PARADIGM BYTES
Newsletter for Paradigm 97
December 20, 2013
PARADIGM DEFINED:1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.
Our website...... http://paradigm97.blogspot.com/Please copy, paste, and bookmark it.
MISSION STATEMENT
Our website...... http://paradigm97.blogspot.com/Please copy, paste, and bookmark it.
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPETS
Tracheostomy care: An evidence-based guide to suctioning and dressing changes (Permission granted by American Nurse to have the full article here)
Tracheostomy care and tracheal suctioning are high-risk procedures. To avoid poor outcomes, nurses who perform them—whether they’re seasoned veterans or novices—must adhere to evidence-based guidelines. In fact, experienced nurses may overestimate their own trach care competence.
Tracheostomy patients aren’t seen only in intensive care units. As patients with more complex conditions are admitted to hospitals, an increasing number are being housed on general nursing units. Trach patients are at high risk for airway obstruction, impaired ventilation, and infection as well as other lethal complications. Skilled bedside nursing care can prevent these complications. This article describes evidence-based guidelines for tracheostomy care, focusing on open and closed suctioning and site care.
Suctioning a trach tube
A trach tube may have a single or double lumen; it may be cuffed or uncuffed, fenestrated (allowing speech) or unfenestrated. Each variation requires specific management. For instance, before suctioning a fenestrated tube, you must insert a plain inner tube, because a suction catheter may puncture the small opening of the fenestrated tube. (See Trach tube positioning by clicking the PDF icon above.)
Regardless of the type of tube used, suctioning always involves:
- assessment
- oxygenation management
- use of correct suction pressure
- liquefying secretions
- using the proper-size suction catheter and insertion distance
- appropriate patient positioning
- evaluation.
Also, be sure to keep emergency equipment nearby. (See Be prepared for trach emergencies by clicking the PDF icon above.)
When to suction
Suctioning is done only for patients who can’t clear their own airways. Its timing should be tailored to each patient rather than performed on a set schedule.
Start with a complete assessment. Findings that suggest the need for suctioning include increased work of breathing, changes in respiratory rate, decreased oxygen saturation, copious secretions, wheezing, and the patient’s unsuccessful attempts to clear secretions. According to one researcher, fine crackles in the lung bases indicate excessive fluid in the lungs, and wheezing patients should be assessed for a history of asthma and allergies.
Suctioning technique
Before suctioning, hyperoxygenate the patient. Ask a spontaneously breathing patient to take two to three deep breaths; then administer four to six compressions with a manual ventilator bag. With a ventilator patient, activate the hyperoxygenation button.
Experts recommend using suction pressure of up to 120 mm Hg for open-system suctioning and up to 160 mm Hg for closed-system suctioning. For each session, limit suctioning to a maximum of three catheter passes. During catheter extraction, suctioning can last up to 10 seconds; allow 20 to 30 seconds between passes.
For open-system suctioning, catheter size shouldn’t exceed half the inner diameter of the internal trach tube. To determine the appropriate-size French catheter, divide the internal trach tube size by two and multiply this number by three.
A #12 French catheter is routinely used for closed suctioning. Premeasure the distance needed for insertion. Experts suggest 0.5 to 1 cm past the distal end of the tube for an open system, and 1 to 2 cm past the distal end for a closed system.
Liquefying secretions
The best ways to liquefy secretions are to humidify secretions and hydrate the patient. Do not use normal saline solution (NSS) or normal saline bullets routinely to loosen tracheal secretions because this practice:
- may reach only limited areas
- may flush particles into the lower respiratory tract
- may lead to decreased postsuctioning oxygen saturation
- increases bacterial colonization
- damages bronchial surfactant.
Despite the potential harm caused by NSS use, one survey found that 33% of nurses and respiratory therapists still use NSS before suctioning. Other researchers have found that inhalation of nebulized fluid also is ineffective in liquefying secretions.
