Post00240 INJECTION SAFETY 07 April 2000
CONTENTS
1. FIELD EVALUATION OF VACCINATION MATÉ’IEL: REPORT
2. UNIVEC CONTACT INFORMATION
3. LAUNCH OF AUTODISABLE SYRINGE WEB SITE
- FIELD EVALUATION OF VACCINATION MATÉ’IEL: REPORT
Technologies have been developed as our responses to identified field needs
and problems at the front line of service delivery. Usually these
technologies are evaluated in fairly controlled field introductions.
Infrequently evaluations are conducted in real health delivery situations ,
and it is even rarer that we get the feedback from these evaluations.
Florence Fermon, MSF, kindly posts their recent evaluation of AD syringes
and safety boxes in a meningitis mass immunization campaign in Sudan in
1999.
"EVALUATION OF VACCINATION MATERIAL" by Florence FERMON. MSF, V鲯nique
Perron. MSF Logistics, November 1999
The evaluation report files are available for download:
send an email to: [email protected]
with this message:
get technet EvaluationAD-SafetyBoxesSudan-MSFNov99French.pdf
get technet EvaluationAD-SafetyBoxesSudan-MSFNov99english.pdf
or on the web at:
ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/Injection
then click on the files:
EvaluationAD-SafetyBoxesSudan-MSFNov99French.pdf
EvaluationAD-SafetyBoxesSudan-MSFNov99english.pdf
Date:
Thu, 30 Mar 2000 13:14:03 +0100
From:
[email protected] (Florence FERMON)
To: [email protected]
Subject:
Evaluation of vaccination material
Hi,
I'm sure you will be interested in our evaluation of vaccination material
(autodestruct syringes and safety container). This work was done by the MSF
team in Sudan during the meningitis mass immunization campaign in 1999.
I'm sure that some technet members will have interest. Very often we
discuss the implementation of new material, but unfortunately, the
evaluation of implementation and quality of material is not really
follow.
You've got two files, one in French and the other in English.
Any comments are really welcome.
By and best regards,
Florence
----
Date:
Fri, 31 Mar 2000 09:14:11 +1000
To: [email protected] (Florence FERMON)
From:
Allan Bass
Subject:
Re: Evaluation of vaccination material
Dear Florence,
Thanks! Very interesting!
I have 4 questions:
1. Burning the syringes/boxes: Were the needles fully trapped in the
residues?
2. Workers protection against smoke and fumes? Distance?
3. Workers attitude or reluctance to incinerate the syringes?
4. What were the MSF specifications on the syringe packaging?
regards and very best wishes,
allan
- Extracts from the English version
EVALUATION OF VACCINATION MATERIAL
Florence FERMON. MSF, V鲯nique Perron. MSF Logistics
November 1999
The purpose of this report is to carry out a review of the vaccination
material (in terms of quantity and quality) used during epidemic response
in Sudan.
Method and evaluation tools
- Physical control of the material
- Interview with the users
- Quantitative data gathered during the vaccination campaigns
- Evaluation grids of the containers and of the autodestruct syringes
I) NEEDLES - SYRINGES 5L SAFETY BOX FOR INCINERATION
MSF has selected the Polynor 5 litre safety box as its reference product in
its medical catalogue.
Due to the extent of the epidemic in Sudan, we had to use other
manufacturers [products] in order to deliver the supplies required by the
teams on time.
The 3 types of containers that were used are:
- Pa-Hu OY (UNICEF), Finland (yellow container)
- POLYNOR
- Danapak Cartons Ltd, UNIVEC.
The three types are referenced in the PIS catalogue under "Fiches
signalé´©ques d'articles",[E10] 1998 Edition. WHO/UNICEF (page 203-204).
These containers were also included in the treatment kits that were
distributed in the health structures responsible for curative treatments
(oily chloramphenicol, syringes needles 19G and 21G and container).
We noticed that the personnel was familiar with this material and used it
on a regular basis. They receive it through the vaccination program
----
Table:
Safety Boxes
----
General Remarks on the incineration safety boxes:
- For the vaccination campaigns, the 5 litre boxes are too small; they need
to be changed too often. 10, 15 or 20 litre containers should be tested. - The diameter of the orifice is too small for mass vaccination campaigns.
- The triangular orifice that has a pre-cut dotted line for burning is not
necessary - Several persons have been accidentally pricked due to manipulation errors
when handling the boxes (container too full) and when opening them for
burning. It would be interesting to have a closer watch over those
accidents.
----
II) AUTODESTRUCT SYRINGES 0,5 ML
MSF has selected the UNIVEC autodestruct syringes 0,5 ml as reference
product in its medical catalogue.
These syringes are referenced in the PIS catalogue under " Fiches
signalé´©ques d'articles ", 1998 Edition WHO/UNICEF (page 172).
