changed its name to Optiva Corporation. In October 2000, Philips Domestic Appliances and Personal Care, a division of Philips, acquired Optiva Corporation. A few months later Optiva Corporation changed its name to Philips Oral Healthcare, Inc. By the end of 2001, Sonicare had become the number-one selling rechargeable power toothbrush in the United States.[1]

Self-ligating braces

2009-06-13T23:14:00.001-07:00

From Wikipedia, the free encyclopedia
This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unverifiable material may be challenged and removed. (January 2009)

Self-ligating braces are a type of dental braces, used to straighten teeth in a much more passive way than conventional dental braces. Dental straightening with the use of self-ligating appliances, supposedly have shorter average overall treatment times, but this is not supported by independent research.

Types of self-ligating braces include the Damon system , Clarity SL, Carriere LX® by Ortho Organizers, In-Ovation R, In-Ovation C, and In-Ovation LMTM by Dentsply GAC. These braces are typically made from stainless steel, but in some cases, are available in ceramic.

Retainer (orthodontic device)

2009-06-13T23:13:00.002-07:00

From Wikipedia, the free encyclopedia

Bottom (at left) and top (at right) Hawley retainersOrthodontic retainers are custom-made devices, made usually of wires or clear plastic, that hold teeth in position after surgery or any method of realigning teeth. They are most often used before or after dental braces to hold teeth in position while assisting the adjustment of the surrounding gums to changes in the bone. Most patients are required to wear their retainer(s) every night at first, with many also being directed to wear them during the day - at least initially. They should not be worn while eating food or drinking staining or acidic beverages (e.g., Cola products and coffee). There are three types of retainers typically prescribed by orthodontists and dentists: Hawley, Essix, and Bonded (Fixed) retainers.
The underneath surface of an upper Wrap Around Hawley retainer resting on top of a retainer caseThe best-known type is the Hawley retainer, which is made of a metal wire that surrounds the teeth and keeps them in place. Named after Dr. Hawley, the labial wire, or Hawley bow, incorporates 2 omega loops for adjustment. It is anchored in an acrylic arch that sits in the palate or lingual walls of the mouth. The acrylic is Methyl Methacrylate which comes in two parts; the polymer (powder) and monomer (liquid). The Hawley retainer is designed for treatment after use of products that close diastemas (gaps). The advantage of this type of retainer is that the metal wires can be adjusted to finish treatment and continue moving teeth as needed.[1]
Vacuum form retainer in the foreground (used on upper); illustration of an early Hawley retainer in the backgroundAnother common type is the vacuum formed retainer (VFR). This is a polypropylene or polyvinylchloride (PVC) material, typically .020" or .030" thick. Essix is a brand name many dental offices are familiar with. This clear or transparent retainer fits over the entire arch of teeth and is produced from a mold. It is similar in appearance to Invisalign trays, though the latter are not considered "retainers". VFRs, if worn 24 hours per day, do not allow the upper and lower teeth to touch because plastic covers the chewing surfaces of the teeth. Some orthodontists feel that it is important for the top and bottom chewing surfaces to meet to allow for "favorable settling" to occur. VFRs are less expensive, less conspicuous, and easier to wear than Hawley retainers. However, for patients with disorders such as Bruxism, VFRs are prone to rapid breakage and deterioration, especially if the material is PVC, a short chain molecule. This breaks down swiftly as compared to polypropylene, a long chain molecule.

Most removable retainers are supplied with a retainer case for protection. During the first few days of retainer use, many people experience extra saliva in their mouth. This is natural and is due to the presence of a new object inside the mouth and consequent stimulation of the salivary glands. It may be difficult to speak for a while after getting a retainer, but this speech difficulty should go away over time as one gets used to wearing it.

An entirely different category of orthodontic retainers are fixed retainers. A fixed retainer typically consists of a passive wire bonded to the tongue-side of the (usually, depending on the patient's bite, only lower) incisors. Unlike the previously-mentioned retainer types, fixed retainers can not be removed by the patient. Some doctors prescribe fixed retainers regularly, especially where active orthodontic treatments have effected great changes in the bite and there is a high risk for reversal of these changes. Fixed retainers may lead to tartar build-up or gingivitis due to the difficulty of flossing while wearing these retainers

Quad Helix

2009-06-13T23:13:00.001-07:00

From Wikipedia, the free encyclopedia

A Quad Helix (or quadhelix) is an orthodontic appliance for the upper teeth that is cemented in the mouth. It is attached to the molars by 2 bands and has four active helix springs that widen the arch of the mouth to make room for crowded teeth, or correct a posterior cross-bite, where lower teeth are buccal (outer) than upper teeth. A variety of this appliance is inserted into attachments that are welded to the bands. In this way the orthodontist can adjust the appliance without removing the bands.

Periodontal probe

2009-06-13T23:12:00.001-07:00

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A periodontal probe is an instrument in dentistry commonly used in the dental armamentarium. It is usually long, thin, and blunted at the end. The primary purpose of a periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium. There are markings inscribed onto the head of the instrument for accuracy and readability.

Michigan O probe with Williams markings (left) and Naber's probe with shades alternating every 3 mm (right).Proper use of the periodontal probe is necessary to maintain accuracy. The tip of the instrument is placed with light pressure of 10-20 grams[1] into the gingival sulcus, which is an area of potential space between a tooth and the surrounding tissue. It is important to keep the periodontal probe parallel to the contours of the root of the tooth and to insert the probe down to the base of the pocket. This results in obscuring a section of the periodontal probe's tip. The first marking visible above the pocket indicates the measurement of the pocket depth. It has been found that the average, healthy pocket depth is around 3 mm with no bleeding upon probing. Depths greater than 3 mm can be associated with "attachment loss" of the tooth to the surrounding alveolar bone, which is a characteristic found in periodontitis. Pocket depths greater than 3 mm can also be a sign of gingival hyperplasia.

There are many different types of periodontal probes, and each has its own manner of indicating measurements on the tip of the instrument. For example, the Michigan O probe has markings at 3 mm, 6 mm and 8 mm [2] and the Williams probe has circumferential lines at 1 mm, 2 mm, 3 mm, 5 mm, 7 mm, 8 mm, 9 mm, and 10 mm [3]. The PCP12 probe with Marquis markings has alternating shades every 3 mm. Unlike the previous two mentioned, the Naber's probe is curved and is used for measuring into the furcation area between the roots of a tooth.

Rapid Palatal Expander

2009-06-13T23:10:00.001-07:00

A palatal expander, also known as a rapid palatal expander, rapid maxillary expansion appliance, palate expander or orthodontic expander, is used to widen the upper jaw so that the bottom and upper teeth will fit together better. It is thought this can only be done when the patient is still growing, unless surgery is used to separate the two halves of the palate, however there is evidence to the contrary. It is most often followed by braces to straighten out all the teeth now that room has been created.

The expansion process usually results in a large gap between the patient's top front teeth, although this does not always happen. This gap is closed naturally and the teeth may overlap which leads to braces being needed. Sometimes with expanders, the patient has to turn the expansion screw themselves to tighten up the expander. For expansion that is not managed by the patient on the and lower jaw, a bionator may be a more suitable alternative.

