Surgical And Non-Surgical Drug Delivery Methods In Miniature Swine
|
|
- Jayson Caldwell
- 5 years ago
- Views:
Transcription
1 Introduction Internationally, miniature swine have become a definitive translational research and preclinical pharmacology model. 1-7 Many if not most of the scientific protocols require the administration of test substances or therapeutic agents and the collection of samples of bodily fluids for assays. It is preferable to administer test substances via non-surgical routes however this is not always possible due to both technical and pharmacological factors. Methods of delivery of drugs and collection of test samples for assays have been described in detail. 1, 4-6 This manuscript provides an overview of those methodologies. Non-Surgical Methodologies Oral Administration 1 Swine can be induced to eat many test substances provided they do not have a noxious taste or odor. Capsules, pills and powders can be mixed with palatable substances and fed in small amounts if they will not consume it in their primary food ration. The primary food substances utilized by the author are dog and/ or cat food meatballs, chocolate or strawberry syrup and fruit jelly. (Figure 1) Figure 1. Oral Medication Delivery Methods. Liquid substances can be mixed with Gatorade or sweet soda drinks if they will not consume it in either their food or water. Many times mixing their regular diet with water and the test substance will make it palatable. As a last resort both liquid and powder based substances can be administered via stomach tube. The distance from the mouth to the last rib will provide a guideline on the length of tube that is required to reach the stomach. Most pigs can be trained to comfortable restraint in a humane restraint sling. Silicone stomach tubes with both end and side holes are commercially available from veterinary supply houses. In general small horse or large dog tubes ½ inch or 3/8 inches in diameter are suitable for most miniature swine. The tube should always be lubricated with surgical lubricant prior to passage. Pigs are capable of biting through a tube with their teeth and use of an atraumatic mouth gag is recommended. However with training many pigs will learn to accept stomach tubing followed by providing them with a food reward. Surgical methodologies of implanting gastric tubes and fistulas are discussed below. Injectable Administration 1, 5 Intramuscular injections (IM) are painful in swine because of their dense muscle mass. They should be avoided if another route of injection such as subcutaneous (SC) is acceptable. Repeated injections, especially im, will create an avoidance reaction in swine when approached by personnel. SC injections in the side of the neck are the least objectionable sites for swine. They can either be restrained in slings or a butterfly catheter technique can be utilized. For that technique manual restraint is not necessary. First a butterfly catheter is placed in the neck and the pig allowed to accommodate to the slight pain from the placement of the catheter. The end of the catheter is picked up, attached to a syringe and the injection is administered. (Figure 2)
2 Figure 2. Injection Sites IV injections are typically performed with indwelling catheters. If single IV injections need to be made without a catheter then sedation of the pig would be required and typically the injection is made into a marginal ear vein. The cephalic vein on the cranial surface of the radius can also be utilized for a one time IV injection. Indwelling catheters may be placed using light sedation for short term use of <3days. The short term catheters are usually placed in a marginal ear vein or the precava. It is possible with an Intracath (Intracath Central Venous Catheter, BD Worldwide, g, 8-24 in long) to pass a catheter from the auricular vein into the external jugular catheter. This method provides the most security for a short term catheter. Shorter catheters of various types (14-24 g, in long) can be utilized as well but the shorter catheters make it more likely that the catheter can be displaced from the vein by the pig. (Figure 3) If the auricular veins are used then a gauze roll is placed inside the fold of the ear and taped in place with the catheter. If the precava is used then the catheter entry site is protected with gauze and a iodine impregnated sticky drape (3M Ioban, St. Paul, MN). The surgical drape will stick to the skin after it is shaved and cleaned with alcohol. The alcohol must be dried off the skin prior to the application. Figure 3. Intracath Insertion Into the Auricular Vein. It can be further secured by circumferential taping around the neck. All short term catheters need to be filled with a premeasured amount of heparin or catheter lock solution. (Figure 4) Figure 4. Intravnous Sites. Surgical Methodologies 1, 5-7 Chronic Intravenous (iv) Implantations If catheters are expected to be functional for >3 days then they should be