Evaluation
When evaluating the patient after suctioning, assess and document physiologic and psychological responses to the procedure. Convey your findings verbally during nurseto-nurse shift report and to the interdisciplinary team during daily rounds.
Trach site care and dressing changes
Tracheostomy dressing changes promote skin integrity and help prevent infection at the stoma site and in the respiratory system. Typically, healthcare facilities have both formal and informal policies that address dressing changes, although no evidence suggests a particular schedule of dressing changes or specific supplies for secretion absorption must be used. On the other hand, the evidencedoes show that:
- secretions can cause maceration and excoriation at the site
- the site should be cleaned with NSS
- a skin barrier should be applied to the site after cleaning
- loose fibers increase the infection risk
- the trach tube should be secured at all times to prevent accidental dislodgment, using the two-person securing technique described below under "Securing the trach tube."
Start by assessing the stoma for infection and skin breakdown caused by flange pressure. Then clean the stoma with a gauze square or other nonfraying material moistened with NSS. Start at the 12 o’clock position of the stoma and wipe toward the 3 o’clock position. Begin again with a new gauze square at 12 o’clock and clean toward 9 o’clock.
To clean the lower half of the site, start at the 3 o’clock position and clean toward 6 o’clock; then wipe from 9 o’clock to 6 o’clock, using a clean moistened gauze square for each wipe. Continue this pattern on the surrounding skin and tube flange.
Avoid using a hydrogen peroxide mixture unless the site is infected, as it can impair healing. If using it on an infected site, be sure to rinse afterward with NSS.
Dressing the site
At least once per shift, apply a new dressing to the stoma site to absorb secretions and insulate the skin. After applying a skin barrier, apply either a split-drain or a foam dressing. Change a wet dressing immediately.
Securing the trach tube
Use cotton string ties or a Velcro holder to secure the trach tube. Velcro tends to be more comfortable than ties, which may cut into the patient’s neck; also, it’s easier to apply.
The literature overwhelmingly recommends a twoperson technique when changing the securing device to prevent tube dislodgment. In the two-person technique, one person holds the trach tube in place while the other changes the securing device.
Review trach tube policy and procedures
To achieve positive outcomes in patients with trach tubes, keep abreast of best practices and develop and maintain the necessary skills. Every nurse who performs trach care needs to be familiar with facility policy and procedure on trach tube care. If your facility’s current policy and procedures don’t support evidencebased practice, consider urging colleagues and managers to conduct a patient-care study comparing different approaches to suctioning. Then follow the evidence by advocating for changes if necessary.
Selected references
Chulay M. Suctioning: endotracheal or tracheostomy tube. In: Wiegand DJ, Carlson KK, eds. AACN Procedure Manual for Critical Care. 6th ed. Philadelphia, PA: Elsevier Saunders; 2010:62-70.
Dennis-Rouse MD, Davidson JE. An evidence-based evaluation of tracheostomy care practices. Crit Care Nurs Q. 2008;31(2):150-160.
Edgtton-Winn M, Wright K. Tracheostomy: a guide to nursing care. Aust Nurs J. 2005;13(5):1-4.
Harkreader H, Hogan MA, Thobaben M. Fundamentals of Nursing: Caring and Clinical Judgment. 3rd ed. Philadelphia, PA: Saunders; 2007.
Klockare M, Dufva A, Danielsson AM, et al. Comparison between direct humidification and nebulization of the respiratory tract at mechanical ventilation: distribution of saline solution studied by gamma camera. J Clin Nurs. 2006;15(3):301-307.
Kuriakose A. Using the Synergy Model as best practice in endotracheal tube suctioning of critically ill patients. Dimens Crit Care Nurs. 2008;27(1):10-15.
Lewis SL, Dirksen SR, Heitkemper MM, Bucher L, Camera I. Medical-Surgical Nursing: Assessment and Management of Clinical Problems. 8th ed. St. Louis, MO: Mosby; 2010.
