The Role of Syringes in The Health System

The purpose of this report is to address the use and function of Retractable syringes. It discusses the development over time, the importance and effects on both the individual and the society of the retractable syringe. This report assesses and evaluates the technology and materials used and the technologies and materials have been used in the creation of the retractable syringe. As well as discussing the outcome and whether the innovation of retractable syringes is a success.

The retractable syringe is a mechanism that has a safety feature of removing the needle from a syringe after the desired medicine or liquid in the syringe has been administered. Thus reducing the amount of injuries or cross contamination and preventing the reuse of unsterile needles and therefore reducing the risk and spread of bloodborne diseases.

The retractable syringe was originally developed after the number of needlestick injuries (NSI) increased thus increasing the number of nurses and trained medical professionals who contracted Bloodborne Diseases.

A needlestick injury is an injury that occurs when a nurse or doctor injects a patient, and when removing the needle from the patient, injures themselves, this often causes the cross contamination of blood, thus causing a bloodborne disease. Bloodborne diseases include HIV, Hepatitis A, B and C and Viral haemorrhagic fevers.

There are many types of retractable syringe, this is both because of branding and also because different needles have different uses there are many syringes in different sizes as well as syringes with different retraction mechanisms.

Many injecting syringes are available in a variety of sizes, needle gauges, and needle lengths. The needle is automatically retracted directly from the patient into the barrel of the syringe when the plunger handle is fully depressed. The pre-removal, automated retraction virtually eliminates exposure to the contaminated needle, effectively reducing the risk of needlestick injury. These syringes are easy to use, require no additional steps, and allow for single-handed activation. After activation, they require less disposal space than most other safety needles/syringes and prevent disposal-related needlestick injuries. They protect both the patient and the clinician and are available in a variety of sizes.

For blood collection there are also many different forms of retractable syringe. The use of Automated in-vein retraction effectively reduces the risk of needlestick injuries during blood collection. The trigger indicator is colour coded to easily identify needle gauge, and the design of the finger grips allows for easy handling. When activated, needle retraction clamps the tubing, reducing the risk chance of exposure to blood. Blood collection tube holders are single-use, adhere to safety regulations, and are compatible with standard, multiple-sample blood collection syringes.

The impact on the individual have been immense as many individuals and health care professionals now have a lower risk of needlestick injuries than ever before and therefore the contraction of bloodborne diseases is also lower than ever before. The average risk for HIV transmission after a needlestick injury is approximately 0.3%, the risk of Hepatitis B transmission is 6 to 30%, and the risk of Hepatitis C transmission is approximately 1.8%.

Needlestick injuries (NSIs) have been a serious problem for healthcare workers for decades. A healthcare worker can contract any of over 20 bloodborne diseases, including HIV and hepatitis C, from a contaminated syringe. Many NSI’s occur due to the lack of innovation and funding towards the implementation of Retractable Syringes.

Since the development of the retractable syringe, in 2004, the implementation of it throughout hospitals and doctors’ offices has been a slow incline in their use. Majority of syringes sold across the world have no safety mechanism or features to protect the health care professional and therefore the risk of needlestick injuries is still higher than it should be.

With the development of the retractable syringe with safety features such as the immediate and automatic withdrawal from a patient after depletion of the syringe, and then a locking of the needle within the syringe, prevents it from harming the healthcare professional as well as the patient, there should be a reduced risk of needlestick injuries and thus a reduction of the spread of bloodborne diseases. This removal of the needle from being reused then also decreases the spread of bloodborne diseases throughout the society and although this reduction has been seen it doesn’t necessarily mean that this reduction is down to the implementation of Retractable syringes as their use is not as wide-spread as it should be.

The impacts on both the patient and the healthcare professionals have been immense as they have allowed for many more health care professionals be able to implement treatments of many kinds without having to be fearful of the chance of stabbing oneself and causing a needlestick injury, this has allowed for the easier and more efficient treatment of many patients.

Although, with the lack of funding and innovation from syringe producing companies in this area there has been a lack of widespread use of retractable syringes and thus the amount of needlestick injuries and contraction of bloodborne diseases in health care professionals has not reduced as much as it could have in the last 13 years.

There have been a positive and negative impact on society, although overall it has been seemingly positive. There has been a reduction in the contraction of bloodborne diseases, both in healthcare professionals and in society over all, especially in drug users. This reduction has been because retractable syringes do not allow for the reuse of syringes in any circumstance. This means that there can be no cross contamination from different people or from outside environment, or even a mixing of medicines or drugs within the syringe.

The retractable syringe has also reduced the risk of other people from getting needlestick injuries as any syringe left on the street or rejected in a gutter now has an enclosed syringe to stop any person who comes into contact with that syringe from injuring themselves. It means that any child running around barefoot on the beach or in a park or anywhere can now be free to do that with a minimised risk of being injured from a used and rejected syringe.