3 surgically implanted using methodologies to ensure security of the implant and to protect against sepsis. The catheters can be externalized though an exit on the dorsum of the pig or implanted subcutaneously. Any blood vessel in the periphery or abdomen can be catheterized. For example, catheterization of the portal vein may be indicated in some pharmaceutical metabolism studies. The most common peripheral veins that are catheterized are the external and internal jugular, the cephalic as it crosses the neck (subclavian area) and the portal vein. The femoral and ventral abdominal vessels provide less security and are utilized only if there is specific interest in the areas which they drain. Externalized catheters are used for short tern <14 days of access, especially if frequent vascular access is required. It is difficult to maintain sterility beyond that time. Silicone is the most common material used for these catheters and the tips of the catheter should be rounded not square or angular to prevent thrombus formation at the tip. IV catheters should be secured with circumferential sutures at the site of entry and exit of the catheter from the vessel. A loop of the catheter should be left in the internal incision to allow for movement to prevent dislodgement of the catheter. to move in and out of the skin at that site it is highly likely that the catheter tract will become infected in a few days. (Figure 5) Vascular access ports (VAP) should be utilized if the catheterization is expected to be patent for longer periods of time. 1, 7 (Figure 6) In the author s experience this may be as long as a year. These ports are implanted subcutaneously with the IV catheter attached. Ports have to be accessed with Huber point needles in order to prevent coring of the silicone injection port. It is advisable to have suture retention beads attached to the catheter to increase security at the site of insertion into the vessel. The VAP must be implanted in a subcutaneous pocket distant from the skin incision to prevent erosion. Typically the sites of VAP implantation are along the dorsum of the pig behind the ear or over the rib cage. There are many different designs of ports and readers are encouraged to read the reference material for in depth descriptions of the implantation procedure prior to performing the procedure in a pig. 1, 7 Figure 6. Vascular Access Port. Figure 5. Exit Site of an Indwelling IV Catheter. At the exit site though the skin the catheter should have a cuff in the subcutaneous region to allow ingrowth of fibrous connective tissue, which acts as a seal on the catheter exit site. If the catheter is allowed Gastrointestinal (GI) Access 1, 6 Various areas of the GI tract may need to be accessed for both administration of test substances and for collection of samples. Endoscopic techniques may
4 be used for some of these procedures if the equipment is available and access is limited to a few times under anesthesia. However, it is common for there to be a requirement for access of the various areas of the GI tract to determine the best site of absorption of a drug. Areas which are frequently catheterized are the stomach, duodenum, jejunum, ileum and colon. Specialized catheters have been designed for implantation into these areas of the GI tract. (Figure 7) These catheters are attached to a VAP device. The catheter that is inserted into the intestine must have a closed tip and have small slits cut into the distal sides of the catheter. This prevents the catheter from being plugged by ingesta; however, these catheters can only be utilized for infusion of substances not withdrawal of samples. The VAP body is implanted subcutaneously into a pocket along the dorsal flank of the pig. At the site of insertion into the intestine a fixed suture bead in implanted inside a stab incision into the intestine and closed with a purse string suture. A silicone disc is sutured to the outer serosa to provide for a secure attachment to the intestine which prevents dislodgement during peristalsis. These catheters have remained patent for a year in the experience of the author. should also be sutured to the interior of the abdominal wall and in the subcutaneous tissue at the exit site. The exit site should be in the dependent portion of the intestine in the lateral flank. As the pig grows it is useful to have a device which can be loosened to accommodate the increase width of the abdominal muscles. This growth is minimized in the ventral section of the abdomen. In the authors experience these fistulas may be maintained for as long as a year. 6 Figure 8. Gastric Fistula Cannulas. Discussion Figure 7. Intestinal Access Catheter Implanted Into Duodenum. If sampling of intestinal contents is required then a fistula must be created using cannulas specially designed for the study. (Figure 8) These cannulas should be secured inside the GI tract with a purse string suture leaving a retention disc inside the structure. They This manuscript is meant to provide an overview of the possible methods of delivery of test substanes, such as pharmaceuticals, and the collection of samples for these studies. Surgeons should read the in depth descriptions of the surgical procedures and the perioperative care methods in the selected references prior to proceeding. In all of the catheterization methods the IV catheters should be filled with a pre-measured amount of heparin of taurolidine citrate solution to prevent clotting. Asepsis should be utilized for every access of these sites by cleaning with an antiseptic solution and wearing of sterile gloves. The same degree of asepsis should be utilized for the GI catheters and fistula devices.