Although it may vary from person to person, most usually feel slight pressure on their teeth. As the patient turns the expansion screw using the key, a space develops between the front two teeth. Some may notice a larger space while others do not notice a space at all. It usually takes several days to adjust to eating and speaking after first receiving the rapid palatal expander. Patients may experience pain and headaches while wearing palatal expanders and when the screw is turned. They may also feel a sore on their tongue from contact with the expander's metal bars.

Patients who have expanders may experience extra saliva and lisps (pronouncing the letter S as a T sound) or a slight 'hissing' S sound.

When the palatal expander is first removed, patients usually report that their mouth feels extremely big and spacious.

Oral irrigator

2009-06-13T23:09:00.001-07:00

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An oral irrigator is a device that is used to clear away food debris from teeth using a water jet. It is mostly used by people with braces (to replace dental floss), or periodontal problems (or for the prevention of periodontal problems, cleaning the gingival sulcus).

Mouth prop

2009-06-13T23:08:00.001-07:00

From Wikipedia, the free encyclopedia
A mouth prop (also "Bite block") is a wedge-shaped implement used in dentistry for dentists working with children and other patients who have difficulty keeping their mouths open wide and steady during a procedure, or during procedures where the patient is sedated. It has a rubber like texture and is typically made from Thermoplastic Vulcanizate (TPV) material. They come in several different sizes, from pediatric to adult, and are typically ridged as to use the back teeth to hold them in place

Mouth mirror

2009-06-13T00:21:00.000-07:00

Mouth mirror
From Wikipedia, the free encyclopedia

A mouth mirror
A mouth mirror or dentist's mirror is an instrument used in dentistry. The head of the mirror is usually round, and the most common sizes used are the No. 4 and No. 5. A No. 2 is sometimes used when a smaller mirror is needed, such as when working on back teeth with a dental dam in place. The mouth mirror has a wide range of uses. Three of its most important functions are allowing indirect vision by the dentist, reflecting light onto desired surfaces, and retraction of soft tissues.
Indirect vision is needed in certain locations of the mouth where visibility is difficult or impossible. The posterior (or lingual) surfaces of the anterior maxillary teeth is a notable area where mouth mirrors are often used. Other areas of the mouth can be viewed more readily with the mouth mirror, even though it would be possible to see them if the dentist or dental hygienist adjusted their body into a poor position. Without the mouth mirror, poor body positioning would occur daily and lead to chronic postural problems, especially of the back and neck.
There are other areas of the mouth where lighting is difficult, even with overhead dentists' lights. In these instances, the mouth mirror is used to reflect light onto those surfaces. This is especially useful if the mirror is simultaneously being used for indirect vision of an obscure area.
Additionally, the mouth mirror is used to retract tissues, such as the tongue or cheeks, to gain better visualization of the teeth.
Dentist's mirrors are also commonly used by engineers to allow vision in tight spaces and around corners in equipment. They are a common tool in optics and laser labs as well

The miswak (miswaak, siwak)

2009-06-13T00:12:00.000-07:00

The miswak (miswaak, siwak) is a natural toothbrush made from the twigs of the Salvadora persica tree, also known as the arak tree or the peelu tree. Other tree types that are used are the olive, walnut, and other trees with bitter roots. 2003 scientific study comparing the use of miswaak with ordinary toothbrushes concluded that the results clearly were in favor of the users who had been using the miswaak, provided they had been given proper instruction in how to brush using it.[1] The World Health Organization (WHO) recommended the use of the miswaak in 1986 and in 2000 an international consensus report on oral hygiene concluded that further research was needed to document the effect of the miswak.[2]

Recent research by Dr Otaybi from Saudi Arabia[3] opened a new area for research on the systemic effects of Miswak (Sewak) after discovering its great positive effect on the immune system. Dr. Rami Mohammed Diabi[4] who spent more than 17 years researching on Miswak effects on health and especially its anti-addiction effects on smokers (curative and preventive sides) had opened a great field of science and researches by his last research: "Miswak Medicine theory" or Sewak Puncture medicine[5] which led him to what is so called Beyond Sewak: World of Science and Research.[6] Miswak also is contributing in the fight against desertification,[7] thereby affecting our environment and global climate.

Mandibular advancement splint

2009-06-13T00:11:00.001-07:00

mandibular splint or mandibular advancement splint is a device worn in the mouth that is used to treat obstructive sleep apnea and snoring.

The splint treats snoring and mild to moderate sleep apnea by moving the lower jaw forward slightly, which tightens the soft tissue and muscles of the upper airway to prevent obstruction of the airway during sleep. The tightening created by the device also prevents the tissues of the upper airway from vibrating as air passes over them – the most common cause of loud snoring.

Mandibular advancement splints are widely used in the United States and are beginning to be used in Britain and Israel. Where appropriate, they are considered a good therapy choice as they are non-invasive, easily reversible, quiet and generally well accepted by the patient. The focus of improvement in appliance design is in reducing bulk, permitting free jaw movement (i.e. yawning, speaking, drinking) and allowing users to breathe through their mouth (early 'welded gum shield'-type devices prevented oral breathing).

Less expensive "do it yourself" splints are also available and can provide the same benefits if fitted correctly

A loupe (pronounced loop),

2009-06-13T00:09:00.001-07:00

A loupe (pronounced loop), is a type of magnification device used to see things one is looking at more closely. In this respect, they are simply a form of a modified microscope, allowing the user to be able to better apply the phenomenon of microscopy to his or her trade.

Lentulo Spiral

2009-06-13T00:07:00.001-07:00

A Lentulo spiral is a dental instrument used to properly distribute root canal sealer and cement evenly throughout the root canal system, as when performing endodontic therapy or a post and core cementation.
Maillefer’s Lentulo spiral, produced by Dentsply, is the only one licensed to use the Lentulo name; however, the term is generally used to refer to any of the various brands of root canal sealer and cement distributing spirals.

Invisalign

2009-06-13T00:03:00.000-07:00

Invisalign is a series of clear, removable teeth aligners that both orthodontists and dentists use as an alternative to traditional metal dental braces. As of April 2008, more than 730,000 patients have completed or are currently in treatment.[1]
Invisalign is designed, manufactured, and marketed by Santa Clara-based medical-device company Align Technology, Inc. Align says that over 35,790 doctors are trained to provide Invisalign treatment in the U.S., with 48,130 doctors worldwide.[1] As of January 29, 2008, Align Technology has 1,307 employees worldwide, and has manufactured more than 32 million aligners. The company has 133 patents[citation needed].
Align Technology was in a legal battle with the makers of a competing product, OrthoClear, from early 2005 until September, 2006.[2] Zia Chisti, one of the founders of Align, had started OrthoClear to compete against Invisalign. In a complaint filed with the United States International Trade Commission (ITC) on January 11, 2006, Align alleged that OrthoClear utilized Align's trade secrets and infringed twelve Align patents, comprising more than 200 patent claims, in the production of OrthoClear aligners at a facility in Lahore, Pakistan. On September 27, 2006, Align Technology settled its litigation with OrthoClear. OrthoClear has stopped accepting new cases and discontinued its aligner business worldwide. Align acquired all disputed intellectual property. Contrary to some reports, Align did not purchase OrthoClear

Interdental-brushes.JPG

2009-06-12T23:57:00.000-07:00

An interdental brush also called an interproximal brush is a modified toothbrush used for cleaning between teeth. It is best used in cases where the gingiva does not fill the space between teeth or when there is orthodontic therapy present. It was invented by John O. Butler Company (Today G.U.M, Sunstar).

