I work as an anesthesiologist in Germany and I never seen anyone open that kind of vial, nor met anyone who would want to do that... we use minispikes (as someone below mentioned), or special large-bore drawing needles. And most of our local anesthetics come in plastic vials (where you tear of the cap). Clearly a solution to problem that I gladly never had 😅
Lucky YOU! Being in Germany, you have a luxury of having major manufacturers locally to solve your problems - BBraun, Pajunk, etc. Greetings and Thank you for watching.
Thank you! Looks like an elegant solution. I looked it up on Google. It looks like they are EURO 1.2/peace - which is nearly the same as a 20 ml vial of Bupivacaine. Is that possible - and what is the price your division pays? Thanks and greetings from NYSORA! www.praxisdienst.com/en/Infusion+Injection/Needles/Dispensing+Pins/Mini+Spike+Dispensing+Pin+with+Standard+Tip.html
Also good technique! However, one needle is a hazard to begin with - two - theoretically should be double hazard. However, there are no rules on this - whatever works best for everyone. If you use a LOT of local anesthetics, or medications from vials - double-needle technique would be less practical from what the video describes. What is the size of the needles you use to draw? Thank you for watching!
@@nkn987 another issue with needles is that injecting air into a enclosed vessel will increase the pressure inside, this becomes a problem luer slip syringes where if the needle is not placed well and result the syringe being disconnect and a jet of medication spurting out. however this can be solved with luer locks and user experience. but in a rush, can lead to injuries as well.
I’ve used that vial decapper for probably 10years. The one caveat is if you don’t get the cap off the 1st time and round off the edge of the vial, the decapper won’t work well a 2nd time. I love the decapper.
Great to hear! Indeed - agree with the "gotta get it right the first time". NYSORA is probably 10 years behind your team! Greetings and thanks for watching! and BTW - we're just curious - how many decappers do you have?
@@nysoravideowe only have one decapper. We are a small rural facility. I’ve tried to get the OR to use them, but staff prefer to stick with the “scissor” or “hemostat” technique. My first set was from Kebby industries. When Amazon sold a cheaper version, that’s what I subsequently purchased. I’ve wondered if the decapper has an effect on vial contamination. Perhaps a research project?
Hey i recently started following your channel and i really love the way you guys show us many ways to do many things and i`m seeing many negative comments, i think this another way to get your local anesthtetic, at my institution we use the first method you describe, thank you!
We've never seen one of those in any hospital we worked at. One of the values of these posts is that we can all learn from each other. Can you send a link to the vial adapters? Many thanks and thank you for watching!
Sounds like yet another expensive single use piece of plastic going to the landfill. A reusable tool that allows easy access is a smarter way to go, and no additional garbage to waste. Thanks for sharing the video!
A sterile bowl. See 2:36. However, in other places we have done it differently - drawing from the open vial either with a needle, a straw, or directly from the syringe - straight up with the vial up-side-down. How do YOU do it? Many thanks for watching!
Any views on sterility and possible small particles contamination? Instead why not talking to manufacturers to design something more practical? Nysora could definitely try to do that
@@nysoravideo exactly same argument you put in the introduction and as probably the biggest international body in local anaesthetic you have a lot of weight specially if you join forces with ESRA,🌸😊😊
Why don't you order the plastic ampullae? You can turn the cap of and pour it in the bowl. Another solution is scissors, open them and use them like a bottle opener.
Great question. Medication shortages - they are different in different countries. Glass vials have been most consistent to get wherever we practiced! Thank you for watching!
Also folks, there is this thing called physics. If you simply inject the volume of air you wish to aspirate, you will in fact have a pressure assisted withdrawal of liquid contents with minimal use of force or wasted time. But again, this isn’t complicated. Love the videos but this one was a head scratcher. If you want merchandise to sell, there are bigger problems with possible solutions you can sell.
I don't understand what problem is? I just use a pair of open scissors to pry it off, just like the Decapper. Simple, free and pretty much available at any desk ... & the cap/stopper comes off without any sharp pieces. You can often separate and keep/reuse the stopper that way, too. It's actually much easier than using the Decapper as shown in the video.
This makes no sense to me. If you are prepping ahead of time why does the speed of drawing into a syringe make any difference? Why the sterile gloves to handle a non sterile bottle/tool?
When we say “when seconds count you want a anesthesiologist” this isn’t what we mean folks. Disregard this video as parody at best. This is what you call over thinking a problem that never existed. If this is the stuff you ponder, Internal medicine, even nephrology probably more your specialty.
I work as an anesthesiologist in Germany and I never seen anyone open that kind of vial, nor met anyone who would want to do that... we use minispikes (as someone below mentioned), or special large-bore drawing needles. And most of our local anesthetics come in plastic vials (where you tear of the cap). Clearly a solution to problem that I gladly never had 😅
Lucky YOU! Being in Germany, you have a luxury of having major manufacturers locally to solve your problems - BBraun, Pajunk, etc. Greetings and Thank you for watching.
We simply use Mini-Spikes from Braun. They have an air filter so the solution inside the vial doesnt get contaminated.
Thank you! Looks like an elegant solution. I looked it up on Google. It looks like they are EURO 1.2/peace - which is nearly the same as a 20 ml vial of Bupivacaine. Is that possible - and what is the price your division pays? Thanks and greetings from NYSORA! www.praxisdienst.com/en/Infusion+Injection/Needles/Dispensing+Pins/Mini+Spike+Dispensing+Pin+with+Standard+Tip.html
If you insert e second needle into the rubber, it becomes very easy to draw as air gets in and you don't get negative pressure inside
Also good technique! However, one needle is a hazard to begin with - two - theoretically should be double hazard. However, there are no rules on this - whatever works best for everyone. If you use a LOT of local anesthetics, or medications from vials - double-needle technique would be less practical from what the video describes. What is the size of the needles you use to draw? Thank you for watching!
