ABSTRACT
Many procedures in science and medicine involve the use of a syringe, and its invention is a key milestone in general and regional anesthesia history. The end of the 19th century brought major changes in syringe production. An industry that initially manually crafted syringes to individual physicians' instructions saw the introduction of a large variety of syringes, sometimes with odd and unique modifications. For many of these unique syringes, there was no proven evidence that these modifications were effective or safe to use. This article provides examples of "odd" syringe designs for use in medicine, general anesthesia, and regional anesthesia. Some designs proved functional and have stood the test of time; others quickly disappeared and ended up in dusty collections.
Subject(s)
Anesthesia , Physicians , Humans , SyringesABSTRACT
Measurement of core body temperature-clinical thermometry-provides critical information to anaesthetists during perioperative care. The value of this information is determined by the accuracy of the measurement device used. This accuracy must be maintained despite external influences such as the operating room temperature and the patient's thermoregulatory defence. Presently, perioperative thermometers utilise invasive measurement sites. The public health challenge of the COVID-19 pandemic, however, has highlighted the use of non-invasive, non-contact infrared thermometers. The aim of this article is to review common existing thermometers used in perioperative care, their mechanisms of action, accuracy, and practicality in comparison to infrared non-contact thermometry used for population screening during a pandemic. Evidence currently shows that contact thermometry varies in accuracy and practicality depending on the site of measurements and the method of sterilisation or disposal between uses. Despite the benefits of being a non-invasive and non-contact device, infrared thermometry used for population temperature screening lacks the accuracy required in perioperative medicine. Inaccuracy may be a consequence of uncontrolled external temperatures, the patient's actions prior to measurement, distance between the patient and the thermometer, and the different sites of measurement. A re-evaluation of non-contact thermometry is recommended, requiring new studies in more controlled environments.
ABSTRACT
More than 125 years have elapsed since the "Maison Lüer" in Paris produced their quintessential all-glass hypodermic syringe. The product would subsequently conquer the medical world, with billions of plastic syringes produced on a yearly basis nowadays. One wonders how a world would look without this priceless diagnostic and therapeutic tool, facilitating the administration of drugs, fluids, and blood products to billions of patients worldwide. The Lüer syringe dates to 1894, when Parisian medical instrument maker Hermann Wülfing-Lüer manufactured a unique graduated all-glass hypodermic syringe. Its conical tip allowed accurate injections with rapid leak-free connections, and was heat-resistant without breaking while autoclaving at 120 °C. The authors of this article rectified several inaccuracies of historical facts, and obtained copies of original patents, documents and syringes to reveal accurate details regarding the originators of the all-glass syringes. The Lüer fittings are simple devices that connect virtually all syringes, needles and tubing. They are used in medicine and beyond, whether it is a Lüer-Slip or a Lüer-Lok™ (Lüer-Lock) version. In 1995, The International Organization of Standardization recommended the standard use of the Lüer-tipped syringe worldwide. Despite this, their popularity has sustained significant setbacks at times, including when reports were published on misconnections and wrong-route administration of drugs, resulting in harm to patients with sometimes fatal outcomes. Healthcare workers mistakenly connected devices with a specific use to other devices used for a different application. Current syringes are now mostly mass-produced, disposable plastic syringes, which still come with Lüer fittings for intravascular and hypodermic needles, whereas specific non-Lüer connectors are designed for other systems.
