Clearer, Brighter: Ultrasound and the CCR Evolution

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Havel’s “4×4 CCR Pattern” provides maximum reflection for echogenic needles under ultrasound.

A change in methodology created the need for an ultrasound-guided needle 

By Zachary Rogers

Editor, Havel’s Inc.

Part Two: Corners, Cubes and the Havel’s Advantage 

Earlier, we looked at how ultrasound-guided needle injections are beginning to dominate the field of regional anesthesia. Terms like “echogenicity” and “needle visualization” became important talking points for doctors wanting a better needle. If the biggest problem was visibility, the answer was found in just three simple letters: CCR.

CCR stands for “corner cube reflectors,” and these multi-angled surfaces reflect sound waves back to the transducer, making the needle appear brighter and clearer on screen. These surfaces offer a number of advantages, including improved shaft and needle tip visibility, thus making the needle more echogenic. CCR marks ensure more exact needle placement in ultrasound-guided procedures like peripheral nerve blocks and muscular skeletal injections, and allow you to see the needle and anesthetic in real-time.

In today’s market, CCR-type markings on both the shaft and near the tip of the needle are common, and this placement does help with echogenicity. However, it makes identifying the exact position of the needle tip more difficult, as one might become confused at differentiating between the shaft and the tip. Ultimately, this defeats the purpose of using an echogenic needle, and it’s why Havel’s has developed special echogenic needles that eliminate the confusion.

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Benefits of ultrasound guidance include better accuracy, faster needle placement and real-time monitoring of anesthesia flow.

At Havel’s, we’ve created what’s called our “4×4 CCR Pattern,” which helps pinpoint the exact location of the needle tip once inside the body. Our echogenic needles have four rows of four multi-angled indentations at the distal end of the needle, which circle around the entire cannula, making the tip appear brighter and in full-view. A total of 16 corner cube reflectors are placed within the first 5.5mm of the needle, allowing you to focus on the tip without any other distractions.

Other competitors have reflectors as far up as 20mm of the cannula, which drives up cost and could potentially lead to a false assumption of the needle tip’s actual location. An abundance of reflectors could also blur the target area and create a cloud around the needle. In the end, you shouldn’t pay more for what you don’t need, and with our line of echogenic needles, you get exactly what you need at an affordable price.

EchoBlock Tip HR Flip_4 hole

Havel’s EchoStim and EchoBlock needles include four rows of four corner cube reflectors placed within the first 5.5mm of the needle, which helps to easily identify the location of the needle tip.

Havel’s 4×4 CCR Pattern is available on some of our most popular insulated and non-insulated needles, including the EchoStim, EchoBlock and EchoBlock MSK. Advantages to our 4×4 pattern include better accuracy, faster needle placement, increased success rates and reduced needle sticks and breaks. The 4×4 CCR Pattern also lessens the need for needle rotation because the CCR marks appear around the entire tip. Our echogenic needles allow you to see the needle, confirm the trajectory, locate the tip and watch the anesthetic encircle the target area. At Havel’s, our focus is on the tip, and yours should be too.

 

 

 

Since 1981, Havel’s has offered premium quality ultrasound needles, anesthesia needles, radiology needles and surgical scalpel blades to doctors, hospitals, veterinarians and other leading medical professionals. To see Havel’s selection of procedure needles and surgical scalpel blades, click here: Havel’s Procedure Needles and Surgical Scalpel Blades.

 

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Clearer, Brighter: Ultrasound and the CCR Evolution

ultrasound_machine_2

Ultrasound technology has become more portable and affordable over the years, and is now able to provide a high-quality image on screen.

A change in methodology created the need for an ultrasound-guided needle 

By Zachary Rogers

Editor, Havel’s Inc.

Part One: The early days of ultrasound in anesthesia 

In recent years, there has been a shift towards using ultrasound guidance in a number of different regional anesthesia procedures. Most notably, ultrasound has emerged as a leading force in needle-injection procedures like peripheral nerve blocks and muscular skeletal injections, and because of this, there is a large industry demand for better needles that perform well under ultrasound. The market for this demand has exploded in the last five years, and it’s still on the rise today. This new wave in ultrasound technology offers better image quality, better portability and, most importantly, better and more affordable pricing. Because of this, ultrasound guidance is becoming the standard of care for most regional anesthesia procedures.

The emergence of ultrasound-guided needle injections is due mostly to the significant benefits it provides. Doctors are now better able to position the needle where it’s needed, while at the same time monitor the distribution of the anesthetic in real-time. It also allows doctors to observe the needle’s trajectory as it’s inserted into the body, which makes avoiding internal structures easier than before. Adjustments can be made on the spot, and overall success rates are dramatically increased.

