Cannula And Infection


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Published in: Health & Medicine
  • Problem with IV Cannula and catheters

    Royal Hampshire Hospital, UK has claimed to have eliminated MRSA bloodstream infections by stopping the routine practice of administering intravenous injections. By prescribing the use of IV Cannula by specialist and signed off by a doctor to ensure that they are used only when absolutely necessary. MRSA infection was reduced from 11 to nil in 2007. (Times UK April, 2008 & BBC News 2008)

    Many doctors claim a high success rate for inserting cannulae, but may still require several attempts to get it right in certain cases. Cannulation can prove problematic and time consuming, which causes difficulties in urgent situations. In emergencies optimal attention to aseptic technique is not always feasible and multiple punctures are more likely to result in
    introducing bacterial infection. (GMC Today; 11-January 2007)

    High failure rate (60% of doctors insert cannula in 1st attempt, and 90% at the end of 2 years), poor aseptic technique, failure of antiseptics to kill pose danger of introducing antibiotic resistant bacteria into a vein by doctors and nurses result in bacteraemia and death. (How Safe Are Cannula? Arab Health World; 2008)

    Needle Stick Injury

    Published data prove the risk of contracting infection due to needle stick
    injury is considerably low. Between 1996-2004, in UK nine (9) healthcare workers contracted Hepatitis C & one (1) developed HIV infections. The risk of contracting HIV said to be 1 in 300. (Practice Nurse, 2006)
    The range of possibilities encompasses a cost to US hospitals of $374 million/year to a saving of $90 million/year. This is either a lot of money, or not a big deal. (Health Economics of NSI; Bandolier 2007)

    Problem with Disinfectants, Antiseptics and Hand wash

    Biocides, the bacteria-killing chemicals in disinfectants and antiseptics, are universally used in hospitals to clean surfaces, sterilize medical instruments and equipment, and decontaminate skin before surgery and introduce cannula through the skin are said to help spread bacteria.
    Hospital bacteria such as MRSA becoming resistant to most disinfectants and Antiseptics used in hospitals. Bacteria which survive attacks by biocides are becoming ultra resistant super bugs which cannot be killed.
    Although aseptic technique is critical to obtain reliable results, it is infrequently taught and audited. Skin cleaning is often incomplete, & many attendants still palpate with non-sterile gloves the venipuncture site before needle insertion. 58% of healthcare workers are said to be colonized with MRSA. (Aseptic technique is often incomplete. BMJ, 2008)

    It’s “All In How You Wipe”, Says study examining antibacterial products. In a study that focused solely on wipes, researchers concluded that instead of preventing hospitals acquired infections the wipes could actually be spreading bacteria when used improperly by hospital staff. (Germicidal Wipes Can Spread Bacteria; June 2008)

    Hand washing has now been linked to dermatitis, increased bacterial count in hands and colonization of antibiotic resistance developing in the hands of healthcare workers. Study found that dry nurses’ hands were twice as likely to be colonized by bacteria. Some bacteria with a genetic pre-disposition to resistance to antibiotic properties will survive. When these resistant bacteria divide, they pass their resistance on, creating entire colonies of antibiotic-resistant bacteria colonized in the healthcare worker’s hands. (The Retriever Weekly, Nov 2008)
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  • Washing Hand Has Less Published Information

    Hand washing using soap and creams has been associated with preventing the spread of antibiotic resistant bacterial infections. This used to be true, but now hand washing has also been linked to a few health problems and spreading infections.

    Healthcare workers who frequently washed their hands were monitored. Fifty-eight percent (50%) of the participants developed dermatitis on their hands. Nurses who washed their hands more than ten times a day were the most likely to develop the skin condition. Too much, hand washing results in scaling, redness, itching, and burning due to exposure to allergens or irritants. Dry hands are more likely to harbour pathogens. Dry nurses' hands were twice as likely to be colonized by bacteria, which have been known to cause infection in patients

    Despite the fact that many bacteria cover our skin, most are harmless unless they cross the protective barrier created by the skin. If skin becomes cracked, punctured or begins to bleed will increases the risk of bacteria entering skin resulting in serious infections. Women's skin harbours a larger variety of bacteria than men's skin.

    The increasing popularity of antibacterial and antimicrobial soaps has also increased the prevalence of antibiotic-resistant bacteria. Though washing with soap will eliminate most of the hand's bacteria colonies, some pathogens with a genetic pre-disposition to resist the soap's antibiotic properties will survive. When these resistant bacteria divide, they pass their resistance on, creating entire colonies of antibiotic-resistant bacteria.

    Detergents & chemicals used in house and hospitals are also increasing the odds that some medicines will no longer be able to combat dangerous diseases. The warning has been made by Birmingham and Warwick university scientists, who say disinfectants and other products washed into sewers and rivers are triggering the growth of drug-resistant microbes. Soil samples from many areas have been found to contain high levels of bacteria with antibiotic-resistant genes, the scientists have discovered - raising fears that these may have already been picked up by humans.

    The study is important because it suggests that the problem of drug resistance is not merely the result of the over-prescription of antibiotics or poor hygiene standards in hospitals. Drug resistance is not confined to hospitals, but is out in the community. It is spreading and all the time it is eroding our ability to control infections.

    Every day, huge volumes of these chemicals are flushed from homes, hospitals, enter sewers and rivers. In high concentrations, they kill bacteria. However, in sewage, these chemicals become diluted and bacteria have evolved resistance to them.

    If good bacteria are killed, those that are resistant will survive and, without competition, will multiply in vast numbers. We have created an ideal environment for the emergence of antibiotic-resistant bacteria in our drains and sewers. These microbes are now being spread round the country in river water and in sewage sludge used on farms.
    We are producing sewage and river water that have more and more drug-resistant bacteria in them and now poised to enter the food chain.