A Glot-Up

2009-06-12T23:56:00.000-07:00

A Glot-Up is type of dental equipment, something in between a mouthguard and an adult-sized pacifier.
It was designed by an Acupuncture and Osteopathy Practice in Barcelona. It is an oral prottusor used mainly to treat TMJ (Temporo Mandibular Joint syndrome) because it relieves the tension from the jaw by replacing the grinding movement (Bruxism or night bruxism) which often causes the dysfunction of the TMJ in the jaw.
It is also a tool for use in mobilising the SBS (Sphenobasilar synchondrosis) as the suction acts as a way to manipulate this bone at the base of the skull.

Global dental microscopes

2009-06-12T23:51:00.000-07:00

Global dental microscopes are designed specifically for dentistry, and are used by more dentists around the world than any other brand of microscopes. A focus on ergonomics and ease of use permits easy installation and integration into the dental workflow, by providing better lighting, magnification, and tooth visualization.[1]

Floss pick

2009-06-06T15:30:00.001-07:00

A floss pick is a disposable oral hygiene device generally made of plastic and dental floss. The instrument is composed of two prongs extending from a thin plastic body of high-impact polystyrene material. Between the two prongs, a single piece of floss is fused into the plastic, one respective to the other on each prong. The prongs generally are attached to a body ending in the shape of a toothpick.

There are two types of angled floss picks in the oral care industry, the 'Y'-shaped angle and the 'F'-shaped angle floss pick. The floss end of the pick usually is ergonomically designed into the shape of a hyperbola for maximum disruption of bacterial pockets in the inter-proximal spaces of the teeth. At the base of the hyperbola where the 'y' begins to branch there is a handle for gripping and maneuvering before it tapers off into a pick.

Floss picks are manufactured in a variety of shapes, colors and sizes for adults and children. The floss can be coated in fluoride, flavor or wax.[1]

Floss picks have been proven in clinical studies to be just as efficacious as rolled floss

Explorer (dental)

2009-06-06T15:29:00.001-07:00

From Wikipedia, the free encyclopedia

A No. 23 explorer, also known as a 'sickle probe'
A dental explorer (sickle probe) is an instrument in dentistry commonly used in the dental armamentarium. A sharp point at the end of the explorer is used to enhance tactile sensation.
Until recently, it was advised that dentists use the explorer to determine the presence of tooth decay on tooth enamel. Some dental professionals have questioned this practice. Since enamel is demineralized in the early stages of tooth decay,the use of an explorer opens a cavity in the enamel where none existed previously. Instead, they argue that fluoride and oral hygiene should be used to remineralize the enamel and prevent it from decaying further. This debate still continues because sometimes decay can be difficult to diagnose without tactile verification. Additionally, radiographs and products designed to identify decay help the dental professional make a final diagnosis of tooth decay.
There are various types of explorers, though the most common one is the No. 23 explorer, which is also known as a "shepherd's hook". Other types include the 3CH (also known as "cowhorn" or "pigtail") and No. 17 explorers, which are useful for the interproximal areas between teeth.

End-tufted brush

2009-05-30T08:00:00.001-07:00

Set of end-tufted brushes.
An End-Tufted brush is a modified toothbrush used for cleaning along the gumline adjacent to the teeth. The bristles are usually shaped in a pointed arrow pattern to allow closer adaptation to the gums. An end-tufted brush is ideal for cleaning specific, difficult-to-reach areas, such as between crowns, bridgework and crowded teeth.

From Wikipedia, the free encyclopedia

Electrical Toothbrush

2009-05-23T04:48:00.000-07:00

Electric toothbrush
An electric toothbrush is a toothbrush that uses electric power to move the brush head, normally in an oscillating pattern, though electric toothbrushes are sometimes called 'rotary' toothbrushes

Dentist Chair

2009-05-23T04:45:00.000-07:00

A rinse and spit, plus a water and air hose so the dentist can rinse and dry the patient's mouth while working on it.

Dental syringe

2009-05-22T10:54:00.000-07:00

Dental syringe

A dental syringe is a syringe used by dentists for the injection of an anesthetic. It consists of a breech-loading syringe fitted with a sealed cartridge containing anesthetic solution.

The ancillary tool (generally part of a dental engine) used to supply either water or air to the oral cavity for the purpose of cleaning debris away from the area the dentist is working on, is also referred to as a dental syringe. A 3-way syringe has separate internal channels supplying air, water or a mist of air and water, created by combining the pressurized air with the waterflow. The syringe tip can be separated from the main body and replaced when necessary.

Dental sealant

2009-05-20T23:31:00.001-07:00

Dental sealants are a dental treatment consisting of applying a plastic material to one or more teeth, for the intended purpose of preventing dental caries (cavities) or other forms of tooth decay.

Dental Laser : Dental Equipment

2009-05-19T11:44:00.000-07:00

From Wikipedia, the free encyclopedia

A dental laser is a type of laser designed specifically for use in oral surgery or dentistry.

In the United States, the use of lasers on the gums was first approved by the Food and Drug Administration in the early 1990s, and use on hard tissue like teeth or the bone of the mandible gained approval in 1996.[1]

Several variants of dental laser are in use, with the most common being diode lasers, carbon dioxide lasers, and yttrium aluminium garnet laser. Different lasers use different wavelengths and these mean they are better suited for different applications. For example, diode lasers in the 810–900 nm range are well absorbed by red coloured tissues such as the gingivae increasingly being used in place of electrosurgery and standard surgery for soft tissue applications such as tissue contouring and gingivectomy

Use of the dental laser remains limited, with cost and effectiveness being the primary barriers. The cost of a dental laser ranges from $8,000 to $50,000, where a pneumatic dental drill costs between $200 and $500. The lasers are also incapable of performing some routine dental operations.[2]

Dental lasers are not without their benefits, though, as the use of a laser can decrease morbidity after surgery, and reduces the need for anesthetics. Because of the cauterisation of tissue there will be little bleeding following soft tissue procedures, and some of the risks of alternative electrosurgery procedures are avoided.

Dental Key : Dental Equipment

2009-05-19T11:38:00.000-07:00

Dental key
From Wikipedia, the free encyclopedia

An unusual dental key with an ingenious handle mechanism. Pressure on the metal lever over the handle causes the clasp to rotate the hinged claw against the bolster. This allows the clasp to secure the root of the tooth without needing to rotate the tooth key. The handle is elevated by a steel spring which keeps the clasp extended in the resting position. The handle is made from rosewood and has an ivory inset on one side for orientation. Unsigned but high build quality and an extremely rare dental instrument, of French origin.
llustration demonstrating the use of the dental key for extracting teeth.
The dental key is an instrument that was used in dentistry to extract diseased teeth. Before the era of antibiotics, dental extraction was often the method of choice to treat dental infections, and extraction instruments date back several centuries. The dental key, (also known as Clef de Garengeot, Fothergill-Key, English-Key, Dimppel Extractor or Tooth Key) dates back to the 1700s and remained popular into the 20th century when they were replaced by the more modern forceps. Modeled after a door key, the dental key was used by first inserting the instrument horizontally into the mouth, then its "claw" would be tightened over a tooth. The instrument was rotated to loosen the tooth. This often resulted in the tooth breaking, causing jaw fractures and soft tissue damage.
The design of the dental key evolved over the years. The original design featured a straight shaft, which caused it to exert pressure on the tooth next to the one being extracted. This led to a newer design in 1765 by F.J. Leber where the shaft was slightly bent. Newer designs, such as those manufactured by medical instrument maker Charriere featured interchangeable claws. By the end of the 19th century, the introduction of forceps rendered the tooth key mostly obsolete. However, a modern version of the dental key, the Dimppel Extractor, briefly revitalized its use later in the 20th century.