5 Miniature pigs would be preferred over farm pigs for these types of studies because of their slower growth rate and smaller size which would require a lesser amount of test substance. They can also be selected at a reasonable size at sexual maturity in order to study the effects of the drug on a sexually mature animal. Farm pigs would not be manageable at sexual maturity for such studies. There is also a large body of literature available to study the effects of drugs on the various miniature breeds Swindle MM, Nolan T, Jacobson A, Wolf P, Dalton MJ, Smith AC: Vascular access port (VAP) usage in large animal species. Contemporary Topics in Lab Anim Sci, 44(3): 7-17, Selected References 1. Swindle MM: Swine in the Laboratory: Surgery, Anesthesia, Imaging and Experimental Techniques, 2nd Edition, Boca Raton: CRC Press (Taylor and Francis), Swindle MM, Makin A, Herron AJ, Clubb Jr FJ, Frazier KS: Swine as models in biomedical research and toxicology testing. Vet Path 49(2): , Helke KL, Swindle MM: Animal models of toxicology testing: the role of pigs, Expert Opinion Drug Metabolism & Toxicology 9(2): 1-13, Swindle MM, Smith AC, Helke KE: Recommendations for medical device implantation in swine, Israel J Vet Med, 68(1): 3-11, Swindle MM, Smith AC: Best practices for experimental surgery in swine, J Invest Surg 26(2): 63-71, Swindle MM, Smith AC, Goodrich JG: Chronic cannulation and fistulation pro cedures in swine: a review and recommendations. J Invest Surg, 11(1):7-20, Swindle MM, Nolan T, Jacobson A, Wolf
ompanionport Speciality Medical Devices For The Veterinary Community Surgical Suggestions
Speciality Medical Devices For The Veterinary Community suture holes Place the CompanionPort in the subcutaneous port pocket off to one side so that the septum of the port will not lie directly beneath
More informationAppendix E: Overview of Vascular
Appendix E: Overview of Vascular 56 Peripheral Short Catheter, less than 3 inches (7.5 cm) in length; over-the-needle catheter is most common. Inserted by percutaneous venipuncture, generally into a hand
More informationPlacing PEG and Jejunostomy Tubes in Dogs and Cats
Placing PEG and Jejunostomy Tubes in Dogs and Cats I. Gastrostomy tube A. Percutaneous Endoscopic Gastrostomy (PEG) tube placement Supplies for PEG tube placement: Supplies and equipment for general anesthesia
More informationMary Lou Garey MSN EMT-P MedFlight of Ohio
Mary Lou Garey MSN EMT-P MedFlight of Ohio Function Prolonged and frequent access to venous circulation Allows for patient to carry on normal life; decrease number of needle sticks Medications, parenteral
More informationAus Artificial Uretheral Sphincter Port System
NORFOLK VET PRODUCTS the AUS for the long-term relief of incontinence in dogs and cats making life easier for pets Speciality Medical Devices For The Veterinary Community the Aus Artificial Uretheral Sphincter
More informationInitial placement 24FR Pull PEG kit REORDER NO:
Initial placement 24FR Pull PEG kit REORDER NO: 00710805 INSTRUCTIONS FOR USE 1 of 5 These products have been manufactured not to include latex. Intended Use: The Initial placement 24FR Pull PEG kit is
More informationDivision 1 Introduction to Advanced Prehospital Care
Division 1 Introduction to Advanced Prehospital Care Chapter 7 Intravenous Access and Medication Administration Part 1 Principles and Routes of Medication Administration Topics Aseptic Technique Medication
More informationInitial placement 20FR Guidewire PEG kit REORDER NO:
Initial placement 20FR Guidewire PEG kit REORDER NO: 00710802 INSTRUCTIONS FOR USE 1 of 5 These products have been manufactured not to include latex. Intended Use: The Initial placement 20FR Guidewire
More informationSURGICAL PROCEDURE DESCRIPTIONS
SURGICAL PROCEDURE DESCRIPTIONS GONADECTOMY: CASTRATION USING SCROTAL METHOD 1. The animal is anesthetized and placed in dorsal recumbency with the tail toward the surgeon. 2. The abdominal and scrotal
More informationProcedures/Risks:central venous catheter
Procedures/Risks:central venous catheter Central Venous Catheter Placement Procedure: Placement of the central venous catheter will take place in the Interventional Radiology Department (IRD) at The Ohio
More informationThe Percutaneous Endoscopic Gastrostomy. Geoffrey Axiak Clinical Nutrition Nurse St. Luke s Hospital
The Percutaneous Endoscopic Gastrostomy Geoffrey Axiak Clinical Nutrition Nurse St. Luke s Hospital What is a P.E.G.? Percutaneous Endoscopic Gastrostomy Indications for P.E.G. Insertion In cases of long-term
More informationDocument No. BMB/IFU/40 Rev No. & Date 00 & 15/11/2017 Issue No & Date 01 & 15/11/2017
Central Venous Catheter Device Description Multi-lumen catheters incorporate separate, non-communicating vascular access lumens within a single catheter body. Minipunctur Access Sets And Trays: Used for
More informationIV therapy. By: Susan Mberenga, RN, MSN. Copyright 2016, 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
