By, Dr Kadiyali M Srivatsa, CEO, Medifix Limited, 3000, Cathedral Hill, Guildford, Surrey, GU2 7YB, UK
When a patient is admitted to hospital in an emergency it is common practice to insert a cannula to allow easy introduction of blood, fluids and medication. However before much-needed treatment can be given doctors often need to wait for the results of blood tests.
Under pressure unnecessary blood tests are often requested. Liver function, urea and electrolytes, haemoglobin, differential count and erythrocyte sediment tests are frequently carried out when they are not needed. In the process several disposable
devices are used, including syringes, blood collecting bottles and phlebotomy needles. This is a waste of valuable resources, not to mention time at a moment when every second counts.
The doctors at Medifix, inventors of the cannula-introducing device, the U-Cann™, have come up with a potential solution. By incorporating blood-testing strips into the collecting chamber of the device venous access and blood testing could be carried
out simultaneously. Strips are currently available to test for blood sugar, acidity, urea, sodium, potassium, ammonia and bilirubin levels as well as the presence of drugs and bacteria. Test strips to check levels of thyroxin and other hormones are undergoing trial.
Using these strips to carry out blood tests immediately upon admission could make a real difference to the prognosis for an acutely ill patient. Doctors would be able to work out the right treatment to use more quickly, saving time and saving lives. And
of course using one piece of equipment rather than several reduces waste, good for the environment and the budget.
How it works
When the tip of the cannula needle enters the blood vessel, blood flows into U-Cann TS™ collection blood in the chamber (flashback), indicating needle entry into the vein. This is the signal to start retracting the knob of U-Cann™, introducing the cannula into the blood vessel. A test strip placed in the blood chamber would absorb the blood, automatically carrying out crucial tests indicated by changing colors.
There are many benefits associated with the new technique:
· The huge amount of disposable equipment currently used for blood collection and testing has a serious environmental impact. The equipment cannot be recycled for hygiene reasons and has to be destroyed.
· The expensive blood analysis equipment used in the UK, the USA and Europe make the cost of providing emergency treatment very high. Developing nations cannot afford this equipment, leaving doctors to rely on instinct. This blind treatment can be dangerous for patients. For example a child may be suffering from fits due to high or low blood glucose. If the medical team could establish this on spot appropriate treatment could begin immediately, preventing brain damage or even death.
· As the cannula is already in place in the blood vessel appropriate treatment can begin as soon as the results are known. This is likely to have a positive impact on the outcome.
· In an emergency, traditional blood collection can add to the distress of an already traumatised patient. Using U-Cann TS™ for blood collection and testing
· as well as venous access would avoid this.
· Each puncture of the skin presents an opportunity for skin commensal to enter the bloodstream, which could lead to MRSA or other serious infections. Using U-Cann TS™ for blood collection as well as introduction of fluids and medication results in a single puncture.
· U-Cann TS™ needle-tip is covered by a needle guard, eliminating accidental needlestick injuries. Conversely the needles traditionally used for collecting blood for testing are not protected, again presenting an increased risk.
· Reducing the use of unguarded needles is particularly important during the management of critically ill patients. Doctors and nurses under pressure may neglect to safely dispose of used needles, exposing themselves and others to a risk of being pricked by a contaminated needle. The delicate glass collecting containers and capillaries currently used in phlebotomy may also cause injuries if they break, which is obviously more likely when speed is of the essence.
Having worked in critical care for almost thirty years we, the Medifix team, have seen many of the negative impacts of traditional blood testing techniques first hand.
We believe it is time to learn from our experience and rationalise the standard procedures, reducing waste, cutting costs and improving the safety of staff and the outcome of treatment for patients.
2005© Dr Kadiyali M Srivatsa