The document discusses modern anesthesia in the MR environment and safety of cannulae. It describes a new anesthesia workstation from Dräger Medical specially designed for use in MRI environments. It ensures no interference with MRI systems up to 3 Tesla and includes additional safety displays. The document also discusses the risks of peripheral venous cannulae (PVCs), such as phlebitis and bacteremia. Up to 73% of people can be colonized by MRSA on their hands. New spring-loaded cannulae designed by Medifix International aim to reduce insertion attempts and the risk of needlestick injuries and spreading infections like MRSA.

2. FEATURES
Anesthesia and Pain Management
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ARAB HEALTH WORLD (AHW) January - February 2008 / Vol. XXIII Issue 1 visit us at: www.ahwmag.net
Modern Anesthesia in the MR Environment
.MRI ‫א‬ Ħ Ħ Ġ‫א‬ ‫א‬ ،Dräger Medical ‫א‬ ‫א‬ ª Fabius ħ ‫א‬
. ‫א‬ ‫א‬ ú ، ‫א‬ ‫א‬ Ğ‫א‬ ‫א‬ ‫א‬ ‫א‬ ª‫א‬ Fabius MRI
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
، ‫א‬ ª ‫א‬ ‫א‬ ‫א‬ ‫א‬ ª Ħ Ġ‫א‬ ‫א‬ ‫א‬ (MRSA)Ħ ‫א‬ × ‫א‬ ‫א‬ Ù ğ‫א‬
. ‫א‬ ‫א‬ Ø Ħ ‫א‬Ø ‫א‬ ‫א‬ Ħ ‫א‬ Ħ . ª ě ª Ë Ħ Ħ Medifix
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.