Smith-Miller C. Graduate nurses’ comfort and knowledge level regarding tracheostomy care. J Nurses Staff Dev. 2006;22(5):222-229.
Wiegand DJ, Carlson KK, eds. AACN Procedure Manual for Critical Care. 6th ed. Philadelphia, PA: Elsevier Sauders; 2010.
Betty Nance-Floyd is a clinical assistant professor at the University of North Carolina at Chapel Hill School of Nursing.
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FROM THE MEMBERS
This was sent to me by Laregis (Laura)...check with her if you have any questions: Laregis@AOL.com..
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This was sent in by MarGerlach@AOL.com, who writes: This is really interesting and could be lifesaving info for everyone.
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(Thank you, Barbara for this article -- BAcello)
When Heather Dougherty heard the news last week that the Food and Drug Administration had recommended tightening how doctors prescribed the most commonly used narcotic painkillers, she was overjoyed. Fourteen years earlier, her father, Dr. Ronald J. Dougherty, had filed a formal petition urging federal officials to crack down on the drugs.
< snip>
On Friday, public health advocates who had cheered the agency’s decision the day before were dismayed when the F.D.A. approved a new, high-potency painkiller despite an 11-2 vote by an expert panel of its
own advisers not to do so. The panel concluded in December that the long-acting opioid, called Zohydro, could lead to the same type of abuse and addiction as OxyContin.
A top F.D.A. official, Dr. Douglas Throckmorton, said Zohydro would give doctors another drug to treat long term pain. But Representative Harold Rogers, Republican of Kentucky, said on Friday that top F.D.A.
officials had recently assured him they would only approve new opioids like Zohydro if they were marketed in formulations intended to deter abuse. OxyContin is now formulated that way, but Zohydro, which contains hydrocodone without acetaminophen, is not. Its producer, Zogenix, says it will closely monitor use of the drug.
http://tinyurl.com/FDA-shift
< snip>
On Friday, public health advocates who had cheered the agency’s decision the day before were dismayed when the F.D.A. approved a new, high-potency painkiller despite an 11-2 vote by an expert panel of its
own advisers not to do so. The panel concluded in December that the long-acting opioid, called Zohydro, could lead to the same type of abuse and addiction as OxyContin.
A top F.D.A. official, Dr. Douglas Throckmorton, said Zohydro would give doctors another drug to treat long term pain. But Representative Harold Rogers, Republican of Kentucky, said on Friday that top F.D.A.
officials had recently assured him they would only approve new opioids like Zohydro if they were marketed in formulations intended to deter abuse. OxyContin is now formulated that way, but Zohydro, which contains hydrocodone without acetaminophen, is not. Its producer, Zogenix, says it will closely monitor use of the drug.
http://tinyurl.com/FDA-shift
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Welcome to winter...almost. This Saturday is the winter solstice which not only is the shortest day and the longest night of the year, but also marks the first day of winter.
RANDOM FACT:
On the winter solstice the sun appears at its lowest point in the sky, and its noontime elevation appears to be the same for several days before and after the solstice. Hence the origin of the word solstice, which comes from Latin solstitium, from sol, "sun" and -stitium, "a stoppage." Following the winter solstice, the days begin to grow longer and the nights shorter.
RANDOM FACT:
On the winter solstice the sun appears at its lowest point in the sky, and its noontime elevation appears to be the same for several days before and after the solstice. Hence the origin of the word solstice, which comes from Latin solstitium, from sol, "sun" and -stitium, "a stoppage." Following the winter solstice, the days begin to grow longer and the nights shorter.
Bonus Fact:
The reason for the different seasons at opposite times of the year in the two hemispheres is that while the earth rotates about the sun, it also spins on its axis, which is tilted some 23.5 degrees. Because of this tilt, the Northern Hemisphere receives less direct sunlight (creating winter) while the Southern Hemisphere receives more direct sunlight (creating summer). As the Earth continues its orbit the hemisphere that is angled closest to the sun changes and the seasons are reversed.
