FEATURES Anesthesia and Pain Managementא/.-,+*$()'א&%$א"!

ARAB HEALTH WORLD (AHW) January - February 2008 / Vol. XXIII Issue 1 visit us at: www.ahwmag.net

Modern Anesthesia in the MR Environment

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REFER TO RIN 14 ON PAGE 82

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The newest member of the Fabius family of Dräger Medical AG & Co. KG, subsidiary of Drägerwerk AG, was specially designed to meet the requirements of Magnetic Resonance Imaging (MRI). The system is also suitable for other applica-tions involving magnetic fields such as a cardiac catheteriza-tion laboratory or proton therapy. The functionality is guaran-teed for use on MRI systems of 1.5 and 3 tesla. That means that there is no mutual interference with an MRI system at these magnet strengths. An automatic acoustic distance de-

tector for maximum proximity to an MRT system (40 mtesla ~ 400 gauss) helps to position the device. The uniform operating concept of Dräger anesthesia devices has also been built into the MRI anesthesia workstation. The size of the MRI system usually requires the anesthetists to be outside the room or some distance away from the device dur-ing an examination. Additional optical alarm displays (LEDs) at the top of the system actively contribute to patient safety in this specialized environment. Above all, however, the stan-dards to which clinical personnel are accustomed from the classic OR application must apply to the MR environment. Differentiated ventilation modes (volume and pressure con-trolled, pressure support and SIMV), needed especially for care of premature infants, newborns, and ICU patients, can be used in this environment.The electrical ventilator allows controlled compliance com-pensation guaranteeing the necessary flow especially for low tidal volumes. Since longer ventilation tubes are often used in the MR environment, an electrical ventilator is particularly advantageous. Comparable to the standard OR devices, the newest anesthesia solution also has holders for MR compat-ible gas cylinders and an integrated country-specific multiple socket outlet. All accessories including hoses, suction ejec-tor, anesthesia gas line, etc., have been tested and released for use with Fabius MRI.

How Safe Are Cannulae?

Since JAMA published a paper, in its Oct 2007 issue, about the incidence of invasive Community Associated Methicillin Resistant Staphylococcus Aureus (CA-MRSA) in the U.S., patients, doctors and healthcare workers have begun looking more carefully at various procedures carried out in hospitals. A big number of Peripheral Venous Cannulae (PVCs) cur-rently used in clinical practice result in an increasing number of PVC-related complications such as phlebitis, thrombosis, and bacteremia. Chhadia, Ankur et al, in a study published in The Journal of Hand Surgery, reported that 73% of people

!،1&HL%23e!P)Z*2א!M3>א-3#[א!c7%d!Y!H&]52א!fAאa!M3)+I2!/893:א-91;!א!gH2!B#(%234!hZ(%2א`!(MRSA)/7)(%#72!PG`3I-א!P)23IJi2א!P&a5I+823!א&j%k4!]3l%0S!m`a!=`Vnא!fUo!"GJ3t!x76y!.P)#7<!z]3{!"#9!3#F%)238|!M3Z}S!~!/JH&HU!/%)+�!Medifix!Pe1�!�HIJ/!אI2+(%/!>7;!14אw\!אrAvאq)Ar72!/Jst3U!3#t`!u!א6%2+(p!`!א%2)5&^.

REFER TO RIN 15 ON PAGE 82

have their hands colonized by MRSA. Most guidelines advise healthcare professionals to use the hand to place a PVC. This was based on previous studies carried out in intensive care settings and evidence from central venous catheters (CVC).Incidence of staphylococcus infection of blood is more com-mon in patients having an IV Cannula administered in the ER. Since almost all the national effort and progress to date to reduce the risk of IVD-related infection has focused on cen-tral venous cannulae used in hospitals; infection control pro-grams must now strive to consistently apply essential control measures and preventive technologies with all types of IV cannulae. Skin preparation may not always be effective as most anti-septics are bacteriostatic. This may result in the introduction of the microorganism present on the skin, resulting in severe toxemia, shock, and possible death of the patient. Spring-loaded cannula and U-Cannula presented by Medifix International Ltd were designed to reduce the number of at-tempts required to introduce a cannula. The device was de-veloped after the hypothesis was tested clinically and results published in medical journals. These cannulae are safer than safety cannulae because they offers protection from needle stick injury and may help reduce introduction of spreading MRSA to patients. These products are patented and now available for licensing to manufacture and market.