    1. Washing hand carries little risks By Elizabeth Silberholz
    2. Shampoo in water supply trigger growth of deadly drug-resistant bug;
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Cannula And Infection

  1. 1. Major Threat To Medical Profession and Humankind
  2. 2. Braunula <ul><li>First Cannula invented in Germany </li></ul><ul><li>Rapidly accepted by medical profession </li></ul><ul><li>Technique of introduction not evaluated </li></ul><ul><li>Used in USA & Europe since 1954 </li></ul><ul><li>Increase of Staphylococcal infection in tandem increased with this device </li></ul><ul><li>Average attempts required is 2-3 / patient </li></ul>
  3. 3. Types of Cannula <ul><li>Neonatal cannulae </li></ul><ul><li>Straight Cannulae </li></ul><ul><li>Winged Cannulae </li></ul><ul><li>Wing with port </li></ul><ul><li>Winged with stop cork </li></ul>All these cannula do the same job
  4. 4. Cannula Insertion Technique <ul><li>Wash hands with soap and water </li></ul><ul><li>Wear un-sterile glove </li></ul><ul><li>Identify good vein to cannulate </li></ul><ul><li>Prepare skin of patient </li></ul><ul><li>Insert cannula needle through skin </li></ul><ul><li>Puncture blood vessel </li></ul>
  5. 5. Common Problems <ul><li>Needle Bends when pressure is applied from the top </li></ul>
  6. 6. Flash-Back <ul><li>Blood noticed in Collecting chamber </li></ul><ul><li>Stop moving cannula needle forward </li></ul><ul><li>Failure rate high </li></ul>
  7. 7. Failure Rate Increase <ul><li>Puncture sites </li></ul><ul><li>Pain and discomfort </li></ul><ul><li>Spreading bacterial infections </li></ul><ul><li>Cost of wasted cannula </li></ul><ul><li>Hospital contaminated waste </li></ul><ul><li>Environmental pollution </li></ul><ul><li>Help bacteria to colonise and multiply </li></ul>
  8. 8. How Cannula Spread Infection
  9. 9. “ This is Not a Problem” <ul><li>1996-2004 </li></ul><ul><li>Hep : 9 infected of 997 exposure </li></ul><ul><li>HIV : 1 infected of 551 exposure </li></ul><ul><li>16% Healthcare of 35,000 sustained sharp injury </li></ul>
  10. 10. Ported Cannula <ul><li>Major cause for spreading bacterial infection </li></ul>
  11. 11. Ported Cannula <ul><li>50% of patients develop Bacteraemia </li></ul><ul><li>17 million used in UK </li></ul><ul><li>Banned in USA & Europe </li></ul><ul><li>Bacteria colonize in the port </li></ul><ul><li>Must be banned in UK Hospitals </li></ul>
  12. 12. MRSA Infections in Europe
  13. 13. Antibiotic Resistant Statistics Annual cost in Canada $200 - $250 million Cost of MRSA infection in USA/Year 3.2 - 4.2 Billion $ Cost of MRSA in Scotland / Year £183 million Cost of Skin Testing in Scotland next year £16 million Cost of deep cleaning hospitals in UK £2 Billion Clinical drug (11 are given IV) trials 13 Drugs C diff death in 2006 in UK, up 72% 6,480 Canadians died of MRSA 2,300 Death of MRSA in the USA in 2005 19,000 Death from MRSA in UK, 2006. 1,652 Health People carrying MRSA on their skin 3 out of 10 Patients who get infections in UK 1 in 10
  14. 14. Bactrial Threat High <ul><li>Increased practical procedure </li></ul><ul><li>Poor hand washing technique </li></ul><ul><li>Antiseptic skin solution not effective </li></ul><ul><li>Use of un-sterile gloves </li></ul><ul><li>48% Healthcare workers are carriers </li></ul><ul><li>Rapidly adopting bacteria </li></ul><ul><li>17% Doctors have adequate knowledge </li></ul><ul><li>Politicians ignoring this threat </li></ul>
  15. 16. This Proved our Hypothesis
  16. 18. Major Problem
  17. 19. Hand Wash <ul><li>Bacteria are now resistant to Biocide </li></ul><ul><li>Nurses / Doctors do not observe drying time </li></ul><ul><li>Use hand wash gel only when water and soap are not available </li></ul><ul><li>Low concentrated wash increase bacteria hand </li></ul><ul><li>Washing more than 10 times increase colony count in hands </li></ul><ul><li>Women have more bacteria in their hands </li></ul><ul><li>Quick swipe of skin with spirit not remove bacteria </li></ul><ul><li>High concentrated chemicals produce dermatitis </li></ul><ul><li>Biocides kill good germs and increase resistant germs growth </li></ul><ul><li>More than ten bacteria are now resistant </li></ul><ul><li>Simple puncture site with needle can get infected </li></ul>
  18. 20. Infected Injection Site
  19. 21. Antibiotic Resistant Bacteria Threatening Us <ul><li>Enterococcus faecium </li></ul><ul><li>Staphylococcus aureus </li></ul><ul><li>Klebsiella species </li></ul><ul><li>Acinetobacter baumannii </li></ul><ul><li>Pseudomonas aeruginosa </li></ul><ul><li>Enterobacter species </li></ul><ul><li>Streptococcus Pnemococcus </li></ul><ul><li>Meningococcal Infections </li></ul><ul><li>Gonococcus </li></ul><ul><li>Tuberculosis </li></ul>
  20. 22. Please Stop This Happen Again?