Automatic injectors are now commonly used in MDCT and MRI for intravenous contrast/saline administration. Considering the increasing volume of investigations, these are indispensable. Although it is very convenient to use the SAME syringe for multiple consecutive patients to save time and cut costs, it can be a potential source of infection. Multiple-use of syringes is known to be associated with increased risk of infection, which is particularly important in sick patients and single use syringes that are disposable should be preferred. For example, a study conducted by Buerke et.al found that the first four samples of each simulation experiment were sterile, and the subsequent probes were found to be contaminated with typical dermal bacteria, such as staphylococci (1). The use of a one-way valve too does not guarantee the prevention of cross-contamination as documented by Nandy et.al in their study published in the American Journal of Infection Control (2).
There are multiple reasons why Single-Use Disposables should be re-used with caution. These include (3):
- Single-use devices may not be designed to allow thorough decontamination.
- Reprocessing may alter device characteristics, and performance may be compromised as a result.
- Single-use devices do not undergo extensive testing validation and testing for reuse.
- Single-use devices may cause cross-infection due to design (for example, fine bores of tubes).
- Some materials can absorb certain chemicals, which can gradually leach from the material over time.
- Chemicals may corrode or change device materials.
- Device material may experience stress during reuse and may fail, stretch, or break.
- Inadequately cleaned equipment can carry bacterial endotoxins, which remain after bacteria are killed.
Owing to these, re-use of single use medical devices is banned in many countries including China, France and the UK (4).
Buerke et. al in another study published in the American Journal of Radiology proved that single use syringes prefilled with contrast and saline, revealed no bacterial contamination as opposed to multiple-use of conventional saline injection for patients which revealed contamination with coagulase-negative staphylococci in two saline syringes (5). A simple analogy is that of reusing medical syringes and the increased incidence of infections often encountered in IV drug users. Although there is a far higher risk in IV drug abusers, cross-contamination of contrast syringes does pose a potential health risk.
Hence, the re-use of single use disposables for CT/ MRI injectors should be avoided. An important downside to this practice is loss of time efficiency due to the increased number of syringe changes required. However, Buerke et al. in the same study found that using the single-use protocol the time required for assembly of the automatic injection system to be only slightly longer (2.3 ± 1.1 minutes) than that for the multiple-use protocol (2.0 ± 1.4 minutes), which amounts to hardly a few seconds (5). Use of prefilled syringes can help to cut down the time required for CT / MRI injections (5).
Bayer Single use Syringes for MEDRAD® Injection Systems.
Bayer Syringes for MEDRAD® Injection Systems ensure optimal device performance, thereby enhancing patient safety.