The present invention relates to syringes, and in particular to syringes for delivering medication through an intravenous port, or for providing a combination of medications.
A patient who requires regular intravenous medication is normally fitted with an intravenous (IV) port, to avoid the need for separate injections. Often only one medication is required, and this is delivered by means of a standard syringe having a plunger working in a barrel. Initially a standard metal needle is attached to the syringe. The needle is inserted through a rubber sealing septum into a vial containing the medication. The correct amount of medication is drawn into the barrel, and the needle removed from the vial. For some types of IV port, the needle must be removed from the syringe before the syringe can be connected to the IV port. This carries a risk of needlestick injury to the health care worker performing the procedure. Some types of IV port accept a needle, but there is still a risk of needlestick injury both when the syringe is attached to, and removed from the port.
It is also quite common for a patient (especially in hospital) to require injections containing several different medications, perhaps because the patient has a complicated condition or several different conditions. In such a case it is advantageous, where possible, to combine different medications in one injection, to minimise the number of injections that are needed.
Combining of medications is known as compounding and is carried out to fit the unique medical needs of the patient. For example, it may be required to obtain an exact dose, to change the form of medication from solid to liquid, or to avoid a non-essential component that the patient is allergic to. The compounded medication may be administered by a standard syringe, or through an IV port.
Where such multiple-medication injections are to be given, a syringe is filled with the correct amounts of the different medications in the hospital pharmacy or ward, or by an external compounding company. Again, a standard syringe having a plunger working in a barrel, to which is attached a metal needle, is used for this purpose. As described above, the needle is inserted through a rubber sealing septum into a vial containing a medication. The correct amount of the medication is drawn into the barrel, the needle removed from the vial, and the process repeated until the barrel contains all the necessary medications. It may be possible to give the injection using the same needle, but if there is a risk of contamination while the syringe is being taken to the patient, the syringe must be capped. As re-capping a needle is against all guidelines for injection safety, because of the relatively high risk of needlestick injury, the original needle is removed and discarded. A new, covered needle is attached for the injection. Obviously the removal of the needle still carries the risk of a needlestick injury.
If the compounded medication is for delivery through an IV port, the original needle is removed. It is likely then that a transport cap will be attached, to prevent contamination while the syringe is being taken to the patient. The transport cap will be removed so that the syringe can be attached to the IV port either directly or with a further needle if required. Whether or not a transport cap is attached, the removal of the original needle carries a risk of a needlestick injury.
One solution to the problem of needlestick is for a special plastics pin, rather than the standard metal needle, to be attached to the syringe for drawing up the medication or medications. When the syringe is filled the pin is removed, and a transport cap put on. This is in turn removed for IV delivery, or replaced by a needle for injection. The special pins are generally used only by external compounding companies, as they are very expensive. It is not generally practical to use them in a hospital environment, particularly for single medication for IV delivery, because of the cost.
A syringe shown in WO2006/029528 aims to reduce the risk of needlestick by using a cannula moulded integrally with the barrel. The cannula is able to pierce the septum of a vial to allow contents to be drawn into the barrel. The cannula may then be used to deliver the contents to an intravenous line. Alternatively, it has a weakened portion on either the external or internal surface to enable the end of the cannula to be broken off and a metal needle fitted for injection. The barrel and cannula may be provided with a luer connection for the needle. The disadvantage of this construction is that considerable force must be applied to break off the end, and it may not break cleanly, with a risk that plastics particles could enter the barrel. Further, although the cannula may be covered with a standard cap, there is no indication of how the filled syringe is secured for transportation to reduce the risk of contamination.
According to the present invention, we provide a syringe comprising a barrel having a plunger in slidable and sealing engagement therein, and a piercing member formed integrally with the barrel, the piercing member having a bore in communication with the distal end of the barrel, and a piercing point and an aperture at its distal end, and the distal end of the barrel also having a means for sealing connection of a transport cap, an intravenous port or an injection needle, the distal end of the piercing member being removable and having an external recess and a corresponding internal step to define a separation plane for the distal end.
The invention enables the medications to be drawn up without a needle, so that the risk of needlestick injury on removal of the needle is avoided. In use, the distal end of the piercing member is removed when the syringe has been filled. This operation does not carry a needlestick risk and reduces the possibility of contamination. If the medication can be delivered immediately to the patient via an IV port, the syringe may be attached to the IV port straight away. If the syringe requires transportation to the patient, the transport cap is attached to seal the contents. For injection, the transport cap is removed and a standard needle attached. For delivery through an IV port, the transport cap is removed and the syringe attached to the IV port. The arrangement of the external recess and internal step enables the distal end to be removed with a minimum of force, while ensuring a clean break, to reduce the risk of plastics particles entering the barrel, and contaminating the medication. Thus, a single, simple item can readily be used without risk of needlestick injury or contamination, for IV delivery of a single medication, as well as for compounded medications either through IV delivery at a needle-free port or injection.
Conveniently, the distal end of the piercing member is removed by application of a substantially lateral force.
A separate protective cap may be provided to protect the piercing member initially. The protective cap will be removed to enable medications to be drawn up, and may then be used to apply the force to remove the distal end of the piercing member. The cap may be constructed with an open-ended removal recess at its distal end, separated from the recess at its proximal end which fits over the piercing member for protection. The removal recess at the distal end fits over the distal end of the piercing member. The cap may then be used to apply the force to remove the distal end of the piercing member and to retain the removed end in the removal recess for disposal. The removal recess is conveniently shaped to conform to the profile of the distal end of the piercing member so that removal and retention are assured. The distal end of the cap may be provided with an enlarged portion for ease of use. The enlarged portion may include a funnel leading to the removal recess, to provide a guide for the removable distal end of the piercing member. The funnel may also have one or more guide ribs.