IV therapy By: Susan Mberenga, RN, MSN 1 IV Therapy Types of solutions Isotonic Hypotonic Hypertonic Caution: Too rapid or excessive infusion of any IV fluid has the potential to cause serious problems
More informationPonsky * PEG Safety System - "Pull" Bard * PEG Safety System - "Guidewire" Information for Use
Ponsky * PEG Safety System - "Pull" Bard * PEG Safety System - "Guidewire" Information for Use Rx only Single patient use DEHP-Free This product and package do not contain natural rubber latex STERILE
More informationSOP: Urinary Catheter in Dogs and Cats
SOP: Urinary Catheter in Dogs and Cats These SOPs were developed by the Office of the University Veterinarian and reviewed by Virginia Tech IACUC to provide a reference and guidance to investigators during
More informationTo you who will receive a T-Port PATIENT INFORMATION
To you who will receive a T-Port PATIENT INFORMATION T-Port Patient information What is a T-Port? Why this booklet The purpose of this handout is to help you understand how it is to receive and live with
More informationCentral Venous Catheter Care and Maintenance (includes catheter troubleshooting guide)
Central Venous Catheter Care and Maintenance (includes catheter troubleshooting guide) A Guide for Patients in the Home Phone Number: Nurse/Contact: Central Venous Catheters This manual is a guide for
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Code: D: PC-5555 Entity: Fairview Pharmacy Services
More informationPediatric ER Half-day Rounds October 12, 2011 Dr. Karen Bailey
Pediatric ER Half-day Rounds October 12, 2011 Dr. Karen Bailey Objectives to identify various enteral and vascular access lines what do they look like? indications & contraindications proper placement
More informationCentral Venous Access Devices. Stephanie Cunningham Amy Waters
Central Venous Access Devices Stephanie Cunningham Amy Waters 5 Must Know Facts About CVAD s 1) What are CVAD s? 2) What are CVAD s used for? 3) How are these devices put in? 4) What are the complications
More informationPer-Q-Cath* PICC Catheters with Excalibur Introducer* System
Bard Access Systems Per-Q-Cath* PICC and Catheters with Excalibur Introducer* System Instructions For Use Table of Contents Table of Contents Page Contents 1 Product Description, Indications & Contraindications
More informationParenteral Products. By: Howida Kamal, Ph.D
Parenteral Products By: Howida Kamal, Ph.D Dosage forms Route of administration Enteral INTO Parenteral ONTO Topical Dosage forms Physical form Solid Liquid Semi-solid Powder Granules Tablets Capsules
More informationInsertion of a totally implantable vascular access device (TIVAD)
Insertion of a totally implantable vascular access device (TIVAD) What is a TIVAD? A TIVAD is a long hollow tube that is inserted into one of the large veins in your body. One end of the tube sits in a
More informationInserting a percutaneous biliary drain and biliary stent (a tube to drain bile)
Patient information - Radiology Unit Tel 0118 322 7991 Inserting a percutaneous biliary drain and biliary stent (a tube to drain bile) Introduction This leaflet tells you about the procedures known as
More informationGeoffrey Axiak M.Sc. Nursing (Manch.), B.Sc. Nursing, P.G. Dip. Nutrition & Dietetics Clinical Nutrition Practice Nurse
The Percutaneous Endoscopic Gastrostomy Geoffrey Axiak M.Sc. Nursing (Manch.), B.Sc. Nursing, P.G. Dip. Nutrition & Dietetics Clinical Nutrition Practice Nurse What is a P.E.G.? Percutaneous Endoscopic
More informationPacemaker and AV Node Ablation Patient Information
Melbourne Heart Rhythm Pacemaker and AV Node Ablation Patient Information The Heart The heart is a pump responsible for maintaining blood supply to the body. It has four chambers. The two upper chambers
More informationGastrointestinal Tract Imaging. Objectives. Reference. VMB 960 April 6, Stomach Small Intestine Colon. Radiography & Ultrasound
Gastrointestinal Tract Imaging VMB 960 April 6, 2009 Stomach Small Intestine Colon Objectives Radiography & Ultrasound Contrast Examination of the Small Intestine Reference Chapters 45 47 Pages 750 805
More informationVascular access device selection & placement. Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University
Vascular access device selection & placement Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University How to make the right choice of vascular access device.. Peripheral
More informationVictoria Chapman BS, RN, HP (ASCP)
Victoria Chapman BS, RN, HP (ASCP) Considerations: Age Sex Body Composition Hydration Status Chemotherapy Use Access History Considerations: Immunosuppression Use Chemotherapy Frequency of plasma exchanges
More informationPortacath Insertion. Patient Information Leaflet
Portacath Insertion Patient Information Leaflet What is a Portacath? A Portacath (also referred to as Port, Chemoport or Power Port) is an implanted central venous access device (CVAD) recommended for
More informationOverview of CVADs. Type of device commonly used. Dwell time Flushing requirement Associated complications. lumens
