Vital Care Products

Scatter Radiation Protection: How does your facility handle it?

Posted by Jim Catherine on Tue, Jun 18, 2013 @ 03:10 PM

Scatter Radiation Protection

ALL Fluoro-guided procedures produce scatter radiation

+ Femoral Entry             + Dialysis Declotting           + Peripheral

+ Device Implant           + Vertebroplasty                  + Biopsy

For the typical patient who is exposed to radiation 5-10 times in their life it’s not a issue. For the interventional physician exposed to radiation 5-10 times a day, it is a serious issue.

Some intervential procedures result in significantly more scatter radiation than others. Differentiating factors include: complexity of procedure, total fluoro time, size of patient, and operator proximity to the primary beam/image intensifier. All radiation doses are cumulative and multiple low-level procedures each day put doctors, nurses and techs in  a potentially harmful situation. For this reason, clinically proven non-lead shields are available in a wide spectrum of protection levels, up to 95% at 90kVp to drastically reduce scatter radiation in every interventional procedure.

What are your peers saying?

Brain & Neck Tumors Among Physicians Performing Interventional Procedures
“...the brain is relatively unprotected and the left side of the head is known to be more exposed to radiation than the right.” Full Article>> 

Brain tumours among interventional cardiologists: a cause for alarm?
“Interventional cardiologists have the highest radiation exposure among health professionals, major awareness of radiation safety and training in radiological protection are essential and imperative, and should be used in every procedure.” Full Article>> 

The Importance of Radiation Safety for Healthcare Workers as Well as Patients
"Radiation is an important diagnostic tool, but it must be treated with respect. It has become apparent that there is significant room for improvement in radiation safety practices, which can vary widely from institution to institution, and from clinician to clinician. All who work in hospital radiation environments, including technologists, nurses, physicians and others, must make a commitment to the safer use of radiation, for the good of everyone." Full Article>>

Safety standards require that radiation exposure to medical personnel be As Low As Reasonably Achievable (ALARA)

The commitment to use non-lead proceduce-specific shields in conjunction with established imaging safety protocol, is a recognized and invaluable solution to meet this directive with confidence.

If you have any questions, or if you need additional information, please contact your Vital Care Product Specialist at 800 837 5511 x200.

Topics: Scatter radiation, radiation safety, interventional cardiologist, Flouro-guided, procedures

Do you have EtCO2 monitoring when performing procedural sedation?

Posted by Jim Catherine on Mon, Mar 04, 2013 @ 12:41 PM

EtCO2 monitoring

 

 

When performing

procedural sedation,

ensuring patient safety

and adequate ventilation

is essential.

 

When performing procedural sedation, ensure patient safety and adequate ventilation with Nonin RespSense.

The American Society of Anesthesiologists (ASA) “Standards for Basic Anesthetic Monitoring” recommends monitoring for the presence of exhaled carbon dioxide during procedures where the patient is sedated.* The ASA standard states:

“During moderate or deep sedation the adequacy of ventilation
shall be evaluated by continual observation of qualitative clinical signs
and monitoring for the presence of exhaled carbon dioxide.“

Capnography monitors provide continuous and reliable monitoring to help identify potentially life-threatening ventilation status changes such as respiratory depression during procedural sedation.

About Fast, First-Breath Waveform Capnography
Waveform capnography provides real-time feedback on how the patient is breathing or ventilated. Ideal for spot-check and continuous EtCO2 monitoring, Nonin Medical's LifeSense® and RespSense™ capnographs with proven MedAir™ EtCO2 technology offer the earliest indicator of an adverse breathing event. Whether used at the bedside, in the field or during transport, Nonin capnographs provide accurate, first breath EtCO2 value and waveform — even under difficult breathing conditions. The LifeSense and RespSense capnographs are easy-to-use, powerful devices ideal for use in hospitals, clinics, ambulatory surgery centers, special procedure areas or anywhere anesthetic sedation is administered.

Key benefits include:

+ Waveform trend monitoring for endotracheal tube placement verification 

+ Fast, first breath detection of breathing irregularities 

+ Extreme portability for continuous monitoring of airway integrity during transport 

+ Unique moisture management to prevent occlusion 

+ No calibration or auto zeroing required during patient monitoring for added efficiency

The Nonin RespSense monitor (NM-8883-002), only $1,800, provides fast and easy EtCO2 monitoring.

