From the March 2016 issue of HealthCare Business News magazine
What is required from a patient safety point of view? Consider the following:
• Ease of use and low complexity are key elements of patient safety. If there are only a few variables and components, the user training is fast and the error margin low.
• “Open” contrast media and saline volumes should not be used to prevent infections, sepsis and contaminations.
• Standard (and easy) operating procedures for injection should be in place to avoid extravasation and air emboli.
• Some injector systems on the market offer optional extravasation protection (through sensors that measure variances in skin surface or RFID signals).
• All procedures should allow for the removal of any air in the tubing by rotating the injector head and slowly pushing liquid into the tubing with an optional air bubble detection sensor.
• Injector systems should include sensors and safety measures if an overpressure occurs.
• Optional sensors for contrast leaks could be helpful.
• Some vendors now offer RFID identifiers that prevent using single-use syringes more than once.
• Equipment should allow for the possibility to recall some forensic data such as the amount of contrast media injected with what parameters at what time.
Other features not directly patient safety- related that are optionally offered are RIS/data management systems connections and network integrations that allow for the measurement of workflow efficiency and imaging optimization. This also allows management of injector service issues and can track historical use of contrast media with respect to patients, diseases and imaging protocols.
The syringes (single or multi-use) and their cost — but also patient safety issues related to multi-use — are definitely quite an important consideration. Especially in the U.S., pre-filled syringes are getting more popular while other vendors are betting on larger volume bottles that reduce the preparation time and the cost of the consumables. Dual flow allows the parallel injection of contrast media and saline solution, and with that could help to provide new or enhanced contrast particularly for cardiac imaging.
Contrast media viscosity is temperature dependent, as a warmer application temperature decreases the viscosity and flow resistance. Warming the contrast media before injection is therefore beneficial, and some injectors have such a feature built into the system.
Another hardware aspect is the power source and weight of the injector systems. While most CT injectors are directly connected to a power outlet (weight between 5kg and 25kg), MRI injectors (weight 10kg to 35kg) usually have a battery integrated that has a tendency to be empty every once in a while when you really need it. Alternative solutions are hydraulic-driven systems or almost entirely mechanical systems with a small battery backup of injection information and control of safety features. Especially for use in the MRI suite, electronic and metallic components are a potential safety and operational hazard and for ultimate patient safety the device should be lightweight and manufactured from nonferromagnetic materials with little to no electronic components,
