"Hospitals ought to be thinking about the cost of supporting one HIV patient for the rest of their life," says Dana Trom, director of materiels management for Martha Jefferson Health Services in Charlottesville. "Just bite the bullet. You have to look at the whole picture and you need to support your employees."

One of the obstacles to a stronger prevention effort is that injuries happen in such a wide variety of ways. Arnold and Algie's injuries occurred while the needle was in the patient's arm. Wetzel's was after the procedure. Forced to cap the needle because there was no sharps disposal container at the patient's home, she was injured when the cap dislodged from the infected needle and punctured her finger. Cieniawa's was with a needle she had not even used, but one that someone left carelessly behind.

"Every needle stick injury has a sequence of events, and you have to break these down categorically," says Murray Cohen, former CDC chief of medical device evaluations who heads the Frontline Healthcare Workers Safety Foundation. "That's why you can't get all excited about a product and think that it will solve it. If it was so simple, we would have already figured it out."

So for now Arnold, Wetzel, Algie and Cieniawa count their good days. "Sometimes I worry, if I die, what will happen to my family," says Arnold about her husband and two young children. "Health care worker safety is a right, not an option. . . . We have to remember, there are so many others. Somewhere out there, someone's been infected with a deadly virus just because they went to work one day."

ChaSyr™ Prefilled Syringe

The ChaSyr DDS is a prefilled, multi–chamber, sequential delivery syringe.  In a nutshell, it means that the syringe has more than one medication chamber separated by a rubber stopper with a valve that keeps the medications disparate and prevents air/gas from passing through the valve.  The syringe comes prefilled with saline or heparinized saline in the posterior chamber.  The clinician aspirates medication into the front chamber using conventional practices. 

The ChaSyr DDS is then connected to a Y-site where the multiple medications are then injected into the patient serially.  After infusion of the medication from the front chamber, the clinician simply continues to push the syringe plunger.  When the rubber stopper (ChaSyr valve) comes in contact with the tip of the syringe a valve opens allowing the saline solution in the back chamber to flow through the valve thus flushing the Y-site and IV line of the original medicant and leaving a saline lock in the system.  The ChaSyr DDS with its prefilled inline post-flush simplifies nursing procedure, reduces line manipulations and line breaks by up to 50% thereby reducing contaminations rates and nosocomial infections.

For medications that are patient specific, a pharmacist/nurse is able to easily and accurately prepare and deliver an entire measured dose through a port/spike fluid pathway and into the IV container with safety.  This assures that the entire measured dose reaches the patient.  Let's look at how an infusion of a hazardous drug with the ChaSyr DDS product would work.  Looking at figure 1

It is shown that rear chamber of the ChaSyr  DDS has a prefilled saline flush, the front chamber of the ChaSyr  DDS is filled by the pharmacist with the drug of choice and a saline lock is placed in an extension set with a clamp.  Looking at figure 2 -

The clinician removes the cap from the extension set (only clinician exposure is to saline) and attaches the extension set to the catheter.  After opening the clamp, the syringe plunger is pushed thus infusing the saline pre-flush then the drug through the IV.  Looking at figure 3 -

The plunger is continued to be pushed until the valve in the first plunger is activated.  Saline then flushes the hazardous medication from the Y-site and the IV catheter thus rendering the catheter free of medicant and filled with the flush solution.