The personnel was familiar with the autodestruct syringes and used them.
They are distributed within the vaccination program.
EVALUATION
PRESENTATION:
The syringes are delivered in 2 different presentations:
- Package with units that guarantee the sterility of the material. This
presentation was prepared according to a specific demand on behalf of MSF,
- Self-protected syringes with tip protectors + needle.
Each box contains 100 syringes.
REMARKS :
- Self-protected syringes
There is no way to identify the manufacturer
There is no information on how to sterilise them
The term " sterile " is not mentioned; neither is the sentence "check the
integrity and the sterility of the package before use "
The protectors ensure a physical protection (plunger and needle) and
preserve the sterility. Under no circumstances can they GUARANTEE
sterility, since there is no device that indicates whether the package has
been opened before or not.
Some protectors have come apart and the users were pricked when taking the
syringes from the plastic wrapping.
- Single packaging:
The information is printed on the package " Tuberculin 1 ml " or " WHO+
logo "
There is no way to identify the manufacturer
In both cases, the information about the product that is printed on the
boxes containing 100 units is wrong or incomplete.
LOSSES
Altogether, 570,750 syringes were used to vaccinate 548,913 persons, which
corresponds to a 4% loss. This loss is minimal. These losses are due to
manipulation errors and quality problems of the product. The evaluation
carried out did not enable us to quantify the different causes of loss.
The users have underlined the fact that the reduced diameter of the syringe
limits the volume occupied by the product, especially when refilling the
containers.
MANUFACTURING DEFECTS
The following paragraph mentions defects that were noticed by the users of
the product. Samples are available. The proportion of syringes presenting
these defects was minimal and was not precisely quantified.
REMARKS:
- Needles:
Length of needles sometimes different
Bevels damaged
Bevels Missing
Needles coming apart from the syringe and remaining in the rubber of the
flask or once in the person's arm
Needles missing or fallen
- Syringes:
Joint of the rubber bulb of the plunger comes apart
Joint of the rubber bulb of the plunger is not there
The suction is sometimes difficult
The angles of the finger flange are slightly sharp after being handled a
lot Metal blocking ring is not there or is placed too low
CONCLUSION:
The presentation in single packaging is preferable, as it is the only one
that guarantees sterility. The information printed on the package and the
box must be exact and complete. The percentage of loss is minimal. Some
defects must undergo a stricter verification when being manufactured.
Other models of autodestruct syringes must be appraised.
*
- UNIVEC CONTACT INFORMATION
Action, comments and additions please: [email protected]
or use your reply button
From:
"Alan H. Gold, M.D."
To: "Technet Moderator"
Subject:
Re: Post00337 WASTE MANAGEMENT + INJECTION SAFETY
Date:
Thu, 30 Mar 2000 07:54:12 -0500
Dear Allan,
As part of the most recent Technet communication, a list of BD contact
numbers was included to facilitate communications from Technet field
personnel. I would appreciate your including the UNIVEC contact information
as well.
There need only be a single point of communication for any of the
Technet members to be able to obtain information or request auto-destruct
syringe products from UNIVEC.
It can be done through a single email address:
[email protected]
or directly through a single telephone call to: (1) 516 -777- 2000 (USA)
or even a single fax communication to: (1) 516- 777- 2786 (USA)
Thank you,
Alan Gold
CEO UNIVEC
*
- LAUNCH OF AUTODISABLE SYRINGE WEB SITE
Star Syringe is an autodisable syringe technology company. The K1 AD
syringe is manufactured by independent syringe companies that license the
K1 technology.
The E8 injection device specifications are in the WHO/V&B document:
EPI Standard Equipment Specifications and Test Procedures:
E8: Injection devices (Ordering code: WHO/EPI/LHIS/97.11)
http://www.who.int/vaccines-documents/DocsPDF/www9512/e08-9512.pdf
Action, comments and additions please: [email protected]
or use your reply button
Date:
Wed, 05 Apr 2000 07:32:00 +1000
To: [email protected]
From:
Marc Koska
Subject:
Launch of Autodisable Syringe Web Site
K1 AUTODISABLE (AD) SYRINGES HAVE A WEB SITE!
Please look up and then bookmark http://www.k1.adsyringes.com
K1 AD syringes meet the WHO E8 specification for Immunisation.
This web site has been set up to allow access to AD syringes, to anyone,
from anywhere. Enquiries for K1 AD syringes will be serviced by the most
appropriate manufacturing licensee of K1.
Please forward this to anyone you feel will be looking for Autodisable
syringes, now, or in the future.
One Injection - One Syringe
Marc Koska
Tel: 44 1342 302502
Mobile:
44 410 305064
E Mail:
[email protected]
Web Site:
*