Dental Floss : Dental Equipment

2009-05-19T11:36:00.000-07:00

Dental floss is either a bundle of thin nylon filaments or a plastic (teflon or polyethylene) ribbon used to remove food and dental plaque from teeth. The floss is gently inserted between the teeth and scraped along the teeth sides, especially close to the gums. Dental floss may be flavored or unflavored, and waxed or unwaxed.

Dental engine/machine

2009-05-16T00:15:00.001-07:00

From Wikipedia, the free encyclopedia

A dental engine is a large chair-side appliance (possibly including the chair itself) found in a dentist's office. At minimum, a dental engine serves as a source of mechanical or pneumatic power for one or more handpieces; typically, it will also include a small faucet and a spit-sink, which the patient can use for rinsing, as well as one or more suction hoses, a compressed air/irrigation water nozzle, for blowing and/or washing debris clear of the work area in the patient's mouth, and possibly an ultrasonic cleaning appliance, as well as a small table to hold the instrument tray, and possibly a worklight and/or a computer monitor.

Dental Drill Dental Equipment

2009-05-16T00:09:00.000-07:00

From Wikipedia, the free encyclopedia

A high-speed dental handpiece.A dental drill (or dentist's drill) is a small, high-speed drill used in dentistry to remove decayed tooth material prior to the insertion of a dental filling. Dental drills are used in the treatment of dental caries. The term "dental drill" is considered the more colloquial form of the term "dental handpiece," although it can also be construed as to include the power source for one or more handpieces, a "dental engine." "Handpiece" and "engine" are more generic and euphemistic terms for generic dental tools.

Modern dental drills can rotate at up to 500,000 rpm,[citation needed] and generally use hard metal alloy bits (actually small rotary files) known as 'burs'. Dental burs come in a great variety of shapes designed for specific applications. They are often made of steel with a tungsten carbide coating, or of tungsten carbide entirely. The bur may also have a diamond coating.

Dental drills, which have a distinctive, shrill sound, are often a prominent factor in many people's fear of dentistry (dentophobia).

Dental dam

2009-05-13T04:58:00.000-07:00

From Wikipedia, the free encyclopedia

Dental dams or rubber dams are rectangular sheets of latex used in dentistry, specifically endodontic therapy. They are also used during sexual activities as a safe sex technique[1].
In dentistry

Dental dam in patient's mouth.A dental dam, also known in Europe as a "Kofferdam" (from German), is used mainly in endodontic treatment and when putting fillings into teeth. They are thin squares of latex rubber. For those with latex allergy, they are also available in silicone.

The main function is to isolate the tooth being treated from its environment, in particular from the bacteria in the oral cavity. The rubber dam is held over individual teeth or groups of teeth by appropriate rubber dam clamps or threads (ligatures) along the edge of the gum. The tooth crown stands out from the rubber dam through individual holes made by a hole punch. This permits a clean and dry operative field, retracts the lips and cheeks, and enables treatment of the appropriate tooth without contamination from blood or saliva. Another function of rubber dam is to protect the patient's airway from any materials which may fall down there during treatment.

Routine use of dental dams is not always appropriate because of some difficulties: for instance communication with the patient is significantly reduced and the patient may feel restricted. However for endodontic procedures it is considered mandatory. For adhesive dentistry procedures involving bonding dental composite it is to be encouraged as the operative field must avoid moisture contamination in order to get maximum bond strength from restorative material to tooth substance. Glass ionomer cement is affected by moisture during its setting reaction and thus a rubber dam is considered advisable during placement

Dental braces ( orthodontic braces) : Dental Equipment Catagory

2009-05-12T07:48:00.000-07:00

Teeth move through the use of force. The force applied by the archwire pushes the tooth in a particular direction and a stress is created within the periodontal ligament. The modification of the periodontal blood supply[2] determines a biological response which leads to bone remodeling, where bone is created on one side by osteoblast cells and resorbed on the other side by osteoclasts.Two different kinds of bone resorption are possible. Direct resorption, starting from the lining cells of the alveolar bone, and indirect or retrograde resorption, where osteoclasts start their activity in the neighbour bone marrow. Indirect resorption takes place when the periodontal ligament has become(necrosis or hyalinization), for an excessive amount and duration of compressive stress. In this case the quantity of bone resorbed is larger than the quantity of newly formed bone (negative balance). Bone resorption only occurs in the compressed periodontal ligament. Another important phenomenon associated with tooth movement is bone deposition. Bone deposition occurs in the distracted periodontal ligament. Without bone deposition, the tooth will loosen and voids will occur distal to the direction of tooth movement.A tooth will usually move about a millimeter per month during orthodontic movement, but there is high individual variability. Orthodontic mechanics canvary in efficiency, which partly explains the wide range of response to orthodontic treatment.

CEREC dental restoration

2009-05-12T07:42:00.000-07:00

CEREC
From Wikipedia, the free encyclopedia
CEREC is a dental restoration product that allows a dental practitioner to produce an indirect ceramic dental restoration using a variety of computer assisted technologies, including 3D photography and CAD/CAM. With CEREC, teeth can be restored in a single sitting with the patient, rather than the multiple sittings required with earlier techniques. Additionally, with the latest software and hardware updates, crowns, veneers, onlays and inlays can be prepared, using different types of ceramic material.Cerec
Cerec is the preferred technology for dentists in the United States for the fabrication of all-ceramic dental restorations in a single treatment appointment. Cerec can create permanent, all ceramic crowns, onlays, inlays, and veneers. All in a single appointment. Cerec can rapidly restore any tooth that is decayed, weakened, or broken, to its natural strength, color, and beauty. The entire process takes about an hour.

The Cerec Procedure
The Cerec restoration procedure begins with the removal of all decay and weakened tooth tissue. The tooth is then coated with a non-toxic, tasteless powder. An optical 3D image is taken of the tooth with a small digital camera. The restoration will then appear in 3D on the computer screen. The restoration will then be created and designed by the dentist on the screen using the 3D image of the tooth. Once this is completed, the Cerec machine will begin to mill a ceramic block to reproduce the design. Once the milling has been completed, the restoration is polished and the dentist places the restoration to fit precisely. All of this is done in about 1 hour.

