[CARPA] Re: Ben Pen needle jams

[Peter Nihill]

Benzathine needle jams? No easy answers here, but a few points I've 
found through bitter experience (mine and the needle recipients):

* gentle mixing is best, slowly introduce the water/lignocaine and 
roll (don't shake) the vial

* lots and lots of gentle mixing, once you've drawn the mixture back 
into the syringe keep rolling it until just before administration

* don't push the mixture up into the needle until JUST before 
adminstration, then push a bit through the needle, to make sure it's 
clear

* sometimes with a block, withdrawing the needle half a cm out of the 
patient will help - working on the theory that there is a local tissue 
block, rather than a needle block

I still don't have a 100% no-block-up rate, but a lot better than when 
this awful stuff first appeared in the clinic.

Peter Nihill RAN Borroloola / Robinson River


Date: Fri, 12 Jan 2007 11:15:10 +0930
From: "Alex Hope" <alex.hope at ltyentyeapurte.com.au>
Subject: [CARPA] benzathine needle jams
To: carpa at ozdocit.org
Message-ID: <200701121115100206.1AB4A4E2 at mail.bigpond.com>
Content-Type: text/plain; charset="ISO-8859-1"

G'day All,

is it just us mob?

We are having a lot of trouble with the Pan Benzathine product,
no matter how well we mix it, and whether with water or lignocaine,
and despite running it in and out of a syringe through a needle into 
the vial,
when giving the actual injection the stuff jams part way through.
sometimes you can retrieve it by jiggling the plunger, sometimes you 
can't. 
Then you pull the needle out, and try squirting it through and hey 
presto, the bloody thing is unblocked!

But you won't always get a second or third go at the patient's 
backside!

we are using 21G needles for giving, some say even with a 19G needle 
(in adults for RHD prophylaxis) it will jam up.

Anyone else having the same trouble?

Any clues as to how to get around it?Dr Alex Hope

Community GP,
Ltyentye Apurte Community Government Council Health Centre,
CMB Santa Teresa,
via Alice Springs,
NT 0872.

Ph  08 8956 0911
Fax 08 8956 0910
Mobile 0408 085 143