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Jet Injector Medical Presentation
A Brief Disclaimer
This article is provided as a service to potential users of jet injection devices for informational purposes only with information supplied by Mada Medical and physician users. Every effort has been made to ensure that the information is accurate. However, users accept all responsibility for verifying the usefulness of the information, taking any and all precautions, and determining the safe and proper medical use and settings of any jet injector.
Certainly most physicians can put a needle into a patient’s tissues with minimal pain. However, it is not so much the pain from the needle that bothers patients, IT IS THE NEEDLE ITSELF that patients fear. "Needle Phobia" is a real phenomenon that physicians contend with on a daily basis. Reducing this fear can make procedures easier and faster for both physician and patient.
The Jet Injector is a fine precision instrument that has the unique capability to function not only as an injection device for local anesthetic agents into the skin, but also to accomplish deep tissue infiltrations through ALL BODY ORIFICES. The Jet Injector is one of the only jet injection devices with this capability, allowing physicians to inject into oral cavity and laryngeal areas, the vagina and cervix, rectum, ear and nasal areas, open wounds and surgical openings.
The physiological advantages of injections to the above areas is that the physician can provide effective anesthesia using small volumes of local anesthetic with minimal patient discomfort compared to conventional needle and syringe techniques. Another advantage of jet injection technique is that a very small amount by volume (0.1 cc of 2% anesthetic) will provide unusually high levels of tissue anesthesia. This advantage results in the absence or minimal blood levels of any medication injected with the Jet Injector.
The controlled depth of anesthetics, or other aqueous medicaments into the intradermal tissue is seen in the following diagram. In contrast to "pooling" of medication by syringe/needle, the Jet Injector disperses the medication into the tissue in tiny droplets, producing immediate effect and greater intensity of the drug used.
The Medical Jet Injector is available with Extended Tips varying in length from 3/4" (19.05 mm) to 6.5" (165.1 mm) and these lengths are selected by the physician according to the applications required. The Extended Tips are removable and interchangeable between patient uses. They can be sterilized by autoclaving, cold sterilization and other normal sterilizing procedures. Each Extended Tip comes with a protective sheath which is normally placed gently on the tissues to be injected. The sheath should be left on the Extended Tips at all times.
A. Plastic Surgeons/Reconstructive Surgeons:
a. Local anesthetics into skin tissue for biopsies, keloids, minor surgical procedures, hair transplants.
b. Capabilities of injecting into the inner nasal and ear (otic) tissues.
c. Pinpointing tissues around the eyes.
d. Suturing or removal of sutures.
NOTE: The Jet Injector with its unique capability of producing excellent tissue anesthesia without producing the "ballooning" effect caused by syringe and needle technique is of great value in allowing the surgeon to suture the proximal edges of the wound or incision without distortion of these tissues, which minimizes scar formation and greatly minimizes tissue artifacts (abnormal histological tissue changes) in doing biopsies etc.
e. Infiltration of steroids into tissues to reduce inflammation and pain which normally occurs in many cases where simple non-infectious inflammatory conditions can exist.
The longest history of use has been with this specialty. The Jet Injector with the provided 3/4" Extended Tip has been used by many dermatologists to inject dermatological lesions, with great advantages for the patient:
a. Far less painful than the use of a needle and syringe.
b. Allows for minimal volumes of steroids to be used while producing much better control and treatment of these dermatological lesions.
c. Reduces greatly the possibility of causing blood levels (titers) of the steroids used.
d. Greater control of depth of penetration (4-4.5 mm) below the epithelium in the intradermal areas.
e. .Allows physician to mix the steroid to be used in much smaller volumes, with 2% Lidocaine as diluant. This procedure provides much better patient acceptability by reducing the ache or pain from the steroids hours after treatment.
NOTE: Practitioners have told us that it is important always to keep the steroids cold before treatment to prevent crystal growth in the vial and always to keep the anesthetic at body temperature to prevent burning sensations and discomfort from use of cold anesthetic agents.
Practitioners have made a suggestion regarding the dilution mixture of the steroid with 2% Lidocaine is to initially use 1/3 part by volume of the anesthetic and 2/3 part by volume of the steroid. The concentration of the steroid can be increased after the first or second treatment. The steroid often successfully used is Celestone Soluspan by the Schering Company.
In this specialty there are few instruments available that can perform local injections of anesthetics or steroids as can the Jet Injector.
Jet injection technique allows for the use of small volumes of local anesthetics to produce unusually high levels of anesthesia.
a. Injection into the tissues of the anterior and posterior portions of the aural and nasopharyngeal areas are easily done with much less pain for the patient, and if larger volumes of anesthetics are needed by using the needle and syringe, the patient will have minimal discomfort from this procedure, although this is not often necessary.
b. Many otolaryngologists are also involved in facial plastic and reconstructive surgery including installation of adipose (fat) tissue from other parts of the body as well as the infiltration of collagen materials or similar medicaments for facial wrinkles. The Jet Injector has been clinically used for this procedure.