Articulator (Dental Equipment)

2009-05-10T02:23:00.000-07:00

This article is about a dental instrument. For articulators in linguistics, see Manner of articulation.
An Articulator is a mechanical device used in dentistry to which casts of the maxillary (upper) and mandibular (lower) teeth are fixed and reproduces recorded positions of the mandible in relation to the maxilla. An articulator assists in the fabrication of removable prosthodontic appliances (dentures), fixed prosthodontic restorations (crowns, bridges, inlays and onlays)and orthodontic appliances.From Wikipedia, the free encyclopedia

Apex locator (Dental Equipment)

2009-05-10T02:16:00.000-07:00

An apex locator is an electronic device used in endodontics to determine the length of the root canal space. The electronic principle is relatively simple and is based on electrical resistance; when a circuit is complete (tissue is contacted by the tip of the file), resistance decreases markedly and current suddenly begins to flow. According to the device, this event is signaled by a beep, a buzz, a flashing light, digital readouts, or a pointer on a dial. The original electronic apex locators operated on the direct current principle. A problem with these devices was that conductive fluids such as hemorrhage, exudate, or irrigant in the canal would permit current flow and therefore a false reading. Newer devices are impedance-based, using alternating current of two frequencies;these measure and compare two electrical impedances that change as the file moves apically. The benefit is that these devices are much less affected by fluid conductive media in the canal. The impedancetype apex locators have been demonstrated to be 80 to 95% accurate in identifying the apical foramen. Therefore after obtaining a reading, 1 to 2 mm is subtracted as the corrected working length. Although there are some variations with newer devices, most operate similarly. One electrode is attached to the patient (commonly a lip clip); the other electrode is clipped to the file. The patient therefore forms part of the circuit. When current flows, the operator is notified by one of the aforementioned signals. After the length adjustment is made, a confirmatory radiograph is made (angled when indicated) with an appropriate size file at this length.*From Wikipedia, the free encyclopedia

Amosan

2009-05-10T02:12:00.000-07:00

Amosan

Amosan is an oral wound cleanser manufactured in Belgium and sold under the Oral-B brand, belonging to Procter & Gamble after its recent acquisition of Gillette (2005). It is used to aid in the prevention of as well as speed the recovery from canker sores, denture irritation, orthodontic irritation, and oral injuries or after dental procedures. It is distributed in a powdered form requiring reconstitution with warm water, after which it is used as a mouthrinse. It is customarily packaged in 1.2 g envelopes and sold in boxes of 20 packets each.
A recent double-blind crossover study has suggested that hydrogen peroxide, which is released during the use of this product, may prevent or retard the colonization and multiplication of anaerobic bacteria, such as those which are known to inhabit oral wounds.
A very similar if not identical product, also manufactured under the Oral-B brand name, called Bocasan, used to be distributed in the UK, but appears to have been discontinued some time after 2003.From Wikipedia, the free encyclopedia

Akers' clasp (Dental Equipment)

2009-05-10T02:03:00.000-07:00

Akers' clasp
An Akers' clasp is the classic direct retainer for removable partial dentures. Named after its inventor, Polk E. Akers, this suprabulge clasp consists of a rest, a guide plate, a retentive arm and a reciprocal arm. Akers' clasps, as a rule, face away from an edentulous area. Should they face the edentulous area, they are termed reverse Akers' clasps.
Conventional clasp dentures, cause resisting force when they are inserted, leading to shorter life of the abutment tooth. Sectional dentures that do not produce hazardous lateral force and can exert adequate retaining force by making use of the abutment tooth�es undercuts, have also been used�P. However the latter type of denture requires complex operation and, for this reason, has not been frequently used clinically. Under these circumstances, we recently devised a new retainer for removable dentures which makes use of the concept of sectional denture and employs a magnetic attachment. When this retainer was used clinically, the outcome was good.
From Wikipedia, the free encyclopedia

Central Venous Catheter Equipment

2009-05-06T07:23:00.001-07:00

Central venous catheter

Central line equipment
In medicine, a central venous catheter (CVC or central venous line or central venous access catheter) is a catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian vein) or groin (femoral vein). It is used to administer medication or fluids, obtain blood tests (specifically the "mixed venous oxygen saturation"), and directly obtain cardiovascular measurements such as the central venous pressure. Certain medications, such as inotropes and amiodarone, are preferably given through a central line.[

Balloon Catheter

2009-05-05T16:20:00.001-07:00

From Wikipedia, the free encyclopedia
Diagram of a balloon catheter.A balloon catheter is a type of "soft" catheter with an inflatable "balloon" at its tip which is used during a catheterization procedure to enlarge a narrow opening or passage within the body. The deflated balloon catheter is positioned, then inflated to perform the necessary procedure, and deflated again in order to be removed.
angioplasty or balloon septostomy, via cardiac catheterization (heart cath)
tuboplasty via uterine catheterization
Angioplasty balloon catheters
Balloon catheters used in angioplasty are either of Over-the-Wire(OTW) or Rapid Exchange(Rx) design. When a balloon catheter is used to compress plaque within a clogged coronary artery it is referred to as a plain old balloon angioplasty or POBA. Balloon catheters are also utilized in the deployment of stents during angioplasty. Balloon catheters are supplied to the cath lab with a stent premounted on the balloon. When the cardiologist inflates the balloon it expands the stent. When the cardiologist subsequently deflates the balloon the stent stays behind in the artery and the balloon catheter can be removed. Stents that are used in conjunction with a balloon catheter are known as balloon expandable stents.

Arterial catheter

2009-05-05T16:16:00.000-07:00

Arterial catheter
From Wikipedia, the free encyclopedia
An arterial line, or art-line, is a thin catheter inserted into an artery. It is most commonly used in intensive care medicine to monitor the blood pressure real-time (rather than by intermittent measurement), and to obtain samples for arterial blood gas measurements. It is not generally used to administer medication.
An arterial line is usually inserted in the wrist (radial artery); but can also be inserted into the elbow (brachial artery), groin (femoral artery), foot (pedal artery), or neck (carotid artery).
Insertion is often painful; however an anesthetic such as Lidocaine can be used to make the inserion more tolerable, but this can make insertion more difficult.

a catheter

2009-05-02T03:32:00.000-07:00

In medicine a catheter is a tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage, injection of fluids or access by surgical instruments. The process of inserting a catheter is catheterization. In most uses a catheter is a thin, flexible tube ("soft" catheter); in some uses, it is a larger, solid tube. ("hard" catheter)

The ancient Egyptians created catheters from reeds. "Katheter" originally referred to an instrument that was inserted such as a plug. The word "katheter" in turn came from "kathiemai" meaning "to sound" with a probe. The ancient Greeks inserted a hollow metal tube through the urethra into the bladder to empty it and the tube came to be known as a "katheter".

Electronic fluency devices

2009-05-02T03:14:00.000-07:00

Electronic fluency devices (also known as assistive devices, electronic aids, altered auditory feedback devices and altered feedback devices) are electronic devices intended to improve the fluency of persons who stutter. Most electronic fluency devices change the sound of the user's voice in his or her ear.