Vital Care Products offers flexible and dependable vital sign and patient montoring solutions available in many configurations for applications including: Non-invasive blood pressure (NIBP), Cerebral Oximetry (StO2), Pulse Oximetry (SpO2), and Capnography (EtCO2).


* American Society of Anesthesiology Standards for Basic Anesthetic Monitoring, Committee of Origin: Standards and Practice Parameters, amended October 20th, 2010

Topics: Capnography, EtCO2, SpO2, procedural sedation, waveform, RespSense, LifeSense, ASA Standards

How to Protect from Scatter Radiation during Vascular Surgery

Posted by Jim Catherine on Thu, Feb 07, 2013 @ 12:18 PM

 

Scatter Radiation Protection for Vascular Surgery

ALL Fluoro-guided Procedures Produce Scatter Radiation

Some interventional procedures result in significantly more scatter radiation than others. Differentiating factors include: complexity of procedure, total fluoro time, size of patient, and operator proximity to the primary beam/image intensifier.


Minimally invasive interventional procedures lower costs and risks for patients.
Ironically, physicians put themselves at greater risk and pay
a personal high price in radiation exposure multiple times every day.

Start protecting your health, your team, and your career today with lead-free radiation protection products. Sterile shields are placed on the patient to stop scatter radiation at the source. By standing in the "shade" created by the shield, the physician is able to reduce his exposure to radiation.

Peripheral Shield Placements for Vascular Surgery & Cardiothoracic Surgery
Interventional Peripheral Shields provide excellent protection during any peripheral procedure. The added length of the shield allows the physician to work along the entire length of the limb while fully protected. It is available in an absorbent covering due to the volume of fluids associated with these procedures. The physician should always position the shield between himself and the primary beam.

Abdominal Peripheral Shields provide excellent protection
during AAA and TAVR procedures. These procedures require
staff on both sides of the patient, and with two shields provide
excellent protection. (see illustration for proper placement).

5110A 5Abdominal Position Illus

The Lower-extremity Peripheral Shield is correctly positioned
along the length of the limb, near the area of interest and out of
the primary beam. The shield is designed to drape down to the
table top to protect the physician from scatter emanating from
the side of the patient. Usual entry is at the patient’s right femoral.

 5110A Right Leg Position Illus

The physician may cross over and fluoro down the left leg
(opposite leg). If this is the case, place the shield so that it covers
a portion of the left leg that is closest to the physician, but do not
place the shield in the primary beam. The shield will cover the
area between the patient’s legs and part of the patient’s right leg.

 5110A Left Leg Position Illus

Why Protect from Scatter Radiation?
ALL radiation doses are cumulative and multiple low-level procedures each day put doctors, nurses and techs in a potentially harmful situation.

For this reason, clinically proven shields are available in a wide spectrum of protection levels, from 50% to 95% at 90kVp to drastically reduce scatter radiation in every interventional procedure.

Procedure-specific shields absorb radiation and create a shade zone in which clinicians can work and be completely protected from scatter radiation.

Safety standards require that radiation exposure to medical personnel be As Low As Reasonably Achievable (ALARA). The commitment to use lead-free shields in conjunction with established imaging safety protocol, is a recognized & invaluable solution to meet this directive with confidence.

CTA-Article-Button

What are your peers saying?
Download a portfolio of clinical summaries from recent studies involving scatter radiation protection for Fluoro-guided Procedures.

Count on Vital Care Products to follow industry trends, healthcare mandates and to identify and introduce vital, cost-effective, risk-reducing solutions that benefit patients and clinicians. For more information call 800 837 5511 or email sales@vitalcareproducts.com.

