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Original ArticleOpen Access
Deadspace : A Potential Error in Concentration of Medication During Dilutional Process in Neonates
Watanachai A 
,
Suprasongsin C
,
Suprasongsin C ARUCHALEAN WATANACHAI, BSc*,
CHITTIWA T SUPRASONGSIN, MD*
Objective : To evaluate the volume of deadspace (DS) and degree of errors in concentration
of medications during medication dilution with needle removable syringe (NRS) compared to needle
nonremovable syringe (NNRS).
Material and Method : 300 syringes were tested and divided into 3 groups as follows: The
first group was 100 syringes of needle removable insulin 1 ml syringe (NRIS) with a 27 gauge needle
(TerumoเธŽ), the second group was 100 syringes of NRIS with a 27 gauge needle (NiproเธŽ) and third group
3 was 100 syringes of needle non removable insulin syringe (NNRIS) with a 27 gauge needle (TerumoเธŽ).
All syringes with needle sets (without needle cover) were weighed with a Mettler electronic balance.
Volume of DS was measured and calculated using a standard method. 10 syringes of each group were
randomly selected to test for degree of errors in concentration of medications during the dilutional pro-
cess using standard insulin (310 micro unit per ml) as a medication for dilution. All specimens were
collected by ejecting all diluents into collecting tubes and insulin concentrations were measured using
radioimmunoassay technique (insulin-CT biointemational, France) twice in each sample. Concentration
was then calculated back and the results were noted and analysed.
Results: Means of DS in group 3 (2.4
เธ‘
0.8~-tl)
was significantly less than group 1 (49.7
เธ‘
00.9
~-tl)
and group 2 (65.3
เธ‘
0.7~-tl)
(median= 2 microlitre). All three groups were significantly different from
each other with the largest DS in group 2. After dilution, insulin concentrations from diluents in group
3 were still close to standard insulin (335
เธ‘
28
vs
310 microunits/ml), whereas group 1 and 2 were
significantly higher than group 3 (1.7 and 1.9 times) and standard insulin (1.8 and 2 times).
Conclusions : DS in NRIS is not negligible and is considered a potential source of error in
the concentration of medications when it is used to dilute parenteral medications in the neonatal inten-
sive care unit (NICU).
Key word : Deadspace, Neonatal, Needle Nonremovable Insulin Syringe, Needle Removable Insulin
Syringe, Dilution, Concentration
CHITTIWA T SUPRASONGSIN, MD*
Objective : To evaluate the volume of deadspace (DS) and degree of errors in concentration
of medications during medication dilution with needle removable syringe (NRS) compared to needle
nonremovable syringe (NNRS).
Material and Method : 300 syringes were tested and divided into 3 groups as follows: The
first group was 100 syringes of needle removable insulin 1 ml syringe (NRIS) with a 27 gauge needle
(TerumoเธŽ), the second group was 100 syringes of NRIS with a 27 gauge needle (NiproเธŽ) and third group
3 was 100 syringes of needle non removable insulin syringe (NNRIS) with a 27 gauge needle (TerumoเธŽ).
All syringes with needle sets (without needle cover) were weighed with a Mettler electronic balance.
Volume of DS was measured and calculated using a standard method. 10 syringes of each group were
randomly selected to test for degree of errors in concentration of medications during the dilutional pro-
cess using standard insulin (310 micro unit per ml) as a medication for dilution. All specimens were
collected by ejecting all diluents into collecting tubes and insulin concentrations were measured using
radioimmunoassay technique (insulin-CT biointemational, France) twice in each sample. Concentration
was then calculated back and the results were noted and analysed.
Results: Means of DS in group 3 (2.4
เธ‘
0.8~-tl)
was significantly less than group 1 (49.7
เธ‘
00.9
~-tl)
and group 2 (65.3
เธ‘
0.7~-tl)
(median= 2 microlitre). All three groups were significantly different from
each other with the largest DS in group 2. After dilution, insulin concentrations from diluents in group
3 were still close to standard insulin (335
เธ‘
28
vs
310 microunits/ml), whereas group 1 and 2 were
significantly higher than group 3 (1.7 and 1.9 times) and standard insulin (1.8 and 2 times).
Conclusions : DS in NRIS is not negligible and is considered a potential source of error in
the concentration of medications when it is used to dilute parenteral medications in the neonatal inten-
sive care unit (NICU).
Key word : Deadspace, Neonatal, Needle Nonremovable Insulin Syringe, Needle Removable Insulin
Syringe, Dilution, Concentration
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