Anti-stuttering devices :Edinburgh Masker

2009-05-02T03:08:00.000-07:00

The Edinburgh Masker was a device used to control stuttering. It consisted of a microphone strapped across the throat near the larynx, the microphone plugged into a small box worn on the belt or in the pocket, and then earphones were plugged into the device.[1]

The masker is an electronic aid to alleviating stammering. It generates a noise, random noise or white noise, which prevents the wearer from hearing the sound of his or her own voice. It is no longer made, and so is now only available second-hand. In contrast, an AAF (Altered Auditory Feedback) device may sometimes have the option to produce masking sound.[2]

The Edinburgh Masker (U.S. Pat. No. 3,566,858 and U.S. Pat. No. 3,773,032) electronically remove the sounds added by nasal and oral cavities, providing only a sound similar to laryngeal vibration. This device reduces or eliminates stuttering in about 90% of users[

Delayed Auditory Feedback(Anti-stuttering devices)

2009-05-02T03:02:00.000-07:00

Delayed auditory feedback (DAF), is a device that enables a user of the device to speak into a microphone and then hears his or her voice in headphones a fraction of a second later. Some DAF devices are hardware; DAF computer software is also available.
The DAF machine is a proven technique to aid with stuttering. When the DAF delay is short, (25 to 75 milliseconds, or about a twentieth of a second), this immediately reduces stuttering about 70%. A longer delay (75 to 200 milliseconds, or about tenth of a second) produces a greater increase in fluency, however it also causes significant reductions in rate of speech and stretched vowels. The longer delay is generally used in therapy settings. Some DAF devices have been found to produce carryover fluency, that is, to train a stutterer to no longer need the device.
DAF usage (with a 175 millisecond delay) has been proven to induce mental stress.[1]
The DAF machine has also been claimed to be helpful with cluttering. The DAF machine reduces the rate of a clutterer, and thus reduces the cluttering disfluencies To use Delayed Auditory Feedback for immediate improvement, the delay can be set between 25 and 70 milliseconds to reduce stuttering about 70% at a normal speaking rate, without training, mental effort, or abnormal–sounding speech.
In one study nine adult stutterers used DAF devices thirty minutes per day, for three months. The thirty minutes consisted of ten minutes reading aloud, a ten–minute conversation with a family member, and a ten–minute telephone call. The subjects received no speech therapy.The devices were used with binaural (two ears) headsets. The subjects were allowed to set the delay where they wanted. Most selected delays around 100 milliseconds.Before three months of DAF use, the subjects stuttered on 37% of words, on average. When they put on the DAF device their stuttering dropped to 10%. Meaning, the device improved their speech about 70%.Three months later the subjects stuttered on 17% of words, when not using the DAF device. When wearing the DAF device they stuttered on 13% of words.This shows that, when not wearing the devices, the subjects' stuttering diminished from 37% of words to 17% of words, or a 55% improvement. This is "carryover fluency." Put another way, the devices trained the users to need the devices less.Click here to learn more about using FluencyCoach for independent at–home treatment of stuttering.Two other studies combined speech therapy with a DAF device. One study was of adults, the other of children. Both studies found that combining DAF and stuttering therapy trained the subjects to speak fluently (less than 2% stuttering) and no longer need the devices.In conjunction with speech therapy, notably as used in the well documented Perkin´s Fluency Shaping Therapy, Delayed Auditory Feedback is commonly used to support the fluency shaping target of slow speech with stretched vowels. For this purpose the delay is usually set at 200 milliseconds and then reduced to shorter delays (as short as 75 milliseconds) over the course of the therapy program. FluencyCoach in conjunction with Fluency Shaping Therapy.Frequency–shifted Auditory Feedback (FAF) shifts the pitch of your voice in your earphones. A FAF upshift makes you hear your voice sounding like Mickey Mouse. A FAF downshift makes you hear your voice sounding like a gravel–voiced radio announcer.A quarter–octave pitch shift reduces stuttering about 35%. A half–octave pitch shift reduces stuttering about 65–70%. A full–octave pitch shift reduces stuttering about 70-75%.
Shifting pitch up or down is equally effective in short–term studies. But there may be long–term differences between up– and downshifts. FAF causes non–stutterers to speak at a higher or lower vocal pitch, depending on whether the device is set for an up or down frequency shift. This higher or lower pitch vocal pitch results from changing vocal fold tension. In other words, FAF induces changes in vocal fold tension in non–stutterers.Vocal fold relaxation is a primary target of fluency shaping therapy. A study found that a half–octave FAF downshift didn't cause a change in vocal pitch in stutterers. But, anecdotally, speech clinics have reported that FAF devices adjusted to one octave downshift, using newer headphones with better bass range, induce vocal fold relaxation in stutterers. A one–octave downshift has also been anecdotally reported to induce a slower speaking rate with stretched vowels. If these reports are true, then FAF downshifts appear to immediately induce, with little or no training or effort, the target behaviors that take weeks of fluency shaping therapy. And, if these anecdotal reports are true, then an FAF downshift should induce long–term carryover fluency.

Pin Index Safety System

2009-05-01T10:45:00.001-07:00

The Pin Index Safety System, or PISS, is a safety system that uses geometric features on the yoke to ensure that pneumatic connections between a gas cylinder and a machine that uses pressurized gases are not connected to the wrong gas yoke. This system can be seen on an anesthesia machine.

Each gas cylinder has a pin configuration to fit its respective gas yoke. Refer to the figure on the right; units are in millimeters.

O2: 2-5
N2O: 3-5
Air: 1-5
CO2: 1-6
Heliox: 2-4

[edit] Standards
International (ISO) and European (CEN) Standard
EN ISO 407 : Small medical gas cylinders - Pin-index yoke-type valve connections
PIN Index Entonox=7

Odom's indicator and Soda Lime (anaesthetic Equipment)

2009-05-01T10:39:00.000-07:00

Odom's indicator is a device used for locating the epidural space in regional anaesthsia.[1] The device works on Dogliotti's principle[2] by finding an area of decreased resistance to injection. It was originally designed on the assumption that the pressure in the epidural space was negative. This device is no-longer popular and alternative methods (e.g. loss of resistance to saline, loss of resistance to air) are now used
Soda lime
Soda lime is a mixture of chemicals, used in granular form in closed breathing environments, such as general anaesthesia, submarines, rebreathers and recompression chambers, to remove carbon dioxide from breathing gases to prevent CO2 retention and carbon dioxide poisoning.[1][2]
It is made by treating slaked lime with concentrated sodium hydroxide solution.

Compostion of soda limeGrace SODASORB is a granulated compound consisting primarily of hydrated lime (above 80% Ca(OH)2) blended with small amounts of sodium hydroxide (below 4% NaOH). SODASORB does not contain potassium hydroxide (KOH), which was removed in January 2000. SODASORB also contains water (12% to 19%, avg. 16% H2O) and a fractional content of an exhaustion indicator dye. Function of soda limeSoda lime is used in breathing systems to absorb expired CO2 during anaesthesia. It can be incorporated in a Mapleson C system or a circle system. The reaction:CO2 + 2NaOH → Na2CO3 + H2O + heatNa2CO3 + Ca(OH)2 → 2NaOH + CaCO3CO2 in solution reacts with sodium hydroxide to form the respective carbonates, which then react with calcium hydroxide to produce calcium carbonate, replenishing sodium hydroxide. Heat and water are produced during the reaction. Exhaustion of its activity is indicated by dyes; the most common one changes from pink to white.Size of granulesThe size of the soda lime granules is 4-8 mesh (i.e. will pass through a mesh of 4-8 strands per inch in each axis or 2.36–4.75 mm).Key learning points:-Exhaled gases are circled back to the canister, where CO2 absorption takes place and water and heat are produced. The warmed and humidified gas joins the fresh gas flow to be delivered to the patient.
-Compound A is a pentafluoroisoproprenyl fluoromethyl ether (an olefin). Fears over production of this have led to the drug’s data sheet in the USA prohibiting its use at low flows. This restriction does not apply in the UK.
-Carbon monoxide production has occurred when volatile agents containing the CHF2 moiety (enflurane/isoflurane/desflurane) are passed over soda lime that has become desiccated or dried out.