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Facts About Mistletoe Mistletoe is part of the Christmas tradition for many people, but how many of us really know anything about mistletoe? We all know about sneaking a kiss under that sprig of mistletoe, but did you know mistletoe is actually a parasite? Here are five "fun" facts about mistletoe you can impress your friends with...or maybe not. ...
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Sleep is a universal characteristic of complex living organisms and has been observed in insects, mollusks, fish, amphibians, birds, and mammals. In fact, sleep is so important that humans can survive longer without food than they can without sleep.
RANDOM FACT: During sleep, the brain "consolidates" memories and skills, meaning that the brain strengthens, reorganizes, and restructures memories during sleep.
RANDOM FACT: During sleep, the brain "consolidates" memories and skills, meaning that the brain strengthens, reorganizes, and restructures memories during sleep.
Bonus Fact: REM atonia, or sleep paralysis, occurs in the typical sleeper every night to prevent people from acting out their dreams. Only a few muscles have the ability to move during REM sleep, such as the eye muscles, the auditory muscles, and the diaphragm for respiration.
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Central lines: Recognizing, preventing, and troubleshooting complications
Central lines can save lives. But dangerous complications can occur unless caregivers know how to identify, prevent, and solve potential problems.
To promote positive outcomes, clinicians caring for patients with central lines must monitor carefully for signs and symptoms of complications. This article discusses potential complications—catheter occlusion, bleeding and hematoma, catheter-tip migration, catheter rupture, phlebitis and associated pain, swelling and deep vein thrombosis (DVT), infection, and embolism. It also provides assessment, prevention, and troubleshooting tips for central lines.
Catheter occlusions: A catheter occlusion occurs when a blockage prevents caregivers from flushing the central line or aspirating blood. An occlusion can be thrombotic or nonthrombotic (not caused by a thrombus). About 40% to 50% of occlusions are nonthrombotic and result from mechanical or postural factors, medication precipitate, catheter malpositioning, or undesirable catheter-tip location.
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RANDOM TIDBIT: On December 17, 1843 (170 years ago), Charles Dicken's holiday classic, A Christmas Carol, was published.
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Monster Mash: Protein Folding Gone Wrong .
Imagine a 1950s horror movie monster—a creeping, gelatinous, gluey tangle of gunk that strangles everything around it. That’s what amyloid plaques are like when they form in body tissues. These gooey protein clumps are associated with many chronic and debilitating disorders, including type 2 diabetes and neurodegenerative diseases like Parkinson’s and Huntington’s.
Amyloid plaques were a mystery for many years. The German physician Alois Alzheimer first noticed them in the early 1900s in the brain of a deceased patient who had experienced a peculiar form of memory loss and mood swings—symptoms of the disease that now bears his name. A few decades ago, scientists determined the basic structure of the plaques. Since then, researchers, many funded by the National Institutes of Health, have made enormous strides in understanding how these structures play roles in disease. ...
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New Batch of Alzheimer's Genes Discovered
Researchers report they have pinpointed 11 new genes linked to late-onset Alzheimer's disease, doubling the number of potential targets for drug development.
The international team of scientists analyzed genetic data from more than 25,500 Alzheimer's patients and more than 49,000 people without the memory-robbing disease in 15 countries.
Along with adding 11 new genes to those already known to be associated with Alzheimer's, the researchers identified 13 other genes that require further investigation, according to the study published Oct. 27 in the journal Nature Genetics.
The findings provide a wider view of the genetic factors that contribute to Alzheimer's and increases the understanding of the disease to new areas. This includes the immune system, where a genetic overlap with other neurodegenerative diseases, including multiple sclerosis and Parkinson's, was identified.