Syringes nowadays are made out of heat-treatable stainless steel or carbon steel. To prevent corrosion, many are nickel plated. Depending on the style of device used, the main body of the tube can be made of plastic, glass, or both. Although these materials are chosen for their ability to be sterilised and cleaned, for most syringes there is no recycling done, the stainless steel which can be very easily melted down and recycled is disposed of as it seen to be unsterile and therefore is generally not reused. This can also be applied to the polyethylene and polypropylene plastic that is usually used to make syringes, this can be recycled if large enough quantities can be collected, but it is not recycled as often it is unsterile and is easier to manufacture from new rather than recycling. This means that the effect on society is that there is a lot of waste and unrecycled goods that could otherwise be recycled, and therefore there is disregarded syringes and wasted materials.

Unfortunately certain clinics such as in doctors’ offices or hospitals or even vets, may have to pay more for these retractable syringes as they are not government standard yet, and are therefore not taken out of the government budget. Therefore the companies who make these syringes must rely on the sale of the syringes in order to keep making those syringes. Therefore someone wanting to buy these syringes may be turned off buying them as they cost more than other syringes with no safety mechanism. Thus the impact on society has not been as immense as it could have been in this area as this innovation has not been supplied to those who need it most, the health care professionals who are implementing treatment to patients and putting themselves and their health at risk of contracting a bloodborne disease from a needlestick injury.

The impacts on society may not have been as effective as they may have been. There has been minimal positive effects on society but little to no negative effects on society. There has been a reduction bloodborne diseases in recent years, especially in healthcare professionals, which may have many causes, including the greater awareness around the spread and contraction of bloodborne diseases. There have been impacts on companies and clinics, such as the higher cost for these retractable syringes, but overall there have been minimal impacts, as the Retractable Syringe is not extremely widespread, and sold widely across the world.

A syringe is cylindrical tube with a pump or plunger inside that can be pulled or pushed to change the volume of the cylinder. Syringes can be fitted with many things at the end of them, such as a hypodermic needle that is small enough and sharp enough to pierce the skin, or a nozzle or tubing to direct the flow of the liquid or gas inside of the tubing. The first syringes were used in Roman times during the 1st century AD and then in the 9th century AD, an Egyptian surgeon created a syringe using a hollow glass tube and suction. In 1650 Blaise Pascal invented a syringe as an application of fluid mechanics that is now called Pascal’s law.

An Irish physician named Francis Rynd invented the hollow needle and used it to make the first recorded subcutaneous injections in 1844. Then shortly thereafter in 1853 Charles Pravaz and Alexander Wood developed a medical hypodermic syringe with a needle fine enough to pierce the skin. In 1899 Letitia Mumford Geer of New York was granted a patent for a syringe design that permitted the user to operate it one-handed.

In 1946 when Chance Brothers in England produced the first all-glass syringe with an interchangeable barrel and plunger. This was revolutionary because it allowed the mass-sterilization of the different components without needing to match up the individual parts.

Shortly after that Australian inventor Charles Rothauser created the world’s first plastic, disposable hypodermic syringe made from polyethylene at his Adelaide factory in 1949. However, because polyethylene softens with heat, the syringes had to be chemically sterilised prior to packaging, which made them expensive. Two years later he produced the first injection-moulded syringes made of polypropylene, a plastic that can be heat-sterilised. Millions were made for Australian and export markets.

Then in 1956 a New Zealand pharmacist and inventor Colin Murdoch was granted patents for a disposable plastic syringe. It was closely followed by the Plastipak – a plastic disposable syringe introduced by Becton Dickinson in 1961. In 1974 African American inventor Phil Brooks received a US patent for a “Disposable Syringe”.

Before the invention of the retractable syringe, and although all syringes are recommended to be single use only there was no safety mechanism or guard to make sure that syringes were only used once, thus allowing them to be left unsafely stored and reused time and time again by drug users. The World Health Organisation (WHO) estimates that about 1.3 million deaths a year are caused by re-use of needles, mainly due to Hepatitis B and C and HIV-AIDS and this includes the number of people who suffer needlestick injuries.

In 1996, Australian inventor Bruce Kiehne, was moved to create a retractable syringe after a member of his family received a needle stick injury from discarded needles in a house they were cleaning up. In 2000 Kiehne formed OMI (Occupational and Medical Innovations Ltd) to get the product to market and in October 2000 the company was listed on the Australian Stock Exchange. A team of designers and engineers at OMI developed his idea and in 2001 the company announced its successful development of a low cost automatic retractable syringe. Then in 2004 it was approved by the Therapeutic Goods Administration (TGA) for the syringe to be distributed throughout Australia.

Although this syringe is not the first of its kind to be developed, the simplicity of its design means it can be produced at the same price as a standard syringe. The only extra part compared to a standard syringe is the spring. The syringe was awarded an Australian Design Award and Powerhouse Museum Selection in 2004 for innovation in design.

Syringes are not only used for medical use nowadays either, although that is majority of their use, they can be used to refill ink cartridges for printers, put glue and other things in hard to reach places or for precision measurement when mixing liquids, and even to feed small animals when they are being hand-reared.