After the distal end of the piercing member has been removed, the transport cap may be attached to seal the contents.
The means for connecting the transport cap, the IV port or the injection needle may be a luer lock connection. The distal end of the barrel may then be provided with a hollow cylindrical collar surrounding the piercing member and provided with an internal screw thread of standard luer lock form. The barrel may therefore be connected to any other device having an appropriate standard external luer lock thread. The transport cap is provided with a corresponding male thread, in the same way as a standard luer lock needle. The protective cap may also be provided with a corresponding male thread, or with projections for engagement with the screw thread.
The piercing member is arranged so that after removal of its distal end its proximal end remains on the barrel, and acts as a support hub for the interior of the transport cap, the IV port or the needle.
The piercing member conveniently has at least one, and preferably two apertures at its distal end.
The syringe barrel and piercing member may be moulded in one piece from a suitable plastics material. One such material is polycarbonate, which has sufficient rigidity to make the piercing point able to pierce rubber septums and the like, and will be easy to snap off. The point will not be suitable for piercing the skin of a human or animal body at all.
The one-piece moulding preferably also includes the hollow cylindrical collar. This makes manufacture of the barrel particularly easy and inexpensive. The protective cap and the transport cap must, of course, be separate components. They may also be moulded from polycarbonate, but any suitable plastics material could be used. In particular, the protective cap may be of polypropylene.
The plunger is preferably of a standard construction, .comprising a rod carrying a head, on which is mounted a seal for engagement with the internal surface of the barrel.
The syringe as a whole therefore has few components, and so is simple to manufacture and assemble.
An embodiment of the invention is illustrated, by way of example only, in the accompanying drawings, in which:
The syringe shown in the Figures comprises a barrel 1 in which works a plunger 2, and a piercing member 3 formed integrally with the barrel 1. A protective cap 4 is provided as a separate component, as is a transport cap 30.
The barrel 1 is generally cylindrical, having a cylinder 5 for containing a liquid to be injected, with an inner cylindrical surface 6 in which the plunger 2 slides sealingly. The outer surface has markings indicating the volume contained. The plunger 2 is of known construction, having a rod 7 with a finger plate 8 at its proximal end and at its distal end a head 9 to which is mounted an elastomeric seal 10 forming a complete seal with the inner surface 6 of the barrel 1.
The proximal end 11 of the barrel 1 is open, and is provided with a gripping flange 12. The distal end is provided with the piercing member 3, and a hollow cylindrical collar 13 also formed integrally with the barrel 1. The collar 13 surrounds the proximal end of the piercing member 3, and is spaced from it. The internal surface of the collar 13 is provided with a female screw thread 14, forming a standard luer lock arrangement, and allowing a sealing connection of the transport cap 30 (as shown in
As best seen in
The transport cap 30 has a male screw thread corresponding to the female screw thread 14, so that the cap 30 engages sealingly with the syringe.
The barrel 1, piercing member 3 and collar 13 are moulded in one piece, from polycarbonate. Polycarbonate can be moulded with sufficient rigidity to make the sharp piercing point 17, and will also enable the distal portion 22 to be snapped off easily. The point 17 will not be suitable for piercing skin, so cannot be used for direct injection into the human or animal body. It will however be able to pierce the rubber septums commonly used to seal vials of liquid medications. The protective cap 4 and transport cap 30 may also be of polycarbonate, although the protective cap 4 may instead be of polypropylene.
The barrel 1 is assembled with the plunger 2, and a protective cap 4, which is attached mechanically during the assembly process. Before use, the syringe is as shown in
If a single medication is being delivered through an IV port, the filling of the syringe may take place by the patient. In that event, after removal of the distal portion 22 of the piercing member 3, the syringe may be attached immediately to the IV port, and the transport cap 30 is not required.
In
The removal recess 31 is shaped to conform to the profile of the removable distal portion 22 of the piercing member 3. Thus, the recess 31 has a reduced diameter substantially conical portion 34 corresponding to the point 17, leading to a bore 35 whose diameter increases towards the open end, to correspond to the increasing diameter portion from the point 17 to the recess 19. At the open end the bore diameter is reduced again so the end 36 corresponds to the shape of the recess 19. Otherwise the cap of
In use, the cap 4 of
The outer surface of the main part of the cap 4 is provided with a circumferential grip profile 43. This, together with the knurling 40, aids in unscrewing the cap 4 and in placing it over the piercing member 3 for removal of the distal portion 22.
The construction of the cap of
In any of the embodiments the luer lock arrangement on the collar 13 may be replaced with a standard luer slip arrangement, where the connection is made through corresponding conical surfaces.
The syringe in all its embodiments is easy and inexpensive to manufacture, because it has few components, but it provides the ability to fill a syringe with different liquid medications in a simple and efficient way, while reducing the risk of needlestick injury and contamination. It is particularly useful where delivery of the medication is through an IV port, as no needle at all is required, either for filling the syringe or delivery through the IV port. The whole process is therefore needle-free.
Number | Date | Country | Kind |
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0921939.5 | Dec 2009 | GB | national |
1007934.1 | May 2010 | GB | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/GB10/52078 | 12/13/2010 | WO | 00 | 9/12/2012 |