Topics: scatter radiation protection, RADPAD, Peripheral Shields, Fluoro-guided Procedures, Cardiothoracic Surgery, Vascular Surgery, As Low As Reasonably Achievable, ALARA

Clinical Use Cases for Capnography

Posted by Jim Catherine on Mon, Feb 04, 2013 @ 02:33 PM

 

EtCO2 Monitors, Capnography


Clinical
Use Cases for Capnography

Hospital-based or freestanding sleep laboratory
Clinical Application: Sleep studies
Standards/Recommendations for EtCO2, Monitoring: American Association for Sleep Medicine (AASM)*
Scoring manual requires monitoring of either transcutaneous PCO2 or end-tidal CO2 for pediatric sleep studies

Outpatient or ambulatory surgery centers; special procedures area
(e.g., cardiac catheterization lab, endoscopy)
Clinical Application: Procedural or conscious sedation – adequacy of ventilation
Standards/Recommendations for EtCO2, Monitoring: American Society of Anesthesiologists (ASA)
Standard of Basic Anesthetic Monitoring (updated 2011) Requires capnography during procedural sedation

General medical/surgical hospital ward
Clinical Application: Patient safety during patient controlled analgesia (PCA)
or continuous narcotic administration
Standards/Recommendations for EtCO2, Monitoring: The Joint Commission Sentinel Event Alert 2004
Recommends capnography monitoring for patients receiving opiates that can suppress respiration
Anesthesia Patient Safety Foundation (APSF)** Recommends continuous ventilation monitoring for all postoperative patients and patients receiving supplemental oxygen to mitigate the effects of opioid-induced respiratory depression

Emergency; crash cart
Clinical Application: Cardiopulmonary resuscitation – confirm endotracheal  tube placement,
determine effectiveness of chest compressions  (CPR) and detect Return of Spontaneous Circulation (ROSC)
Standards/Recommendations for EtCO2, Monitoring: American Heart Association (AHA) 2010 Guidelines
for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Recommend continuous waveform capnography during CPR on intubated patients

ICU, Emergency Department
Clinical Application: Airway management for all intubated  patients
Standards/Recommendations for EtCO2, Monitoring: Royal College of Anaesthetistsand Difficult Airway Society
studies, 2011***
Recommend capnography for all intubated patients

    * The AASM Manual for the Scoring of Sleep and Associated Events; Rules, Terminology and Technical Specifications
  ** APSF Essential Monitoring Strategies to Detect Clinically Significant Drug-Induces Respiratory Depression
      in the Postoperative Period, June 2011
*** Cook TM, Woodall N, Frerk C. British Journal of Anaesthesia 2011; 106(5):617-31 Cook TM, Woodall N, Harper J, Benger J. 
      British Journal of Anaesthesia 2011; 106(5)632-42

Capnographs provide accurate, first-breath EtCO2 value and waveform —
ideal for spot check and continuous EtCO2 monitoring.

Vital Care Products provides flexible and dependable vital sign and patient montoring solutions available in many configurations for applications including: Non-invasive blood pressure (NIBP), Cerebral Oximetry (StO2), Pulse Oximetry (SpO2), and Capnography (EtCO2).

 

Topics: Standards for EtCO2, Monitoring, Capnography, EtCO2, Vital Signs Monitoring

How does your cath lab handle radiation protection?

Posted by Jim Catherine on Thu, Sep 06, 2012 @ 12:52 PM

Radiation Protection for Cath LAb 

How does your cath lab handle radiation protection for physicians and staff?

Minimally invasive interventional procedures lower costs and risks for patients. Ironically, physicians put themselves at greater risk and pay a personal high price in radiation exposure multiple times every day.

ALL Fluoro-guided procedures produce scatter radiation
Some interventional procedures result in significantly more scatter radiation than others. Differentiating factors include: complexity of procedure, total fluoro time, size of patient, and operator proximity to the primary beam/image intensifier. All radiation doses are cumulative and multiple low-level procedures each day put doctors, nurses and techs in a potentially harmful situation. For this reason, clinically proven non-lead shields are available in a wide spectrum of protection levels, up to 95% at 90kVp to drastically reduce scatter radiation in every interventional procedure.

Start protecting your health, your team, and your career today with radiation protection products. Sterilenon-lead shields are placed on the patient to stop scatter radiation at the source. By standing in the "shade" created by the shield, the physician is able to reduce his exposure to radiation.

This product placement guide provides correct protection placement for cardiology / cath labs.

 Placement Guide for Cath Lab

SCAI presents a review, Radiation Safety Program for the Cardiac Catheterization Laboratory, as a practical best practice approach to radiation dose management in the setting of a comprehensive radiation safety program within the cardiac cath laboratory.

