DRAINAGE PRECISION
Controlled performance connections ease operations and prevent misconnections during critical medical procedures
Hama Medical (www.hama-med.co.jp), a leading Japanese manufacturer of electronic devices for the medical market, consistently puts this concept into action.
The company's recent design modifications to its low-pressure drainage systems have led to improvements in the care of patients undergoing chest and gastrointestinal drainage procedures. With these changes, doctors and nurses can now keep their full attention on the patient and procedure.
Quick set up and ease of handling are essential requirements for medical devices used in chest and gastrointestinal drainage. In many cases, a patient in need of a chest tube is in a life-threatening situation. Medical professionals in charge of such emergencies must be able to react quickly with efficient, streamlined equipment.
Hama Medical's Servo-Drain SD-2001 is a low pressure-maintained drainage system for hospitals and other health-care facilities. The SD-2001 is a computer-assisted drain pressure control system that can be used for chest and gastrointestinal drainage.
In developing an improved Servo-Drain SD-2001, Hama Medical wanted to streamline and ease the operation of the system so that medical personnel could remain focused on the procedure. With the existing system, tubes could only be disconnected by utilizing a tube remover or forceps, making the process of changing waste chambers laborious and cumbersome.
Hama Medical began looking for an advanced connection device to simplify this process and asked St. Paul, Minnesota-based Colder Products Company (CPC) to find a solution. The connection device would need to meet three important criteria.
First, medical staff must be able to quickly and securely connect and disconnect the waste bottles from the unit in a single action.
Second, the new connection device needed to eliminate the possibility of accidental misconnection. Incorrectly drained waste can lead to a time-consuming adjustment of the system, which needs to be avoided in emergency situations.
Lastly, the solution must reduce the possibility of tube kinking in order to maintain a continuous flow of fluids into the system.
To address Hama Medical's needs, CPC (www.colder.com) specified a disposable, plastic in-line connection device for installation on the system's waste bottles and associated tubing.
The SD-2001 is now equipped with two units of CPC's disposable, quick-connect medical plastic coupling: the MPC 17006T coupling body and the MPC 22006T coupling insert, both for 3/8-inch ID tubing. The couplings are critical to the safe operation of the system and provide the ease of handling that the medical staff was seeking.
"CPC's experience and expertise implementing controlled performance connections proved to be superior," said Yoshiro Sato, general manager of Hama Medical's technical department. "We have a long relationship with CPC and they continuously meet our needs with their solutions."
Preventing Infection
Chest drainage therapy is performed to relieve pressure on the lungs and remove air, blood, or other secretions that may cause infection in the chest cavity.
This treatment is commonly performed on patients suffering from emphysema or pneumothorax, conditions in which excess air remains in the lung tissues and chest cavity respectively.
Tuberculosis, certain cancers, serious chest trauma, and heart and lung surgeries cause excessive secretions and often warrant chest and gastrointestinal drainage.
To remove air or fluids from the chest, a tube or thoracic catheter is inserted through an incision between the ribs into the chest and secured in place. The tube is connected to the drainage system designed to allow air or fluid to drain out of, but not into, the chest cavity.
Hama Medical's SD-2001 drainage system is controlled by a computer-assisted pressure control circuit. The circuit adjusts the pump pressure and ensures that the actual pressure is equal to the preset pressure. Suction pressure can be set precisely and maintained at a constant level even for extended periods of time. Suction pressure ranges from -3 to -99 cm H2O. The SD-2001, weighing only 3.9 kg and measuring 264 x 405 x 172 mm in size, is also equipped with an alarm function against leakage.
With disposable waste bottles available in capacities of 500, 1000, and 2000 ml, a suitable bottle is selected for the specific application, reducing the need for frequent bottle changes. Each bottle has three separate chambers. Two large collection chambers serve as storage for the waste fluids. The tubing used to drain the fluids attaches and detaches to the collection chambers with CPC couplings.
The system has a CPC coupling on top of each of the large collection chambers, enabling two different wastes to be collected simultaneously, but monitored independently.
The third smaller chamber, designed for water sealing, is filled with sterilized, distilled water. It securely seals off the chest tube and prevents air from flowing back into the patient's pleural cavity, a situation that may lead to a life-threatening situation. Tubing connects the sealing chamber to the suction unit and is attached and detached by a CPC connection.
Saving Time and Avoiding Misconnections
During critical chest or gastrointestinal drainage, time is of the essence. Medical personnel must keep their focus on the procedure and minimize time spent adjusting medical equipment. With CPC's connections, medical staff can quickly and easily change waste bottles during the chest drainage. The connections' quick-disconnect thumb latch enables the waste bottles to be easily attached and detached from the tubing.
In comparison, in the earlier model of the low-pressure drainage system, tubing was connected to a barb, which was then welded to each waste bottle. The tubes could only be disconnected with the help of a tube remover or disconnect forceps, a process that could take some time. In the new system, detaching tubing from the waste bottles does not require any tools and can be done with one hand. An audible "click" assures the user of a secure connection. Once the coupling halves are joined, they can be rotated, which reduces the chance of tube kinking.
To avoid the misconnection of tubing to the incorrect chamber, Hama Medical and CPC devised a clever solution. For the waste chambers, the coupling insert is on the chamber and the coupling body is connected to the tube. For the sealing chamber, this is reversed with the coupling body on the chamber and the coupling insert attached to the tubing. As a result, the tubing can only connect with the correct chamber with misconnections automatically averted.
CPC's MPC connections have a tapered bore through the stem and hose barb. This taper minimizes dead space between the tubing and coupling, which leads to a very low fluid turbulence and leaves no dead space for particles to be trapped in. This avoids the clotting of certain fluids or secretion within the tubing.
Since the development of the new models in 2001, Hama Medical has purchased approximately 50,000 pieces of the Colder MPC 1700T and about 100,000 Colder MPC 22006T. Those numbers are likely to increase over time. Due to the success of the system, new models replace older models still in use. Every year Hama produces about 80,000 waste bottle units for the Japanese medical market.
"Over the last months, the SD-2001 has gained a favorable reputation in the minds of our users," said Sato. "The CPC couplings not only ensure safety for the patients who are dependent on our equipment, but make the system much easier to use for the medical personnel. That is an added value that our users don't want to miss anymore.".
A.B. Isacson Associates, New York
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