Source: Clinical Skills Management of Vascular Access Devices Pre-course handbook. Adapted with permission from NHS Lothian Employee and Education Development Team. Overview of CVADs Type of device Veins
More informationThe University of Toledo Medical Center and its Medical Staff
Name of Policy: Policy Number: Department: 3364-109-GEN-705 Infection Control Medical Staff Hospital Administration Approving Officer: Responsible Agent: Scope: Chair, Infection Control Committee Chief
More informationMODULE 2 THE LABORATORY RAT
University Animal Care Committee LABORATORY ANIMAL BIOMETHODOLOGY WORKSHOP MODULE 2 THE LABORATORY RAT SUBSTANCE ADMINISTRATION AND BLOOD COLLECTION Substance Administration: Subcutaneous injection Intramuscular
More informationVascu-PICC WITH CUFF PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER INSTRUCTIONS FOR USE
Vascu-PICC WITH CUFF PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER INSTRUCTIONS FOR USE INDICATIONS FOR USE: The Vascu-PICC with cuff Peripherally Inserted Central Vein Catheters are designed for
More informationCOMPARATIVE MEDICINE LABORATORY ANIMAL FACILITIES STANDARD OPERATING PROCEDURE FOR RODENT SURGERY
2.A.3 COMPARATIVE MEDICINE LABORATORY ANIMAL FACILITIES STANDARD OPERATING PROCEDURE FOR RODENT SURGERY 1.0 Purpose: Post-operative infections in rodents can and do occur. Such infections, which may not
More informationCentral Line Care and Management
Central Line Care and Management What is a Central Line/ CVAD? (central venous access device) A vascular infusion device that terminates at or close to the heart or in one of the great vessels (aorta,
More informationIV Fluids. Nursing B23. Objectives. Serum Osmolality
IV Fluids Nursing B23 Objectives Discuss the purpose of IV Discuss nursing interventions in IV therapy Identify complications of IV therapy Differentiate between peripheral line, central line, and PICC
More informationInstructions for Use. IJ Catheter Ultrasound Model Version 2400 Series
Instructions for Use IJ Catheter Ultrasound Model Version 2400 Series 3601 Sagamore Parkway North, Suite B Lafayette, IN 47904 Phone 765.742.4813 www.hemocleanse.com Instructions Revision 3.0 2014 Table
More informationTOTALLY IMPLANTED VENOUS ACCESS DEVICES
Information for Parents/Carers TOTALLY IMPLANTED VENOUS ACCESS DEVICES This leaflet tells you about having a totally implanted venous access device (Port). It explains what is involved and what the benefits
More informationATI Skills Modules Checklist for Central Venous Access Devices
For faculty use only Educator s name Score Date ATI Skills Modules Checklist for Central Venous Access Devices Student s name Date Verify order Patient record Assess for procedure need Identify, gather,
More informationIV Fluids Nursing B23 Objectives Serum Osmolality 275 to 295 Isotonic
1 IV Fluids Nursing B23 2 Objectives 3 Serum Osmolality Serum osmolality solute concentration of a solution Higher osmolality means greater pulling power for water Normal serum osmolality is 275 to 295
More informationPort Design. Page 1. Port Placement, Removal, and Management. Selecting a Vascular Access Device. Thomas M. Vesely, MD
Non-Dialysis Procedures Port Placement, Removal, and Management Thomas M. Vesely, MD Saint Louis, Missouri Selecting a Vascular Access Device Duration of use Number of lumens Frequency used Blood flow
More informationBlood Sampling: Venipuncture
Approved by: Blood Sampling: Venipuncture Gail Cameron Senor Director, Operations, Maternal, Neonatal & Child Health Programs Dr. Paul Byrne Medical Director, Neonatology Neonatal Nursery Policy & Procedures
More informationCurraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices
Curraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices Date re-approved: 27 th Jan 2015. Version No: 2 Revision Due: 2018 Index code: CLIN028 Disclaimer: The information
More informationCentral Venous Catheter Insertion: Assisting
Approved by: Central Venous Catheter Insertion: Assisting Gail Cameron Senior Director, Operations, Maternal, Neonatal & Child Health Programs Dr. Santiago Ensenat Medical Director, Neonatology Neonatal
More informationCatheter-directed Thrombolysis
Scan for mobile link. Catheter-directed Thrombolysis Catheter-directed thrombolysis treats vascular blockages and improves blood flow by dissolving abnormal blood clots. A blood clot, or thrombus, can
More informationPart 1 Principles and Routes of Medication Administration
1 Chapter 7, Medication Administration Part 1 Principles and Routes of Medication Administration 2 Caution: Administering medications is business Always take appropriate Standard measures to reduce your
More informationHome Health Foundation, Inc. To create more permanent IV access for patients undergoing long term IV therapy.
PROCEDURE ORIGINAL DATE: 06/99 Revised Date: 09/02 Home Health Foundation, Inc. SUBJECT: PURPOSE: MIDLINE CATHETER INSERTION To create more permanent IV access for patients undergoing long term IV therapy.