"The discovery of [new] pathways is very encouraging, considering the limited success of Alzheimer's disease drugs tested so far," Margaret Pericak-Vance, director of the Institute for Human Genomics at the University of Miami Miller School of Medicine, said in a school news release. ...
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If you haven't followed Truth about Nursing, now is the time to start. I couldn't have all the news from this article in the Newsletter, so feel free to read all the article below:
Awards for Best and Worst Media Depictions of 2012
The Truth About Nursing announces our 10th annual list of the best and worst media portrayals of nurses! We're sorry to be a bit late, but we wanted to let you know about these notable depictions. https://www.truthaboutnursing.org/
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| Quiz Time |
Which advice about incident reports is correct?
a. Give a copy of the incident report to the patient.
b. File incident reports 24 hours after the episode.
c. File incident reports promptly.
d. Document in the patient record that you filed an incident report.
See answer at end of Newsletter.
|
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RANDOM TIDBIT: Mr. Potato Head, the first toy to be advertised on television (in 1952), received four write-in votes in the mayoral election in Boise, Idaho, in 1985. (Let's do it again )!!
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Hospitalized but Not Admitted: Characteristics of Patients With “Observation Status” at an Academic Medical Center
ImportanceThe Centers for Medicare & Medicaid Services (CMS) defines observation status for hospitalized patients as a “well-defined set of specific, clinically appropriate services,” usually lasting less than 24 hours, and that in “only rare and exceptional cases” should last more than 48 hours. Although an increasing proportion of observation care occurs on hospital wards, studies of patients with observation status have focused on the efficiency of dedicated units.
ObjectiveTo describe inpatient and observation care.
Design and SettingDescriptive study of all inpatient and observation stays between July 1, 2010, and December 31, 2011, at the University of Wisconsin Hospital and Clinics, a 566-bed tertiary academic medical center. ...
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Word Origins: Agnes -- Now somewhat old-fashioned, the name "Agnes" comes from the Greek word hagne, meaning "blessed" or "holy." For that reason the name has traditionally been popular as a confirmation name, as well as an adopted name for women entering holy orders.
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December 2-6 is Older Driver Safety Awareness Week.
Here are some facts about older drivers:
33 million:
Number of licensed drivers age 65 and older in the U.S.
Number of licensed drivers age 65 and older in the U.S.
500:
Average number of older adults injured in crashes every day
Average number of older adults injured in crashes every day
75:
Age at which fatal crash rates start increasing, with notable increases occurring after age 80
Age at which fatal crash rates start increasing, with notable increases occurring after age 80
5,500:
More than 5,500 older adults were killed in motor vehicle crashes in 2008.
More than 5,500 older adults were killed in motor vehicle crashes in 2008.
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NIH scientists develop candidate vaccine against respiratory syncytial virus
An experimental vaccine to protect against respiratory syncytial virus (RSV), a leading cause of illness and hospitalization among very young children, elicited high levels of RSV-specific antibodies when tested in animals, according to a report in the journal Science.
Early-stage human clinical trials of the candidate vaccine are planned. Scientists from the Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, built on their previous findings about the structure of a critical viral protein to design the vaccine. The team was led by Peter D. Kwong, Ph.D., and Barney S. Graham, M.D., Ph.D.
In the United States, RSV infection is the most common cause of bronchiolitis (inflammation of small airways in the lungs) and pneumonia in children less than one year old and the most common cause for hospitalization in children under five. Worldwide, it is estimated that RSV is responsible for nearly 7 percent of deaths in babies aged 1 month to 1 year; only malaria kills more children in this age group. Others at risk for severe disease following RSV infection include adults over age 65 and those with compromised immune systems. ...
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HINTS
A recent research shows that almost 50% of reusable grocery bags, contain illness-causing germs. Wash them weekly with hot water, and wash those germs away.
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For the smoothest legs post shaving Replace your shaving cream with olive oil. Like shaving cream, the oil creates a barrier between your skin and the blade. But unlike shaving cream, the oil nourishes your skin, for a super-soft texture.
