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Airway Management
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
If a formal jet injector system is not available, a replacement may be improvised using a length of green ‘bubble’ oxygen tubing cut so that it fits tightly inside the barrel of a 2-mL syringe, with a hole cut across the side of the tubing just before the syringe. The syringe is pushed into the cricothryroidotomy cannula hub and the hole occluded intermittently (‘1 second on, 4 seconds off’).
Intralesional nail therapies
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Chander Grover, Geetali Kharghoria
Jet injection is defined as a needle-free drug delivery system, which utilizes a high-speed stream of fluid containing the drug to penetrate the skin and deposit in the dermis. Needle-free intradermal injection (NFII) can be of two types: spring-loaded jet injector (Dermojet/Port-O-Jet) and gas-powered jet injector. Needleless injectors not only reduce the pain during drug delivery but also confine the drug more evenly in the dermis at the desired penetration level. However, they have inherent disadvantages like clogging of the injector, backsplash, and risk of spread of blood-borne infection (because of difficulty in sterilizing the apparatus). There have also been reports of multiple implantation epidermoid cysts formation following treatment of psoriatic nails requiring amputation. These have been used in intramatricial drug delivery for nail psoriasis and can also be used for drug delivery in other nail diseases. With the advent of disposable jet injectors/cartridges, autoclaving of the injector remains the only reliable method to eliminate the risk of infection.
Microneedles vs. Other Transdermal Technologies
Published in Boris Stoeber, Raja K Sivamani, Howard I. Maibach, Microneedling in Clinical Practice, 2020
Yeakuty Jhanker, James H.N. Tran, Heather A.E. Benson, Tarl W. Prow
Jet injectors subject the active pharmaceutical ingredient (API) solution to high pressure so that it is ejected through a small nozzle, at velocity greater than 100 m/s, with a maximum of approximately 200 m/s (73). The velocity and microjet size influence the delivered volume and penetration depth of the payload, and also the amount of damage to the skin (73). Deeper penetration is achieved with higher velocities, but there is also greater potential for splashback of solution from the skin surface.
Advances in subcutaneous injections: PRECISE II: a study of safety and subject preference for an innovative needle-free injection system
Published in Drug Delivery, 2021
E. Lynne Kelley, Richard H. Smith, Gillian Corcoran, Sandra Nygren, Mary V. Jacoski, Andrea Fernandes
Autoinjectors simplify at-home self-injection of medications, but although hidden, they still contain a needle. Additionally, autoinjectors require the user to press and hold the device against the skin for up to 15 seconds, and larger volumes can require up to 30 seconds (Schneider et al. 2020). Over the past several years, technologies that use needle-free injection methods have been developed to address the challenges associated with injection pain and needle anxiety. A spring-loaded reusable jet-injector has demonstrated positive data for vaccine delivery, although use has been limited to trained healthcare professionals (de Menezes Martins et al. 2015; Basu et al. 2021). Among the newest devices is the Portal PRIME needle-free jet injection system (Portal Instruments, Inc., Cambridge, MA). Where previousneedle-free injection systems relied on mechanical spring-based or gas-based approaches to achieve the high pressure required to eject at a velocity necessary to pierce the skin, the lack of real-time control limited their application for medications that require larger volumes and those with higher viscosity (Taberner et al. 2012). The Portal PRIME needle-free injector delivers a narrow stream of medication through the skin in less than half a second using technology that controls and modifies the fluid velocity in real time by employing a feedback control loop connected to an electro-mechanical actuator that generates the force needed to inject the fluid.
Comparison of glucose variability in patients with type 2 diabetes administrated glargine with needle-free jet injector and conventional insulin pen
Published in Expert Opinion on Drug Delivery, 2020
Yixuan Sun, Jian Wang, Huiqin Li, Xiaojuan Sun, Xiaofei Su, Jianhua Ma
Although the subcutaneous insulin injection is the standard route for insulin delivery, it may be associated with pain, needle phobia, reduced compliance, and risk of infection. Injection-related discomfort continues to have a significant response as insulin injection-related anxiety and non-adherence. Research has shown that up to 94% of insulin users experience anxiety, pain, or fear similar to injection injury phobia [12]. Injection pain and embarrassment are risk factors for injection omission in patients with T2D [13]. Therefore, transdermal insulin delivery has been extensively studied as an alternative in recent years [7]. Jet injection is a needle-free drug delivery method that employs a high-speed stream of fluid that impacts the skin and delivers drugs subcutaneously [14–16]. Needle-free jet injection is associated with high delivery efficiency, with delivery rates over 90%, similar to subcutaneous injection [17].
Poxvirus-based vector systems and the potential for multi-valent and multi-pathogen vaccines
Published in Expert Review of Vaccines, 2018
Natalie A. Prow, Rocio Jimenez Martinez, John D. Hayball, Paul M. Howley, Andreas Suhrbier
Avoiding needles has a series of inherent advantages [99,100] and a number of needle-free vaccination strategies are being developed (Table 5). Smallpox vaccines were usually given using a process of scarification, which involves using a bifurcated needle (which holds a droplet of the vaccinia vaccine) pressed several times into the skin (deep enough to evoke a trace of blood after 15–30 s) [101]. A multi-dose jet injector (‘Press-o-Jet’) was also developed in 1955 for needle-free delivery of smallpox vaccines [102]. rMVA vaccines are usually given via a needle using the intramuscular route (or the subcutaneous route), although the percutaneous route has also worked in preclinical studies [103]. Vet Jet™ delivery of Purevax® represents the first licensed needle-free delivery of a recombinant poxvirus vaccine, with Stratis jet injection of MVA in phase 2 human clinical trials. Other technologies include needle-free intradermal delivery of solid dissolvable vaccine formulations (ImplaVax™) (Table 5). Clearly of considerable value would be systems that provide both lyophilization, solidification, or dry coating technologies that reduce cold chain requirements combined with needle-free delivery. Progress in this field may also open new avenues for multi-vaccine co-delivery, with ‘dry vaccines’ potentially overcoming some of the hurdles associated with simple mixing of multiple liquid vaccines.