Of course, with new methods comes new tools for those methods, and anesthesia is no different. Since ultrasound guidance is becoming such a dominant practice for needle injections, it would be helpful if the needles could be seen clearly under ultrasound. Conventional needles are difficult to distinguish, and it became obvious that in order to make ultrasound guidance easier for doctors new to the technique, the needles themselves needed to be echogenic.

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Echogenic medical needles have advanced over time to make the needles appear brighter and clearer under ultrasound.

Echogenicity is the ability to bounce or reflect ultrasound waves back in order to see something clearly on the screen. When ultrasound began making its way into needle injections, the development of echogenic needles came into play. Visualization of the needle is the most important factor in developing better echogenic needle technology, and it can be challenging, especially at steep angles. As echogenic needles became more advanced, improvements were made that allowed doctors to see their needles more vividly than ever before.

 

Read Part Two of “Ultrasound and the CCR Evolution” on Friday … 

 

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Less Pain, Speedy Recovery With Regional Anesthesia Procedure

Femoral nerve block shows positive results for pediatric knee surgery 

Ultrasound machines help cut hospitalization rates by 98 percent in children who had knee surgery

Dr. Tarun Bhalla of Nationwide Children`s Hospital uses an ultrasound machine to locate and numb specific nerves during a recent knee surgery on a 15-year old patient.

A recent study showed that an ultrasound-guided regional anesthesia technique called a femoral nerve block is both effective and highly beneficial for pediatric knee surgeries. The study, published in an issue of the Journal of Pediatric Orthopedics, was conducted at Nationwide Children’s Hospital and showed how the technique reduces post-operative pain and speeds up recovery, allowing the majority of patients to go home within hours of surgery.

Femoral nerve blocks work by numbing the femoral nerve, which runs adjacent to the femoral artery and transmits signals running along the front of the thigh, the inner leg and the foot. Numbing the nerve cuts off all feeling to the regions, and can last as long as 12 hours for some patients.

Researchers reviewed 376 patient records ranging from ages 7 to 18 who had arthroscopic knee surgery at the hospital between July 2008 and July 2011. Of these patients, 131 received femoral nerve blocks in addition to general anesthesia, while the rest received general anesthesia only. Patients in the first group experienced less pain, required less pain medication after surgery and had shorter hospital stays than the second group.

To read the full article on ultrasound-guided regional anesthesia for pediatric knee surgery, click here.

Since 1981, Havel’s has offered premium quality anesthesia needles and pain management needles for anesthesiologists and other medical professionals. To see Havel’s selection of anesthesia and pain management needles, please click here: Havel’s Anesthesia Needles and Pain Management Needles.

 

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For Teething Pain, No Lidocaine

FDA warns against using prescription lidocaine for teething infants and children 

Baby Chewing On Teething Ring Toy

FDA warns against the dangers of using lidocaine for teething children.

The U.S. Food and Drug Administration issued a warning against the use of prescription oral viscous lidocaine 2 percent solution to treat infants and children with teething pain. They’ve also required a new boxed warning to be included on the drug’s label that highlights the potential risks.

Viscous lidocaine is a gel-like medication commonly prescribed to adults to treat pain from mouth and throat ulcers. However, its use in teething children is dangerous and could even be fatal in some cases.

Topical pain relievers and medications that are rubbed on the gums are not necessary or even useful because they wash out of the baby’s mouth within minutes,” said the FDA in its statement. Accidental ingestion of the drug could result in seizures, severe brain injury, heart problems and even death in children.

Common symptoms can include jitteriness, confusion, vision problems, vomiting, falling asleep too easily and shaking. These symptoms can also increase the risk of choking or breathing in food. This current warning follows the FDA’s warning about benzocaine OTC products back in 2011.

To read the full statement from the FDA, click here.

 

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Hair Regrowth, Hair Rejoice: 5 Promising Treatments in Hair Regrowth Therapy

AAD summer conference offers new advances in hair regrowth research 

Piliang-aad-summer-conference

Dr. Melissa Piliang, MD, dermatologist and dermatopathologist, speaks on hair regrowth at the American Academy of Dermatology’s annual Summer Academy Meeting in Chicago, Illinois.