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For the smoothest legs post shaving Replace your shaving cream with olive oil. Like shaving cream, the oil creates a barrier between your skin and the blade. But unlike shaving cream, the oil nourishes your skin, for a super-soft texture.
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A natural alternative to chemical bathroom cleansers Combine equal parts of kosher salt and baking soda. Add enough lemon juice to make a paste, then use it to scrub the bathroom tiles. The acids in the lemon juice will break down the grime, while the salt and baking soda will buff it away.
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Have a bumper sticker you just can't get off? Try this...
Bumper stickers are easy to remove without any scraping which could scratch your car's finish. Simply rub mayonnaise over the entire sticker and let sit for 15 - 10 minutes. The mayonnaise will help dissolve the glue, so you can peel it right off!
Bumper stickers are easy to remove without any scraping which could scratch your car's finish. Simply rub mayonnaise over the entire sticker and let sit for 15 - 10 minutes. The mayonnaise will help dissolve the glue, so you can peel it right off!
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Word Origins: Campbell's -- Born in 1817 to Scottish immigrant parents, Joseph A. Cambell went into the grocery business in the Philadelphia area as a young man. In 1869, he developed a line of preserves and canned goods, including several kinds of soup. One of his employees, a chemist named Arthur Dorrance, bought the company from Cambell's heirs and kept the family name while changing Joseph A. Campbell & Co. to Campbell Soup Company, now familiarly known as "Campbell's."
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NURSES RETAIN TOP SPOT AS MOST ETHICAL PROFESSION
SILVER SPRING, MD —
SILVER SPRING, MD —
The public continues to rate nurses as the most
trusted profession, according to this year’s Gallup survey that ranks
professions based on their honesty and ethical standards.
trusted profession, according to this year’s Gallup survey that ranks
professions based on their honesty and ethical standards.
/Nurses-Most-Ethical-Profession.pdf
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HUMOR SECTION
A woman in a supermarket is following a grandfather and his badly behaved 3 year-old grandson. It's obvious to her that he has his hands full with the child screaming for sweets, biscuits, you name it. Meanwhile, Grandpa is working his way around, saying in a controlled voice, "Easy William, we won't be long . . . easy, boy."
Another outburst and she hears the grandpa calmly say, "It's okay, William, just a couple more
minutes and we'll be out of here. Hang in there, boy"
Another outburst and she hears the grandpa calmly say, "It's okay, William, just a couple more
minutes and we'll be out of here. Hang in there, boy"
At the checkout, the little terror is throwing items out of the cart and Grandpa says again in a controlled voice, "William, William, relax buddy, don't get upset. We'll be home in five minutes, stay cool, William."
Very impressed, the woman goes outside where the grandfather is loading his groceries and the boy into the car. She says to the elderly man, "It's none of my business, but you were amazing in there. I don't know how you did it. That whole time you kept your composure, and no matter how loud and disruptive he got, you just calmly kept saying 'things would be okay. 'William is very lucky to have you as his grandpa."
Very impressed, the woman goes outside where the grandfather is loading his groceries and the boy into the car. She says to the elderly man, "It's none of my business, but you were amazing in there. I don't know how you did it. That whole time you kept your composure, and no matter how loud and disruptive he got, you just calmly kept saying 'things would be okay. 'William is very lucky to have you as his grandpa."
"Thanks," said the grandpa, "but I'm William. The little sh*t's name is Kevin."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Detecting, managing, and preventing pulmonary embolism
(I would have loved to make this a SNIPPET article, but can not. PLEASE read the entire article even if you decide not to take the test ! )
Pulmonary embolism (PE) occurs when a pulmonary artery becomes blocked—usually by a blood clot that has broken free from its site of origin and embolized or migrated to the lungs. If misdiagnosed, unrecognized, or untreated, PE can cause death quickly—within just an hour. It’s fatal in up to 26% of cases.