More informationTable of Contents. Dialysis Port Care Chemotherapy Port Care G-Tube Care Colostomy Bags Wound Dressings
Table of Contents Dialysis Port Care Chemotherapy Port Care G-Tube Care Colostomy Bags Wound Dressings Dialysis Port Care Know What Type of Vascular Access You Have. Fistula: An artery in your forearm
More informationPERCUTANEOUS BILIARY DRAINAGE
PERCUTANEOUS BILIARY DRAINAGE MEDICAL IMAGING INFORMATION FOR PATIENTS Introduction This booklet tells you about the procedure known as percutaneous biliary drainage, explains what is involved and what
More informationAdult Intubation Skill Sheet
Adult Intubation 2. Opens the airway manually and inserts an oral airway *** 3. Ventilates the patient with BVM attached to oxygen at 15 lpm *** 4. Directs assistant to oxygenate the patient 5. Selects
More informationInjection Techniques Principles and Practice. Introduction. Learning Objectives 5/18/2015. Richard E. Castillo, OD, DO
Injection Techniques Principles and Practice Richard E. Castillo, OD, DO Administering injections is considered a routine clinic activity Safety demands knowledge of: Anatomy & Physiology Pharmacology
More informationAdvancing Lives and the Delivery of Health Care. The High-Flow Port Designed for Apheresis
Advancing Lives and the Delivery of Health Care The High-Flow Port Designed for Apheresis Optimized for Long Device Life Bench Tested up to 1,000 Accesses 1 Bard is proud to introduce the first and only
More informationChapter 7, Medication Administration Part 1 Principles and Routes of Medication Administration Caution: Administering medications is business Always
1 3 4 5 6 7 8 9 10 Chapter 7, Medication Administration Part 1 Principles and Routes of Medication Administration Caution: Administering medications is business Always take appropriate Standard measures
More informationThe High-Flow Port Designed & Indicated for Apheresis
The High-Flow Port Designed & Indicated for Apheresis Advancing Lives and the Delivery of Health Care Bard is proud to introduce the first and only high-flow, power-injectable port designed and indicated
More informationSTANDARD OPERATING PROCEDURE #203 LARGE ANIMAL SURGERY
STANDARD OPERATING PROCEDURE #203 LARGE ANIMAL SURGERY 1. PURPOSE This Standard Operating Procedure (SOP) describes procedures for general surgery of large animal species such as swine, dogs, rabbits,
More informationUnderstanding your HICKMAN CATHETER
Understanding your HICKMAN CATHETER Patient Information What is the purpose of this information sheet? This information sheet has been written by patients, members of the public and health professionals.
More informationProcedure: Chest Tube Placement (Tube Thoracostomy)
Procedure: Chest Tube Placement (Tube Thoracostomy) Basic Information: The insertion and placement of a chest tube into the pleural cavity for the purpose of removing air, blood, purulent drainage, or
More informationM102 New TOMOKO. Introduction/ Table of Contents 1 Purpose 2 Content 3 Precautions concerning handling 4 Usage 5-7 Storage method 8.
M102 New TOMOKO User s Manual (151218) Introduction/ Table of Contents 1 Purpose 2 Content 3 Precautions concerning handling 4 Usage 5-7 Storage method 8 * For the usage of the attached Veinmate 2, refer
More informationMr. Siva Chandrasekaran Orthopaedic Surgeon MBBS MSpMed MPhil (surg) FRACS
Shoulder Arthroscopy Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word arthroscopy comes from two Greek words, "arthro" (joint)
More informationSuccessful IV Starts Revised February 2014
Successful IV Starts Revised February 2014 Why Intravenous Therapy? Used for access to the body s circulation Indications: Administer fluids, blood, medications, and nutrition Obtain laboratory specimens
More informationHaving a radiologically inserted gastrostomy. An information guide
TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Having a radiologically inserted gastrostomy An information guide Having a radiologically inserted gastrostomy Introduction This leaflet
More informationINNOVATIVE PRODUCTS G, J AND GJ-TUBES WITH ENFit TM CONNECTION
MIC * & MIC-KEY * Enterostomy Tubes INNOVATIVE PRODUCTS G, J AND GJ-TUBES WITH ENFit TM CONNECTION DIGESTIVE HEALTH PRODUCT CATALOGUE INNOVATIVE PRODUCTS - G, J AND GJ-TUBES WITH ENFit TM CONNECTION DIGESTIVE
More informationmicromend Skin Closure Device Pre-clinical Studies of Closure of Surgical Wounds in Live Pigs
micromend Skin Closure Device Pre-clinical Studies of Closure of Surgical Wounds in Live Pigs RONALD BERENSON, M.D. and PAUL LEUNG, M.S. EXECUTIVE SUMMARY KitoTech Medical has developed a revolutionary
More informationBetter Post-Op Pain Control Starts Here
Better Post-Op Pain Control Starts Here POST-OP PAIN CONTROL PUMP It s Easy to Get Started About the ACCUFUSER Pump Thank you for considering the This brochure makes it easy for For complete information
More informationChildren's (Pediatric) PICC Line Placement
Scan for mobile link. Children's (Pediatric) PICC Line Placement A peripherally inserted central catheter (PICC line) is most often used to deliver medication over a long period. The doctor or nurse inserts
More information( 1 ) Ball and socket. Shoulder capsule. Rotator cuff.