Earlier this month, the American Academy of Dermatology held its 2014 Summer Academy Meeting in Chicago, Illinois. Among the topics discussed was the subject of hair loss and how it affects patients suffering from conditions like alopecia areata and lichen planopilaris. Dr. Melissa Piliang, MD, dermatologist and dermatopathologist at the Cleveland Clinic, spoke about the state of hair research during her presentation, “Hair Raising Ideas: What’s New in Hair Disorders.” A longtime researcher in hair regrowth therapy, Dr. Piliang discussed a variety of promising treatment options based on ongoing research as well as her own work in the field.

Here are five treatment options highlighted during her presentation for patients considering hair regrowth therapy, all of which are still undergoing further research:

  1. Vitamin D – The role of vitamin D in hair growth and hair cycling is essential. Although no direct link between vitamin D and hair regrowth has been established, vitamin D deficiency is a common trait for many patients suffering from hair loss. “Many people are deficient in vitamin D, so it is an important nutrient to include in the workup of patients with alopecia,” said Dr. Piliang.
  2. Tofacitinib – Tofacitinib is a JAK inhibitor that’s been showing promising effects in hair regrowth. Although more studies need to be done in order to determine its full effects, recent reports have brought this new therapy to the forefront.
  3. Pioglitazone – Pioglitazone is a PPAR gamma receptor blocker that’s being further studied thanks to a patient with lichen planopilaris who showed an improvement in scalp inflammation after a course of pioglitazone.
  4. Light devices – Light devices are growing in popularity thanks to their ease of use at home. Most devices are hand-held and available without a prescription, and offer treatment by providing low-intensity light to the scalp.
  5. Growing new hair follicles – Although previous research hasn’t led to anything significantly successful, a new method of hair regrowth by inducing hair follicle development from epidermis is showing benefits in patients who have androgenetic alopecia. Researchers from Columbia University and Durham University in the UK are still conducting research on the method.

To read the full article from the AAD summer conference, click here.

For over 30 years, Havel’s has offered high-quality sutures and surgical scalpel blades to dermatologists and other medical professionals. To learn more about Havel’s sutures and surgical blades, please click here: Havel’s Nylon Sutures, Synthetic Absorbable Sutures and Carbon and Stainless Steel Surgical Scalpel Blades.

 

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4 Big Reasons Why Virtual Reality Anesthesia is the Way of the Future

New technological advances could change the way we look at anesthesia and sedation 

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Doctors in Spain perform the first-ever virtual reality anesthetic operation, which was live-streamed using Google Glass.

As the worlds of healthcare and technology continue to collide, medical professionals are always looking at different ways new technology can be applied in the operating room. Which has led to this: virtual reality anesthesia. Yes, doctors are now figuring out a way to use VR in place of anesthesia to calm the nerves felt by many going under the knife.

Digital simulations, including clouds rolling over the beach or fireworks exploding in the night sky, are mixed with the comforting sounds of Beethoven in order to soothe those pre-surgery jitters. As futuristic as it sounds, when combined with a simple local anesthetic, VR anesthesia has actually proven to be quite successful, so much so that a hospital in Spain performed a knee operation using VR anesthesia on a live patient. The results? The surgery went off without a hitch, and was even streamed in real-time using Google Glass.

Here are four reasons why VR anesthesia is turning heads in the medical field:

  1. VR simulations can lower heart rate and blood pressure.
  2. It eases anxiety, eliminating the need for a general anesthetic.
  3. Creates total immersion, blocking out all light and noise of a stressful OR.
  4. Has the potential to minimize pharmacological therapy, which reduces the risks associated with sedation.

To read more about virtual reality anesthesia, click here.

Be sure to check out actual footage of the digital simulations here.

 

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Calming Kids Before Surgery: Give Them an iPad

Tablet-based games could help decrease anxiety before an operation 

Game Apps On Apple Ipad Air

Research shows playing tablet-based games before anesthesia and surgery could be more beneficial in reducing anxiety in children.

A new study reports that children who played games on an iPad mini before going under anesthesia for surgery had reduced levels of anxiety compared to regular sedation. The study, published in Pediatric Anesthesia, took 108 kids between the ages of 1 and 11 and randomly assigned each to receive either a dose of oral midazolam syrup (a sedative) or an iPad mini before going under anesthesia. Kids in the iPad group chose an age-appropriate game and started playing it when it was time to separate from their parents for preoperative anesthesia, and continued up until the time they received the anesthesia. The other group received the sedative 15 minutes before anesthesia.

The results showed that children in the tablet group had a 9-point decrease in anxiety (on a scale of 100) when separated from their parents and a 14-point decrease in anxiety when anesthesia was being administered, compared to those who received sedation instead. Recovery time was also affected, with the tablet group recovering much faster after surgery than the sedation group.