Laryngeal Mask Airway

2009-04-29T06:19:00.000-07:00

The laryngeal mask airway was invented in 1983 by British anaesthetist, Dr. Archie Brain.The Laryngeal Mask Airway is an alternative airway device used for anesthesia and airway support. It consists of an inflatable silicone mask and rubber connecting tube. It is inserted blindly into the pharynx, forming a low-pressure seal around the laryngeal inlet and permitting gentle positive pressure ventilation. All parts are latex-free.

Use
A laryngeal maskLaryngeal masks are used in anaesthesia and in emergency medicine for airway management. They consist of a tube with an inflatable cuff that is inserted into the pharynx. They cause less pain and coughing than an endotracheal tube, and are much easier to insert. However, a standard laryngeal mask airway does not protect the lungs from aspiration, making them unsuitable for patients at risk for this complication.

The device is useful in situations where a patient is trapped in a sitting position, suspected of trauma to the cervical spine (where tilting the head to maintain an open airway is contraindicated), or when intubation is unsuccessful. It is not inserted as far as an endotracheal tube (it sits tightly over the top of the larynx, and thus does not need to be inserted into the trachea), and supports both spontaneous and artificial ventilation. It is popular in day case surgery.

However, unlike an endotracheal tube, a laryngeal mask cannot protect the airway or lungs from aspiration of regurgitated material, and deep (subglottic) suctioning cannot be performed through the mask. Steps to improve the ability of the laryngeal mask airway (LMA) have included recent improvements such as channels for gastric suction (LMA Proseal, LMA Supreme), and modification to the LMA to allow it to guide endotracheal tubes through its respiratory gas tubing into the larynx, thus protecting the patient against aspiration of gastric contents with the balloon on the end of the endotracheal tube (LMA Fastrack, Cookgas Air-Q)
Guide to use
Laryngeal mask airways come in a variety of sizes ranging from large adult (LMA size 6) to infant (size 0). The LMA functions as a "periphayngeal sealer," in contrast to another category of supraglottic airways which are "base on tongue sealers," such as the Esophageal-Tracheal Combitube and the King Laryngeal tube (LT). A newer generation of the LMA actually utilizes BOTH airway sealing mechanisms (peripharyngeal sealing and base of tongue sealing), and they result in higher average seal pressures during controlled and assisted ventilation of the patient. These models are the LMA Proseal/LMA Supreme and the Cookgas Air-Q.

The cuff of the mask is deflated before insertion and lubricated. The patient is sedated or fully anaesthetized if conscious, and their neck is extended and their mouth opened widely. The apex of the mask, with its open end pointing downwards toward the tongue, is pushed backwards towards the uvula. It follows the natural bend of the oropharynx and comes to rest over the pyriform fossa. Once placed, the cuff around the mask is inflated with air to create a tight seal. Air entry is confirmed by listening for air entry into the lungs with a stethoscope, by presence of end tidal carbon dioxide and by monitoring the degree and pressure at which the air leaks around the mask in the oropharynx.

As with an endotracheal tube, the laryngeal mask airway may be used for procedures in surgical positions other than supine, although anesthetic practice in the United States has largely limited its use to the supine position. European Anesthesiologists report its common use in lateral position and even prone position cases
From Wikipedia, the free encyclopedia

IoC – View monitor Equipment (Anaesthetic Equipment)

2009-04-29T06:10:00.000-07:00

IoC – View monitor
The IoC - View monitor is a medical device designed by the company Morpheus Medical. The IoC - View has been engineered with cutting edge technology to provide the Index of Consciousness (IoC) to the anaesthesia professional.

Methods The principal parameter of the IoC - View is the symbolic dynamics method. The symbolic dynamics detect the complexity of the EEG which makes it a correlate to the depth of anaesthesia. The IoC - View also integrates the beta ratio during the superficial anaesthesia and the amount of suppression of the EEG (ESR, EEG Suppression Rate) in deep anaesthesia.

The IoC-view for monitoring the depth of anaesthesia.The Index of Consciousness is designed to measure the level of consciousness during general anaesthesia where the correct balancing of anaesthetics or fast recovery is a concern.

The IoC - View features a pocket-size for convenient portability and records the electroencephalogram (EEG) with 3 surface electrodes attached to the forehead of the patient.

Also this monitor of deep anaesthesia uses a continuous processed EEG parameter that correlates to the patient's level of hypnosis where decreasing IoC values correspond to gradually loss of consciousness and a deepening of the level of anaesthesia, where 40-60 indicates adequate anaesthesia.

The IoC is a scale ranging from 0-99, where 99 indicates an awake patient and 0 indicates a flat EEG.

The IoC - View uses the latest technology in electronics design and software ensuring safe and reliable performance. IoC - View is the first depth of anaesthesia monitor to use Bluetooth providing a true wireless solution to the anesthesiologist. All the data obtained with the IoC - View monitor could be sent to PDAs, multiparameter monitors or PCs where it could be monitored in real time and recorded at the same time.

Fresh Gas Flow Equipment (anaesthetic Equipment)

2009-04-29T06:08:00.000-07:00

Fresh gas flow refers to the mixture of medical gases and volatile anaesthetic agents which is produced by an anaesthetic machine. The flow rate and composition of the fresh gas flow is determined by the anaesthetist.
Typically the fresh gas flow emerges from the common gas outlet, a specific outlet on the anaesthetic machine to which the breathing attachment is then connected.
Some older forms of breathing attachment, such as the Magill attachment, require high fresh gas flows (e.g. 7 litres/min) to prevent the patient from rebreathing their own expired carbon dioxide. More modern systems, e.g. the circle breathing attachment, use soda lime to absorb carbon dioxide, so that expired gas becomes suitable to re-use. With a very efficient circle system, the fresh gas flow may be reduced to the patient's minimum oxygen requirements (e.g. 250ml/min), plus a little volatile.