@@nysoravideoboth are equal hazardous.injecting air (some what contaminated & also another needle.) Not much big difference.
@@nkn987 another issue with needles is that injecting air into a enclosed vessel will increase the pressure inside, this becomes a problem luer slip syringes where if the needle is not placed well and result the syringe being disconnect and a jet of medication spurting out. however this can be solved with luer locks and user experience. but in a rush, can lead to injuries as well.
I’ve used that vial decapper for probably 10years. The one caveat is if you don’t get the cap off the 1st time and round off the edge of the vial, the decapper won’t work well a 2nd time. I love the decapper.
Great to hear! Indeed - agree with the "gotta get it right the first time". NYSORA is probably 10 years behind your team! Greetings and thanks for watching! and BTW - we're just curious - how many decappers do you have?
@@nysoravideowe only have one decapper. We are a small rural facility. I’ve tried to get the OR to use them, but staff prefer to stick with the “scissor” or “hemostat” technique. My first set was from Kebby industries. When Amazon sold a cheaper version, that’s what I subsequently purchased. I’ve wondered if the decapper has an effect on vial contamination. Perhaps a research project?
Hey i recently started following your channel and i really love the way you guys show us many ways to do many things and i`m seeing many negative comments, i think this another way to get your local anesthtetic, at my institution we use the first method you describe, thank you!
Welcome aboard! Thank you for your wonderful comment and support! Greetings from NYSORA!
I'm so sorry for you and your patients, unbelievable
Drawing from a vial “takes time” but seems like they’ve been using the hemostats for a while which obviously takes much longer.
Greetings Yipiyo! How do you do it in your practice? Thank you for watching!
In Ireland, we have a small plastic bottle which opens with only a little force.
Lol! Whiskey? Greetings and thanks for watching!
Love these. Two sites I visited had them.
That is interesting to hear. Can we know where were those? Thanks!
Are the NYSORA team somehow unaware that large bore vented vial adapters already exist?
We've never seen one of those in any hospital we worked at. One of the values of these posts is that we can all learn from each other. Can you send a link to the vial adapters? Many thanks and thank you for watching!
Sounds like yet another expensive single use piece of plastic going to the landfill.
A reusable tool that allows easy access is a smarter way to go, and no additional garbage to waste. Thanks for sharing the video!
After the vial is opened do you load the syringe without the needle at the hub ? Or do you empty the contents onto a sterile bowl ?
A sterile bowl. See 2:36. However, in other places we have done it differently - drawing from the open vial either with a needle, a straw, or directly from the syringe - straight up with the vial up-side-down. How do YOU do it? Many thanks for watching!
At our institution, we stick to the rather painfully slow approach- drawing with a syringe with a needle. I will try to introduce your technique here.
A beer bottle opener works as well
Any views on sterility and possible small particles contamination? Instead why not talking to manufacturers to design something more practical? Nysora could definitely try to do that
Great idea. Agreed. How would you phrase the question to the Industry? Thank you for watching!
@@nysoravideo exactly same argument you put in the introduction and as probably the biggest international body in local anaesthetic you have a lot of weight specially if you join forces with ESRA,🌸😊😊
Nice video thank you..!
Thank you for watching!
Why don't you order the plastic ampullae? You can turn the cap of and pour it in the bowl.
Another solution is scissors, open them and use them like a bottle opener.
Great question. Medication shortages - they are different in different countries. Glass vials have been most consistent to get wherever we practiced! Thank you for watching!
Vid. starts 2:50. You're welcome
Also folks, there is this thing called physics. If you simply inject the volume of air you wish to aspirate, you will in fact have a pressure assisted withdrawal of liquid contents with minimal use of force or wasted time. But again, this isn’t complicated. Love the videos but this one was a head scratcher. If you want merchandise to sell, there are bigger problems with possible solutions you can sell.
Unsafe solution to a non-existing problem. Glad most people agree here.
Kebby Decapper for the extremely easy win. No contest. Just so capable. Ebay or Amazon
Agree! Thank you for watching!
Use IV set and everything will finish in second
Hi Hassan. Interesting suggestion. Can you please describe in a bi more detail? Many thanks and Thank you for watching!
I tried that once with sodium bicarbonate bottle ... didn't work..the plastic cover we squeezed inside the bottle
I don't understand what problem is? I just use a pair of open scissors to pry it off, just like the Decapper. Simple, free and pretty much available at any desk ... & the cap/stopper comes off without any sharp pieces. You can often separate and keep/reuse the stopper that way, too. It's actually much easier than using the Decapper as shown in the video.
Hmmm. It does not work that smoothly in our hands. Able to take a quick video and send it to us at info@nysora.com?Thank you for watching!
This makes no sense to me. If you are prepping ahead of time why does the speed of drawing into a syringe make any difference?
Why the sterile gloves to handle a non sterile bottle/tool?
In my part of the world... that is Pakistan, we have glass vials and not these. With a maximum volume of 10mls
That is interesting. And how do you prefer opening them?
@@nysoravideo breaking them with glass cutter or any other vial or even forceps sometimes..!
😮
When we say “when seconds count you want a anesthesiologist” this isn’t what we mean folks. Disregard this video as parody at best. This is what you call over thinking a problem that never existed. If this is the stuff you ponder, Internal medicine, even nephrology probably more your specialty.