Count on Vital Care Products to follow industry trends, healthcare mandates and to identify and introduce vital, cost-effective, risk-reducing solutions that benefit patients and clinicians. For more information call 800 837 5511 or email sales@vitalcareproducts.com.

Topics: scatter radiation protection, ALARA, Scatter radiation, radiation safety, Flouro-guided, Cath Lab, Cardiology, Interventional Radiology

How to access enteral systems without opening lines.

Posted by Jim Catherine on Tue, Sep 04, 2012 @ 02:39 PM

 

Lopez Valve enteral feeding system


Maintain a closed system helping keep you and your patients safe.

Enteral valve technology allows access to enteral systems without opening the lines, protecting healthcare workers from exposure to gastric fluids, mucus membrane secretion, and bloodborne pathogens, such as HIV and Hepatitis C.

 Lopez Valve chart

The Lopez Valve® features clinically-proven stopcock technology that maintains a closed system throughout enteral feeding, drug administration, and suctioning procedures. Maintaining a closed system not only saves time by eliminating the use of nasogastric (NG) tube plugs and suction line connectors, but it also helps keep healthcare workers safe from accidental exposure to infectious bodily fluids.

Traditional methods of nasogastric therapies require the cumbersome manipulation of suction lines and NG tube plugs and wasted time before resuming suction. These traditional methods of NG therapies result in open systems that can expose healthcare workers to bodily fluids which may carry bloodborne pathogens.

The Lopez Valve utilizes stopcock technology to allow for the administration of medication with an NG syringe without having to disconnect a suction or feeding line. Not only does this system reduce the cumbersome process of suctioning NG drainage, but it also increases healthcare worker safety by limiting potential exposure to bloodborne pathogens.

About the Lopez Enteral Valve

Benefits:

+ Avoid unnecessary line manipulation and use of nasogastric (NG) tube plugs

+ Reduce exposure to potentially infectious blood or gastric secretions

+ Facilitates continuous gastric lavage

Materials:
The Lopez Valve is constructed out of four (4) components:

+ A polycarbonate valve body

+ A low linear density polyethylene valve core

+ A polyethylene cap

+ A vinyl adapter tube

Latex is not a component used in the manufacturing or packaging of the Lopez Valve. 

Sterility:
The Lopez Valve (IC-M9000), only $86.50 / case, is a non-sterile product.

The Lopez Valve with tethered cap (IC-M9000T), only $96.50 - / case is a sterile product.

The Lopez Valve can also be custom ordered as a sterile product (IC-M9000-s).

 

Count on Vital Care Products to follow industry trends, healthcare mandates and to identify and introduce vital, cost-effective, risk-reducing solutions that benefit patients and clinicians. For more information call 800 837 5511 or email sales@vitalcareproducts.com.

Topics: Lopez Valve, M9000, ICU Medical, enteral feeding system, enteral valve technology, access enteral systems, stopcock technology

10 Tips to Selecting the Right Professional Finger Pulse Oximeter

Posted by Jim Catherine on Tue, Jul 24, 2012 @ 12:45 PM

fingertip pulse oximeters

 

How do you know which finger pulse oximeter* is right for your use?

10 Tips to Selecting the Right Professional Finger Pulse Oximeter:

1. How accurate is the oximeter and are the accuracy claims backed by evidence, e.g., published papers?

2. Will the oximeter work on a variety of patients, and does your oximeter specifically list accuracy for patients 
    with low perfusion or dark skin tones?

3. Can the oximeter handle a rugged environment? Will it still work after multiple drops and exposure to liquids?

4. Will one device work for different patient size ranges, including very small pediatric up to large adult fingers,
    thumbs or toes
, or will you need to buy two separate oximeters?

5. Find out who offers the best warranty and has the best reputation for excellent customer service.

6. Where is the oximeter manufactured, and who will you call if you have a problem with your oximeter?

7. How long do you expect to use the oximeter? If your device doesn’t last, a lower upfront cost can result 
     in a higher cost
if you need to keep replacing it.

8. Does the oximeter require calibration?

9. Is the oximeter easy to use and does it have a bright LED display?

10. Is the oximeter lead free

 

Oximeter Comparison

A finger pulse oximeter is a valuable tool in any situation where a fast and accurate reading of blood oxygen saturation and pulse rates are needed. Finger pulse oximeters are intended for use by health professionals. Download this comparison chart to learn more about the durability, accuracy, and range of top finger pulse oximeters. 