Massive PE, defined as causing 50% or more occlusion of the pulmonary capillary bed, can result in obstructive shock with systemic hypoperfusion (low cardiac output and acute pulmonary hypertension with right ventricular failure). It must be remedied immediately to save the patient’s life.
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Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow me on Twitter as Dr Robert Hess.
Please follow me on Twitter as Dr Robert Hess.
Pay Only $34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !
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WEBSITES/ LINKS
This is an excellent nursing site, check it out:http://nursingpub.com/
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance
info@sharedgovernance.orgwww.sharedgovernance.org
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Metric conversion calculators and tables for metric conversions
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MEDICAL RECALLS
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Nitroglycerin in 5% Dextrose Injection by Baxter: Recall - Particulate Matter
Baxter’s Nitroglycerin in 5% Dextrose Injection is packaged in 250 mL glass containers, with 12 glass containers per carton. The affected product code is 1A0694, and the affected lot number is G105197. Product affected by this recall was distributed to healthcare centers and distributors in Colombia, Saudi Arabia and the United States.
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Perrigo Acetaminophen Infant Suspension Liquid: Recall - Potential Defect with Co-packaged Oral Syringe
The Perrigo Company announced that it has initiated a voluntary, nationwide product recall to the retail level of 18 batches of its acetaminophen infant suspension liquid, 160 mg/5 mL, sold in 2 oz. and 4 oz. bottles with syringes in a box under store brand products including Babies R Us, Care One and more (refer to the Firm Press Release for full list of affected brand names and products).
The recall is being initiated because of the remote potential that a small number of packages might contain an oral dosing syringe without dose markings. Using an oral syringe without dose markings can result in inaccurate dosing, especially in infants who could mistakenly get too high a dose.
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Draeger Medical Fabius Series Anesthesia Machines - Failure of Automatic Ventilation
Recall Class: Class I
Date Recall Initiated: August 14, 2013
Products:
- Fabius GS Premium Anesthesia Machines
- Fabius OS Anesthesia Machines
- Fabius Tiro Anesthesia Machines
- Fabius Tiro D-M Anesthesia Machines
To locate product codes and lot numbers of affected products, refer to FDA’s Class I Recall.
The affected products were manufactured from February 1, 2013 to May 1, 2013 and distributed from March 1, 2013 to June 1, 2013.
Use: The Draeger Fabius GS Premium, Fabius OS, Fabius Tiro, and Fabius Tiro D-M anesthesia machines are used to administer anesthesia and ventilation to patients during surgical procedures.
Recalling Firm:
Draeger Medical, Inc.
3135 Quarry Rd
Telford, Pennsylvania 18969
Draeger Medical, Inc.
3135 Quarry Rd
Telford, Pennsylvania 18969
Reason for Recall:
The minimum specified clearance between an electrical component and the unit housing was not maintained for some devices. As a result, bypass current flowing in the interior of the unit may cause the automatic ventilation function of the device to fail.
The minimum specified clearance between an electrical component and the unit housing was not maintained for some devices. As a result, bypass current flowing in the interior of the unit may cause the automatic ventilation function of the device to fail.
The failure of this device may cause serious adverse health consequences, including death or injury caused by device failure to ventilate.
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........AccuRuler: Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accuruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
janie.avery@att.net (Janie) December 3, 2013
MKFiveash@windstream.net (Myrac) December 16, 2013
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address. So, be certain to let me know when you change your address. RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
We have created a manic world nauseous with the pursuit of material wealth. Many also bear their cross of imagined deprivation, while their fellow human beings remain paralyzed by real poverty. We drown in the thick sweetness of our sensual excess, and our shameless opulence, while our discontent souls suffocate in the arid wasteland of spiritual deprivation.
--Anthony St. Maarten
Correct answer: c. Incident reports for deviations should be filed promptly. Don’t record in the patient record that an incident report was filed.
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