Adrenaline and amiodarone dosages in resuscitation: rectifying misinformation.

Despite the recognition of specialists in emergency medicine and the professionalisation of prehospital emergency care, international guidelines and consensus are often ignored, and the lag between guideline publication and translation into clinical practice is protracted. South African literature should reflect the latest evidence to guide resuscitation and safe patient care. This article addresses erroneous details regarding life-saving interventions in the South African Medicines Formulary, 10th edition. 

Leak Detection in Flexible Retort Pouches.

Retortable flexible pouches now contain sterilized foods, and a method is needed to identify holes in these pouches. The helium leak test and the fluorescence dye test for metal food containers were modified to find micron-sized holes in flexible retort pouches. The helium test and the dye test were about equal in ability to identify holes. The helium test properly identified 32 of 32 pouches with holes. The dye test identified 31 of the same 32 pouches with holes and was able to indicate the point of leakage. Neither method produced a false positive, but the helium test was more sensitive than the dye test or the original biotest.

Eliminating Cross-Connections Between Raw and Pasteurized Products in Dairy Plants.

A method was developed to identify cross-connections between raw and pasteurized products in dairy plants. A flow diagram of the dairy plant is used to identify post-pasteurization pumps, storage tanks, fillers or other post-pasteurization processing equipment. An envelope is drawn on the flow diagram around all post-pasteurization equipment. Only the few pipelines that penetrate the envelope have the potential of a cross-connection. Each pipeline is traced to its origin to determine if it is a cross-connection.

Helium Leak Test for Micron-Sized Holes in Canned Foods.

A helium leak test for canned foods was developed to provide a more sensitive method than existing ones and to reduce dependence on operator judgment for detecting leaking cans. The test forced helium through holes into cans filled with foods. Can headspace gas was sampled, and the helium content was measured by gas chromatography. An approximately linear (r = 0.81) relationship existed between the helium content of the headspace and the hole size in the can. The method detected holes as small as 1 µm in diameter (the smallest hole tested). Measurements of direct holes and dented seam holes in metal cans indicated that most holes tested smaller upon retesting. However, some seam openings did become larger. Some holes closed completely, probably as a result of clogging by particles. Cans with direct holes of known size were processed in a canning retort, and the cooling water was inoculated with ca. 106 bacteria/ml. Cans with holes greater than 5 µm became contaminated as exhibited by gas production during incubation at 37°C. The described helium test was compared with two modified conventional leak tests. When comparing cans with direct holes of known size, there was no difference between the methods. However, when comparing cans with leaks caused by dented seams, the helium test was found to be the most sensitive method for detecting leaks in cans of food. In order of their sensitivity, the tests for leaking cans were the helium test, the modified fluorescent dye test, and the modified vacuum test.

Acid Equilibrium Development in Mushrooms, Pearl Onions and Cherry Peppers.

Mushrooms, pearl onions, and cherry peppers were packed with either citric acid or acetic acid to determine the time required for the pH inside the particulates to decrease to 4.8 or less. The blanched products were packed into home canning jars, covered with acidified brine, and pasteurized in steam at 100°C. After storage at 25°C, pH measurements were taken on samples of drained brine, individual particulates, and a puree of all particulates. With acetic acid, equilibrium pH was achieved in approximately 1, 15, and 30 d for mushrooms, onions, and peppers, respectively. Longer times would be required to achieve equilibrium pH for each product with citric acid. The time required for the pH inside the particulates to decrease to 4.8 or less was a function of acid type, initial acid concentration, and the product being acidified. With sufficient acidulant to achieve an equilibrium pH of 4.6 or less, the time required for particulates of mushrooms, onions, or peppers to decrease to pH 4.8 or less was 7 d or less in all instances. Since studies (inoculated packs) of similar products have shown that a minimum of about 10 d is required for Clostridium botulinum growth at a pH of 5.0, the rate of acidification for these products was sufficient to prevent growth of C. botulinum .