 

Test In Motion

A study comparing performance of a Nonin Medical finger pulse oximeter with PureSAT® technology and a CHOICE MMED finger pulse oximeter was conducted at a leading hypoxia research laboratory in a challenging condition: motion. Performance was determined using an industry standard breathe-down protocol of induced hypoxia in thirteen subjects. SpO2 values are compared to the gold standard which is CO-oximetry analysis of arterial blood samples. Motion was generated using a mechanical fixture with tapping and rubbing. Download a summary of the study to see the results.  

 

Performance Comparison

Three finger pulse oximeters and one tabletop pulse oximeter were attached to a subject who was breathing for the first minute using a commercially available rebreather to induce hypoxia. The chart below illustrates that over the course of the test; only the Nonin Onyx and Nellcor pulse oximeters accurately tracked the subject’s desaturation down to 81-82% SpO2 and back up to 96% SpO2. See the Difference in this performance comparison video.

*A pulse oximeter is a noninvasive medical device used for measuring a patient’s oxygen level in the blood and pulse rate. These are important vital signs, and accurate readings are crucial.

Count on Vital Care Products to follow industry trends, healthcare mandates and to identify and introduce vital, cost-effective, risk-reducing solutions that benefit patients and clinicians. For more information call 800 837 5511 or email sales@vitalcareproducts.com.

Topics: pulse rate, questions to ask before buying, Finger Pulse Oximeter Comparison, blood oxygen saturation

What is pulse oximetry and how does it work?

Posted by Jim Catherine on Wed, Jul 11, 2012 @ 03:39 PM

fingertip pulse oximeters

What is pulse oximetry and how does it work?

Pulse oximetry is a noninvasive method that enables rapid measurement of the oxygen saturation of hemoglobin in arterial blood.1 It can rapidly detect changes in oxygen saturation, thus providing an early warning of dangerous hypoxemia.2, 3

How it works: A pulse oximeter (like the Nonin GO2) shines light at two wavelengths—red and infrared—through a part of the body that is relatively translucent and has good arterial pulsed blood flow (e.g., finger, toe, earlobe). The ratio of red to infrared light that passes through the measurement site and is received by the oximeter’s detector depends on the percentage of oxygenated versus deoxygenated hemoglobin through which the light passes.2 The percentage of oxygen saturation thus calculated is referred to as the percent SpO2.3

An SpO2 of greater than 95% is generally considered to be normal.
An SpO2 of 92% or less (at sea level) suggests hypoxemia.

By using a finger pulse oximeter you get an accurate, almost instant indication for whether you can continue on with your activity or if you need to take a break or consider contacting your physician. It gives you or your loved one the confidence to continue the life you want to lead with objective and highly accurate information, that way you don’t have to rely solely on subjective symptoms to determine blood oxygen levels.

Building up strength is important - and that requires activity. A personal finger pulse oximeter was designed so that individuals can monitor their pulse rate and oxygen saturation rate wherever they go. It is ideally suited to help individuals manage their own chronic respiratory disease or that of their loved one.

Chronic Obstructive Pulmonary Disease, commonly known as COPD, is the most common lung disease marked with difficulty breathing, chronic bronchitis and emphysema being the two main components. Nonin Medical is the inventor of the world’s first fingertip and wireless pulse oximeter called the GO2™. Nonin has done extensive research with patients and their caregivers and understands the desire to continue to live a normal and full life with a diagnosis of COPD.

To learn more about Staying active with COPD, view a video excerpt from Lifetime TV's The Balancing Act, Maintaining An Active Lifestyle and Ensure The Most Accurate Oximeter.

1. Neuman MR. 1987. Pulse oximetry: physical principles, technical realization and present limitations. Adv Exp Med Biol 220:135-44.
2. National Health Service (UK) Center for Evidence-based Purchasing. 2009. Project initiation document: Pulse oximeters.
3. Holmes S, and SJ Peffers. 2009. PCRS-UK Opinion Sheet No. 28: Pulse Oximetry in Primary Care. www.pcrs-uk.org.