“Anxiety is a major source of concern for children going to the hospital for anything, but especially for surgery,” said Dr. Samuel C. Seiden, lead author of the study. “That whole process of leaving parents or having someone put a mask over your face can be a very traumatic experience. That’s why we spent a lot of time thinking about how we could make this less anxiety-provoking for children.”

To read the full article on the study, click here.

Since 1981, Havel’s has offered premium quality anesthesia needles and pain management needles for anesthesiologists and other medical professionals. To see Havel’s selection of anesthesia and pain management needles, please click here: Havel’s Anesthesia Needles and Pain Management Needles.

 

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Pain and Itch Could Be a Sign of Skin Cancer

New research shows both factors could be deadly in suspicious skin lesions 

Dermatologist examining mole on woman with magnifying glass in c

Research shows that pain and itching in certain areas could be a sign of skin cancer.

In a new study published online in JAMA Dermatology, research indicates that pain and itching could point to several different types of skin cancers. The study, conducted by the Department of Dermatology at Temple University School of Medicine, examined the relationship between pain and itch and histologic features of skin cancers in patients diagnosed with basal cell carcinomas, squamous cell carcinomas and melanomas.

Out of the 268 patients included in the study, almost 40 percent of skin cancer lesions were accompanied by itching, while nearly 30 percent involved pain of some kind. Most of the non-melanoma skin cancers studied, such as basal cell carcinoma and squamous cell carcinoma, had more symptoms of pain and itching than with melanoma.

While more than 45 percent of the skin lesions associated with itching also had pain, 60 percent of painful lesions involved itching in or around the affected area.

To read more about the study, click here.

Since 1981, Havel’s has offered high-quality sutures and surgical scalpel blades to dermatologists and other medical professionals. To see Havel’s selection of sutures and surgical blades, please click here: Havel’s Nylon Sutures, Synthetic Absorbable Sutures and Carbon and Stainless Steel Surgical Scalpel Blades.

 

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American Veterinary Medical Association Announces New President

Dr. Ted Cohn takes the lead in new position 

Cohn-Ted-President

American Veterinary Medical Association announces Dr. Ted Cohn as new president.

Dr. Ted Cohn of Lone Tree, Colorado stepped into his new role last Friday as president of the American Veterinary Medical Association. He assumes the role after more than 35 years in the veterinary medical profession. Cohn attended the University of Colorado and then the University of Arkansas at Little Rock and received his Bachelor of Science degree in biology. Afterward, he completed an internship at Angell Memorial Animal Hospital, and more recently graduated from the certification course in veterinary acupuncture at the College of Veterinary Medicine and Biomedical Sciences at Colorado State University.

Cohn graduated from Tuskegee University in 1975 with his Doctor of Veterinary Medicine degree and later went into private practice as an associate veterinarian at Aspenwood Animal Hospital. Cohn currently serves as a partner and hospital director at University Hills Animal Hospital in Denver. In 1997, he was named Western Region Practitioner of the Year by the American Animal Hospital Association.

To read the full press release from the AVMA, click here.

Since 1981, Havel’s has offered premium quality veterinary sutures, suture needles and surgical scalpel blades for veterinarians. To see Havel’s selection of sutures, suture needles and blades, please click here: Havel’s Veterinary Sutures, Suture Needles and Surgical Scalpel Blades.

 

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TV Special to Highlight Pain Management

Pain remains more prevalent than diabetes, cancer and heart disease combined

Human Joints Concept

A new special airing on public television in August looks to facilitate the national pain management dialogue.

A new public television special airing this August called “Learning About Pain Management” hopes to shed new light on the issues of pain and pain management. The special will focus on the physical experience of “pain,” including how the body senses and is affected by pain. It will also highlight the many pharmacological and non-pharmacological approaches at managing it, and what can be done to further improve pain management.

Pain is something everyone experiences at various points in their lives, and it’s the number one reason for physician visits in the U.S. Even with annual costs ranging up to $600 billion, it still remains a condition that’s usually left undiagnosed, untreated or improperly managed. The special will include experts in the field of pain management from across the country as they weigh in on topics such as the psychology of pain and proper rehabilitation, among other areas of interest.

The special will also look at a number of patients and their families and examine the impact of pain on their daily lives.

For more information on the upcoming special, click here.

Since 1981, Havel’s has offered innovative pain management needles to help physicians in their efforts to relieve pain in their patients. To learn more about Havel’s anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.

 

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