Shoulder Arthroscopy Page ( 1 ) Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word arthroscopy comes from two Greek words, arthro
More informationIntroduction to IV Therapy. BY Terry White, MBA, BSN
Introduction to IV Therapy BY Terry White, MBA, BSN Important It is West Virginia State Law that nursing students (LPN and RN) are forbidden to start IVs or draw blood samples on patients Taking this class
More information1 Description. 2 Indications. 3 Warnings ASPIRATION CATHETER
Page 1 of 5 ASPIRATION CATHETER Carefully read all instructions prior to use, observe all warnings and precautions noted throughout these instructions. Failure to do so may result in complications. STERILE.
More informationTransplant Surgery. Patient Education Guide to Your Kidney/Pancreas Transplant Page 9-1. For a kidney/pancreas transplant. Before Your Surgery
Patient Education Page 9-1 Transplant Surgery For a kidney/pancreas transplant By the time you have your transplant surgery, you may have been waiting for some time. Reading this chapter before surgery
More informationZEPHYR SURGICAL IMPLANTS SÀRL
For Operating Room NOTE This document is a complementary checklist to the two training videos, which you can be accessed and download from our website: ZSI 375 Training Video, ZSI 375 Functioning Protocol.
More informationPORTS SETTING THE STANDARD WITH A COMPREHENSIVE FAMILY OF PORTS
PORTS SETTING THE STANDARD WITH A COMPREHENSIVE FAMILY OF PORTS As a single-source provider, Bard Access Systems sets the standard for implanted ports and vascular access devices. We make it possible for
More informationCentral Venous Line Insertion
Central Venous Line Insertion Understand the indications and risks of CVC insertion Understand and troubleshoot the seldinger technique Understand available sites and select the appropriate site for clinical
More informationCATHETER ACCESS KIT. For use with Prometra Programmable Infusion Systems
CATHETER ACCESS KIT Caution: Federal (USA) Law restricts this device to sale by or on the order of a physician. Table of Contents Contents... 3 Description... 3 Indications... 3 Contraindications... 3
More informationWhat is a Small Bowel Capsule Endoscopy?
What is a Small Bowel Capsule Endoscopy? Capsule endoscopy is a way for your doctor to see inside part of your digestive system. A small bowel capsule endoscopy looks at the lining of the small intestine.
More informationTorn ACL Hamstring Graft
Torn ACL Hamstring Graft The anterior cruciate ligament (ACL) is one of four ligaments that are crucial to the stability of your knee. It is a strong fibrous tissue that connects the femur to the tibia.
More informationVaxcel Implantable Ports Valved and Non-Valved. A Patient s Guide
Vaxcel Implantable Ports Valved and Non-Valved A Patient s Guide Vaxcel Implantable Port This pamphlet provides some answers to questions you may have about your implantable port and how to care for it
More informationRadioembolization (Y90)
Scan for mobile link. Radioembolization (Y90) Radioembolization is a minimally invasive procedure that combines embolization and radiation therapy to treat liver cancer. Tiny glass or resin beads filled
More informationIntravascular Ultrasound
Scan for mobile link. Intravascular Ultrasound Intravascular ultrasound (IVUS) uses a transducer or probe to generate sound waves and produce pictures of the coronary arteries. IVUS can show the entire
More informationAFRRI CHRONIC CAROTID AND JUGULAR CATHETERIZATION IN RHESUS MONKEYS TECHNICAL NOTE AFRRI TN73-2 FEBRUARY J. M. Fein
AFRRI TECHNICAL NOTE AFRRI TN73-2 FEBRUARY 1973 CHRONIC CAROTID AND JUGULAR CATHETERIZATION IN RHESUS MONKEYS J. M. Fein ARMED FORCES RADIOBIOLOGY RESEARCH INSTITUTE Defense Nuclear Agency Bethesda, Maryland
More informationEducation for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath
HOME IV THERAPY PICC Portacath Who To contact Cardio-Respiratory Integrated Specialist Services (CRISS) Office hours 0800 1630 hours Ph: 364 0167 Weekends and after hours, phone Christchurch Hospital operator
More information1 2 3 W. R. Walker, G. L. Morgan and C. V. Maxwell. (Key Words: Swine, Neonatal Pig, Ileal Cannulation, T-Cannula) Introduction
ILEAL CANNULATIONOF THE NEONATALPIG WITH A SIMPLET-CANNULA 1 2 3 W. R. Walker, G. L. Morgan and C. V. Maxwell Story in Bri ef A cannula and surgical procedure suitable for ileal cannulation of pre-weaned
More informationCentral venous access devices for children with lysosomal storage disorders
Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Central venous access devices for children with lysosomal storage disorders This information explains about central
More informationWhat Is an Endoscopic Ultrasound (EUS)?