Equipment Specifications for Complete Monitoring

2009-04-29T06:01:00.000-07:00

Equipment Specifications for Complete Monitoring
System for ICU (REVISED)
UNSPSC Code:
ECRI Code:
1 Description of Function
1.1 Critical patients need to be monitored continuously in ICU
at the bedside as well as at the central nursing station.
2 Operational Requirements
2.1 ICU should comprise of monitors at the bedside and with
central station.
2.2 Capability of storage of patient data and printing of patient
reports.
2.3 Demonstration of the equipment is a must.
3 Technical Specifications
3.1 Minimum 15 inches multi colored TFT display screen.
3.2 Separate CPU/Module rack.
3.3 Eight digital and waveforms/traces display
3.4 Combination of single, dual and multi parameter
modules.
3.5 Parameter modules freely exchangeable between all the
monitors.
3.6 Multi channel (up to 12 leads) ST segment analysis.
3.7 Facility to monitor and display - ECG, Respiration, NIBP,
SpO2, CO2 with capnography, Temp, Cardiac output
(optional), NMT (Optional), BIS/Entropy (optional), EEG
(optional)& IBP – 2 Nos.
3.8 Automatic arrhythmia detection & alarm for standard and
lethal arrhythmia.
3.9 EtCO2 -Main stream/ side stream. Display both inspired
and expired values, showing capnography.
3.10 NMT Module/monitor: For measurement and display of
TOF count, TOF %, ST, DBS, Tetanic and Trend for
continuous usage. Automatic measurement facility in
selected time interval. Automatic selection of
supramaximal current. Include standard accessories.
(Optional)
3.11 EEG Module with all accessories. (Optional)
3.12 Central station for bedside monitors with independently
controlled. 17" multi color TFT Monitor, complete with
Ethernet LAN cabling, alarm management, 72 hours
trending, bed to bed viewing of waveforms and remote
alarm management like silencing of alarms etc.
3.13 Should provide hemodynamic, oxygenation, Ventilation
calculation package.
3.14 Should have drug calculation package.
3.15 Trend of at least 48 hours.
3.16 200 nos. event recall/snapshot facility both manually and
automatically triggered by alarm.
3.17 Automatic Zoom In Facility in the monitor display.
3.18 The monitors should have monitor-to-monitor overview
facility and data transfer over the network.
3.19 Web browsing facility to review each networked monitors
data through hospital LAN via office PC in Hospital LAN
Network and/or through dial up facility from remote
location (OPTIONAL)
3.20 CRT Slave monitors- 21 inches in ICU - one per central
station
3.21 Communications with Information Management Systems:
A. To provide HL-7 compatible server for sending and
receiving information to and from the monitoring network
to and from Hospital Information System, Laboratory
information etc for integration of various information
(OPTIONAL)
B. To provide suitable facility for sending and receiving
DICOM Compatible Radiological Images like Ultrasound,
X-Ray etc to and from the monitoring network to and
from Hospital Information System, Radiology Information
System etc for integration of various information
(OPTIONAL).
3.22 Include Laser Printer and dual channel strip chart
recorder.
3.23 Specifications for Transport Monitor:
1.Portable and light weight preferably< 10 kg.
2.Modular with 12 inches multi color TFT Display.
3.Monitoring Parameters - ECG, Respiration, NIBP, SaO2
and temperature.
4.Digital and six waves/traces display.
5.Trends up to 24 hours.
6.60 minutes or more battery backup.
7.Convenient handle for carrying the same.
8. Able to fix with bed/ trolley.
4 System Configuration Accessories, spares and consumables
4.1 ECG/Resp: 5 Lead ECG Cable with clip- 2 sets per monitor
and 10 Lead ECG Cable with clip- 1 set per monitor.
4.2 NIBP: Adult cuff- 2nos. per monitor and two sizes of
pediatric cuffs- one per monitor (complete sets)
4.3 Reusable SPO2: Adult SPO2 sensor with cable- two nos.
per monitor and Pediatric SPO2 sensors- one no. per
monitor.
4.4 IBP: Include four nos. per monitor of reusable pressure
transducer with bracket, holder and 100 nos. disposable
domes per monitor.
4.5 Temperature: Rectal temperature probe- two per monitor
and skin temperature probe- one per monitor.
4.6 EtCO2 module with all accessories. In case of side stream
EtCO2-10 sets of sampling tubes for each module to be
included.
4.7 Cardiac Output: Should be by thermodilution method with
all accessories
4.8 EEG Modules- with all accessories. Should display at least
two channels. (Optional)
4.9 BIS/Entropy Module: Adult Sensors-200 numbers.
Spectral analysis modules by compressed spectral array.
(Optional)
4.10 Necessary cabling for networking the monitors on turnkey
basis.
4.11 Necessary mounting solution/ mounting on any pendant
for monitors
5 Environmental factors
5.1 The unit shall be capable of operating continuously in
ambient temperature of 10 –40 deg C and relative
humidity of 15-90%
5.2 The unit shall be capable of being stored continuously in
ambient temperature of 0 –50 deg C and relative humidity
of 15-90%
5.3 Shall meet IEC-60601-1-2: 2001(Or Equivalent BIS)
General Requirements of Safety for Electromagnetic
Compatibility or should comply with 89/366/EEC; EMCdirective.
5.4 The supplier shall provide environment friendly furnitures
and wall fittings for the entire system. Cabling has to be
provided by the supplier.
6 Power Supply
6.1 Power input to be 220-240VAC, 50Hz fitted with Indian
plug
6.2 Voltage corrector/stabilizer of appropriate ratings meeting
ISI Specifications. (Input 160-260 V and output 220-240 V
and 50 Hz)
6.3 Suitable UPS with maintenance free batteries for minimum
one-hour back up should be supplied with the system.
7 Standards, Safety and Training
7.1 Should be FDA, CE, UL or BIS approved product
7.2 Shall meet the safety requirements as per IEC 60601-2-
27:1994—Medical electrical equipment—Part 2: Particular
requirements for the safety of electrocardiographic
monitoring equipment.
7.3 Manufacturer/Supplier should have ISO certification for
quality standards.
7.4 Should have local service facility .The service provider
should have the necessary equipments recommended by
the manufacturer to carry out preventive maintenance test
as per guidelines provided in the service/maintenance
manual.
7.5 Back to back warranty to be taken by the supplier from the
principal to supply spares for a minimum period 10 years.
7.6 Comprehensive warranty for 5 years and provision of AMC
for next 5 years.
8 Documentation
8.1 User Manual in English
8.2 Service manual in English
8.3 Must submit user list and performance report within last 5
years from major hospitals.
8.4 Compliance Report to be submitted in a tabulated and point
wise manner clearly mentioning the page/Para number of
original catalogue/data sheet. Any point, if not
substantiated with authenticated catalogue/manual, will not
be considered.
8.5 List of Equipments available for providing calibration and
routine Preventive Maintenance Support as per
manufacturer documentation in service/technical manual.
8.6 List of important spare parts and accessories with their part
number and costing.
8.7 Log book with instruction for daily, weekly, monthly and
quarterly maintenance checklist.
The job description of the hospital technician and company
service engineer should be clearly spelt out

Entropy Monitoring Equipment

2009-04-29T05:55:00.000-07:00

Entropy monitoring is a relatively new method of assessing anaesthetic depth. It was commercially developed by Datex-Ohmeda, now part of GE Healthcare.

It relies on a method of assessing the degree of irregularity in electroencephalogram (EEG) signals. The founding principle behind this theory is that the irregularity within an EEG signal decreases with increasing brain levels of anaesthetic drugs. If we relate the irregularity to the entropy within the signal, then an entropy scale can be assigned.

The signal is captured via a forehead mounted sensor, in a similar way employed by bispectral index (BIS).

Entropy monitors produce two numbers (RE - Response Entropy, SE- State Entropy) that are related to frequency bandpass used. Response Entropy incorporates higher frequency components that include that of electromyogram activity. The reason for using higher frequency bandpass in response entropy is to allow faster response from the monitor in relation to clinical state.

Published studies show that entropy scores do relate to clinical levels of anaesthetic depth. Most anaesthetic drugs are detectable by entropy monitoring, a notable exception being nitrous oxide, in common with BIS monitoring. Future studies may show reduced levels of intraoperative awareness when using this type of monitoring. Future studies may also look into possibilities of influence on outcome when using depth of anaesthesia monitoring.