NOTE: A 6.5” (165.1mm) Extended Tip is available for reaching the pharyngeal areas
D. Colon-Rectal (Proctology):
The areas around the anal sphincter are often injected, as are the tissues externally and adjacent to the sphincter tissues. This is nor=Ally a quite painful procedure and the Jet Injector can be an excellent and a far less painful method of providing adequate anesthetics (2% Lidocaine). It has been reported chat injections directly ~to hemorrhoidal tissues have been successfully done.
NOTE: Various lengths of Extended Tips are available to reach deeper areas up to 6.5'. posteriorily to the sphincter area.
A common procedure in this specialty is cervical biopsies. This often painful procedure is an excellent place where a simple injection of local anesthetic (2% Lidocaine) with the Jet Injector will facilitate the physicians test, and most certainly add to the patients comfort.
Practitioners report that breast tissue biopsy -as previously discussed the injections of 2% Lidocaine adjacent to the tissues to be biopsied with the Jet Injector is an excellent method of anesthetizing these tender tissues. From 1-4 injections can be made at 90 degree points to the area involved.
It has been suggested to us that each of the injections be approximately 1/4" away from the periphery of the nodule. The depth of injection will be 4.5 mm below the epithelium, and will produce a 6 mm wheal at the base of each Jet Injector injection (See page 1 diagram A). The Jet Injector can be autoclaved if it is to be used in the delivery room for use during episiotomy procedures.
F. Emergency Room Physicians:
Lacerations of the face and other parts of the body, especially with children, often requires painful injections of local anesthetics causing the psychological trauma of ".needle phobia". The Jet Injector provides two (2) major advantages:
a. Eliminates the use of the needle and syringe.
b. Will not balloon the tissues. This makes it easier to suture the proximal edges, and also prevents undue amounts of scar tissue from forming from the suture line.
Venipuncture or arterial punctures for blood samplings have been painlessly done by injecting 2% Lidocaine adjacent to the vessel or where needle penetration is done. When attempting to do this directly over the blood vessel, practitioners have reported being able to simply "hump'. the skin tissue between the first finger and thumb and then injecting into this area.
NOTE: If injections of anesthetics are required into the deeper tissue areas, this can easily be done by injections with the Jet Injector and using a 4 X 4 gauze pad to prevent splattering of blood or fluids from the wound.
G. Orthopedic Surgeons:
a. Arthroscopy procedures requires injections of local anesthetics into the knee. This can be greatly facilitated by using the Jet Injector. Several prominent Sports Physicians employ the use of the Jet Injector style injector. Injections at the site where the scope is to be inserted with the Jet Injector have been done using 2% Lidocaine/ 1:1,000,000 epi.
b. Bursal infiltrations – Some practitioners have reported that this frequently painful procedure has been greatly helped by first injecting 2% Lidocaine at the site where "deep needle" insertion is to be made.
Injections in the upper and lateral areas of the scrotum with 2% Lidocaine without epinephrine for vasectomies have been successfully performed. While specific technique cannot be recommended, several physicians have reported excellent results doing no-scalpel vasectomy using a straight headed (podiatry) jet injector set to an injection pressure of 6 Ha (yields a penetration depth of 5 to 6mm) and making 2 to 3 injections per side.
b. Bent Spike Syndrome (Pyronees Disease)
Here injections directly intraurethral through the head of the penis using a mixture of steroids and 2% Lidocaine have been done. Various size Extended Tips are available up to 6.5" in length. This allows the physician to inject directly into the keloids or scar tissue of the patients urethral tissue.
a. Anesthetising the site for spinal injections.
b. Anesthetising the site for arterial or venous punctures.
c. Similarly for insertion of catheters.
d. Biopsies. see diagram B.
4) The Medical Jet Injector is a fine precision instrument and most unique as a Jet Injection Device. Few instruments available can perform the functions or provide the technical advantages of the Jet Injector. There are several important facts concerning the operation and care of the Jet Injector which are important to provide maximum benefits and minimize problems for the physician.
A. Physical Aspects: (See Product Manual)
Please note the diagram of the major parts of the Jet Injector.
The major parts are:
a. Release Button
b. Cocking Lever
c. Finger Rest
e. Body of Jet Injector
f. Jet Injector Stand
g. Pyrex Fill Chambers
h. Head Assembly
j. Extended Tip
B. Function: (See Product Manual)
To familiarize yourself with the Jet Injector, all of the functions should be practiced before using
a. Cocking & Firing
b. Holding the Jet Injector
c. Priming Action
d. Filling the Fill Chamber
e. Placing Jet Injector on tissue.
NOTE: Each Jet Injector has enclosed with it 4 pieces of information:
b. Medical Applications
c. Product Manual
d. Care of the Jet Injector
The Product Manual will take you step by step through the operational use. The single instruction card "Care of the Jet Injector" is most important and although it is simple to perform and takes only a few seconds to do, most of the problems the physician will encounter are due to the fact that these simple directions are not followed.