Topics: pulse oximetry, finger pulse oximeter, oxygen saturation, SpO2, hypoxemia, blood oxygen levels, pulse rate, Chronic Obstructive Pulmonary Disease, COPD

The Value of Cerebral Oximetry in Different Clinical Settings

Posted by Jim Catherine on Fri, Jul 06, 2012 @ 01:29 PM

cerebral oximetry

 

Absolute News is now available.

We invite you to read the articles and testimonials included in this issue that emphasize the value of FORE-SIGHT Absolute Tissue Oximetry in different clinical settings:

Absolute News           

 “Cerebral Oximetry Monitoring During Transcatheter Aortic Valve Implantation (TAVI)” describes the use of FORE-SIGHT during the critical steps of the TAVI procedure empowering clinicians to protect the brain from inadequate perfusion.

A summary of the abstract “NIRS abdominal somatic tissue oxygen saturation validation model for neonates ≤ 4 kg” presented at the 2012 PAS introducing the clinical validation of the new FORE-SIGHT’s neonatal abdominal indication. A testimonial from the lead investigator highlighting the unparalleled non-invasive actionable accuracy of FORE-SIGHT reinforces this new application: 

 “… Clinicians now have a non-invasive and reliable monitoring solution that provides absolute oximetry values to guide clinical intervention… Our data confirmed the accuracy of FORE-SIGHT… and showed a standard deviation of just +/- 5%...this level of quantitative accuracy is a meaningful milestone in the advancement of tissue oximetry as a critical tool in the care of newborns.” 

Two key opinion leaders from the NorthShore University Health Systems (Evanston Hospital, IL) shared their experiences on how FORE-SIGHT allowed them to detect otherwise unnoticed cerebral desaturation events  and individualize care management to each patient’s needs.

The FORE-SIGHT – “A Global Perspective” Section contains an Italian clinical study on patients undergoing Carotid Endarterectomy (CEA) showing:

“The routine use of FORE-SIGHT oximetry as guidance for optimal tissue perfusion could reduce the incidence of adverse events, alerting clinicians to an otherwise unrecognized adverse event and allowing the surgeon to make the right procedure, as appropriate, without delay”.

Gain an expert opinion on the clinical validation of cerebral oximetry. View a video excerpt from the "Current Status Of Cerebral Oximetry" lecture by Dr. Gregory W. Fischer during EACTA 2011, Vienna Austria.

What are your peers saying? Download clinical summaries of recent studies involving cerebral oximetry and other NIRS devices.

Topics: cerebral oximetry, Absolute Newsletter, absolute tissue oximetry, transcatheter aortic valve implantation, TAVI, tissue oxygen saturation, FORE-SIGHT, cerebral tissue oxygen, arterial blood saturation, Absolute News

How does cerebral oximetry differ from pulse oximetry?

Posted by Jim Catherine on Wed, May 02, 2012 @ 11:39 AM

vital signs monitoring systems

How does cerebral oximetry differ from pulse oximetry?

Cerebral tissue oxygen saturation values are comprised of a mix of arterial (~30%) and venous (~70%) blood. Pulse oximeters monitor only arterial blood saturation values from peripheral tissue (oxygen supply).*

Cerebral oximeters measure the balance of cerebral tissue oxygen supply to cerebral tissue oxygen demand in the brain, giving the clinician a better indication of the patient's actual cerebral tissue oxygen saturation status. Cerebral Oximetry provides clinically relevant, absolute measurements that clearly indicate a patient’s cerebral tissue oxygen saturation status. This vital information enables clinicians to identify and react to instances of lowered brain oxygen saturation before the situation becomes critical.

Cerebral Oximeters can also monitor cerebral tissue oxygen saturation values during low perfusion situations, and in cases in which there is no pulsatile flow - such as deep hypothermic circulatory arrest. Pulse oximetry requires pulsatile flow to operate.

Gain an expert opinion on the clinical validation of cerebral oximetry. Click here to view an excerpt from the "Current Status Of Cerebral Oximetry" lecture by Dr. Gregory W. Fischer during EACTA 2011, Vienna Austria

Download clinical summaries of recent studies involving cerebral oximetry and other NIRS devices.

*Webster JG, Design of Pulse Oximeters, IOP Publishing Ltd 1999

Topics: cerebral oximetry, pulse oximetry