ENDOSCOPIC ULTRASOUND (EUS) What Is an Endoscopic Ultrasound (EUS)? An endoscopic ultrasound (EUS) is a specialized procedure that blends: Endoscopy use of a scope to look at the inside lining of the gastrointestinal
More informationLESSON ASSIGNMENT. Urinary System Diseases/Disorders. After completing this lesson, you should be able to:
LESSON ASSIGNMENT LESSON 4 Urinary System Diseases/Disorders LESSON ASSIGNMENT Paragraphs 4-1 through 4-8. LESSON OBJECTIVES After completing this lesson, you should be able to: 4-1. Identify the purposes
More informationDIGESTIVE HEALTH ENTERAL FEEDING PRODUCTS
DIGESTIVE HEALTH ENTERAL FEEDING PRODUCTS HALYARD* MIC* AND MIC-KEY* INTRODUCER KITS HALYARD* MIC* and MIC-KEY* Introducer Kits provide physicians with an innovative solution to facilitate the primary
More informationTransfemoral Amputation
Transfemoral Amputation Pre-Op: 42 year old male who sustained severe injuries in a motorcycle accident. Note: he is a previous renal transplant recipient and is on immunosuppressive treatments. His injuries
More informationIV Catheter Placement
Year Group: BVSc3 + Document number: CSL_A06 Equipment for this station: Equipment list: IV catheter model, with giving set and red fluid bag IV catheter Bung or T-port Tape two strips cut to size before
More informationKINGSTON GENERAL HOSPITAL NURSING POLICY AND PROCEDURE
KINGSTON GENERAL HOSPITAL NURSING POLICY AND PROCEDURE SUBJECT Sample (Adult): Advanced Competency (AC) for Nurses (Registered Nurses and Registered Practical Nurses) PAGE 1 of 5 ORIGINAL ISSUE 1985 January
More informationCAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE
CAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE INDICATIONS FOR USE The LATERA Absorbable Nasal Implant is indicated for supporting upper and lower lateral nasal cartilage. CAUTION: Federal law restricts
More informationHaving a PEG tube inserted
Having a PEG tube inserted This information leaflet is for patients who are having a PEG (Percutaneous Endoscopic Gastrostomy) tube inserted. It explains what is involved, what to expect and what significant
More informationTitle: EZ-IO. Effective Date: January SOG Number: EMS Rescinds:
S O G Title: EZ-IO Effective Date: January 2010 SOG Number: EMS - 25 Rescinds: Scope: Providers Authorized are AIC s in the following certifications EMT-I and EMT-P who have been trained and cleared by
More informationCore procedures assessment form
1. Venepuncture guidance choose appropriate needle or cannula have appropriate vials to hand choose a suitable, palpable vein after applying tourniquet insert needle with bevel upwards and advance 2-3mm
More informationInstruction For Use for All Silicon Foley Catheter
General Description: All Silicone Foley Catheter for single use is a thin, is a flexible tube passed through the urethra and into the bladder to drain urine. It is the most common type of indwelling urinary
More informationVenepuncture and Cannulation. Louise Smith Clinical Nurse Specialist
Venepuncture and Cannulation Louise Smith Clinical Nurse Specialist Outcomes By the end of this session you will be aware of: Basic anatomy Preparation procedures including patient identification Equipment
More informationDesigned to Reduce the Risk of Occlusion (1)
Designed to Reduce the Risk of Occlusion (1) more efficient flushing better outcomes The Vortex* ports feature the Vortex Technology for a more efficient flushing. The Vortex Technology sets up efficient
More informationColorectal procedure guide
Colorectal procedure guide Illustrations by Lisa Clark Biodesign ADVANCED TISSUE REPAIR cookmedical.com 2 INDEX Anal fistula repair Using the Biodesign plug with no button.... 4 Anal fistula repair Using
More informationA-Tube Instructions for Use
a s s i s t A-Tube Instructions for Use Caution: US Federal law restricts this device to sale on or by the order of a physician. IFU-029 Rev. B (06/2016) Rx Only Aspire Bariatrics, Inc. 2016 TABLE OF CONTENTS
More informationPatients with any of the following conditions may not be able to undergo the procedure:
Sharp Rees-Stealy San Diego Department of Gastroenterology Your Appointment Information: Date: Time: *Arrival Time: Physician: You are scheduled to receive a WIRELESS CAPSULE ENDOSCOPY EXAM. Please read
More information