Major Threat Major Threat To To

Medical Medical ProfessionProfession

andandHumankind Humankind

Braunula• First Cannula invented in Germany• Rapidly accepted by medical profession• Technique of introduction not evaluated• Used in USA & Europe since 1954• Increase of Staphylococcal infection in

tandem increased with this device • Average attempts required is 2-3 / patient

Types of Cannula

Neonatal cannulaeStraight CannulaeWinged Cannulae

Wing with portWinged with stop cork

All these cannula do the same job

Cannula Insertion Technique

• Wash hands with soap and water• Wear un-sterile glove• Identify good vein to cannulate• Prepare skin of patient• Insert cannula needle through skin• Puncture blood vessel

Common Problems

Needle Bends when pressure is applied from the top

Flash-Back• Blood noticed in Collecting Blood noticed in Collecting

chamberchamber• Stop moving cannula needle Stop moving cannula needle

forwardforward• Failure rate highFailure rate high

Failure Rate Increase• Puncture sitesPuncture sites• Pain and discomfortPain and discomfort• Spreading bacterial infectionsSpreading bacterial infections• Cost of wasted cannulaCost of wasted cannula• Hospital contaminated wasteHospital contaminated waste• Environmental pollutionEnvironmental pollution• Help bacteria to colonise and multiplyHelp bacteria to colonise and multiply

How Cannula Spread Infection

““This is Not a Problem”This is Not a Problem”1996-2004 • Hep : 9 infected of 997 exposure• HIV : 1 infected of 551 exposure16% Healthcare of 35,000 sustained sharp injury

Ported Cannula

Major cause for spreading bacterial infection

Ported Cannula• 50% of patients develop Bacteraemia• 17 million used in UK• Banned in USA & Europe• Bacteria colonize in the port• Must be banned in UK Hospitals

MRSA Infections in Europe

Antibiotic Resistant Statistics1 in 10 Patients who get infections in UK3 out of 10 Health People carrying MRSA on their skin

1,652 Death from MRSA in UK, 2006.

19,000 Death of MRSA in the USA in 2005

2,300 Canadians died of MRSA

6,480 C diff death in 2006 in UK, up 72%

13 Drugs Clinical drug (11 are given IV) trials£2 Billion Cost of deep cleaning hospitals in UK

£16 million Cost of Skin Testing in Scotland next year

£183 million Cost of MRSA in Scotland / Year3.2 - 4.2 Billion $ Cost of MRSA infection in USA/Year$200 - $250 million Annual cost in Canada

Bactrial Threat High• Increased practical procedure• Poor hand washing technique• Antiseptic skin solution not effective• Use of un-sterile gloves• 48% Healthcare workers are carriers• Rapidly adopting bacteria• 17% Doctors have adequate knowledge• Politicians ignoring this threat

This Proved our Hypothesis

Major Problem

Hand Wash• Bacteria are now resistant to BiocideBacteria are now resistant to Biocide• Nurses / Doctors do not observe drying timeNurses / Doctors do not observe drying time• Use hand wash gel only when water and soap are Use hand wash gel only when water and soap are

not availablenot available• Low concentrated wash increase bacteria handLow concentrated wash increase bacteria hand• Washing more than 10 times increase colony count Washing more than 10 times increase colony count

in handsin hands• Women have more bacteria in their handsWomen have more bacteria in their hands• Quick swipe of skin with spirit not remove bacteriaQuick swipe of skin with spirit not remove bacteria• High concentrated chemicals produce dermatitisHigh concentrated chemicals produce dermatitis• Biocides kill good germs and increase resistant Biocides kill good germs and increase resistant

germs growthgerms growth• More than ten bacteria are now resistantMore than ten bacteria are now resistant• Simple puncture site with needle can get infectedSimple puncture site with needle can get infected

Infected Injection Site

Antibiotic Resistant Bacteria Threatening Us

1. Enterococcus faecium2. Staphylococcus aureus3. Klebsiella species4. Acinetobacter baumannii5. Pseudomonas aeruginosa6. Enterobacter species7. Streptococcus Pnemococcus8. Meningococcal Infections9. Gonococcus10.Tuberculosis

Please Stop Please Stop This Happen Again?This Happen Again?