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UntitledPre-Filled OR Syringes from
PharMEDium Services, LLC
By Dennis Roberts, DPh
The Regional Medical Center at Memphis is a critical Acceptance From Anesthesia
access teaching hospital, affiliated with the University Anesthesia has quickly accepted the new cefazolin push syringes, of Tennessee and operating eight centers of excel- since they can be administered in two to three minutes, versus the lence, including burns, level 1 trauma, high-risk obstet- 30 minutes needed for cefazolin piggybacks. The shorter adminis- rics, wound care, newborn, adult special care, sickle tration time also made it easier to comply with the Centers for cell, and bariatric care. We are licensed for 355 beds and 25% Medicare and Medicaid Services (CMS) core measures for surgicalto 30% of our patient population is indigent or self pay.
infection prophylaxis, which require the medication to be adminis- To ensure the proper labeling and beyond-use dating for our OR tered within the hour prior to surgery. Our anesthesiologists also ucts on a daily basis for use in our four Since using pre-filled syringes, the Regional Medical Center
has witnessed a reduction in cefazolin costs and
waste, as well as simplified inventory control for a
variety of drugs used in the OR.
security, and 45-day beyond-use dating.
our cefazolin, phenylephrine, ephedrine, and succinylcholine to well in advance of their expected use. We have also noted a sig- PharMEDium as a beta site for their OR syringes.
nificant reduction in costs and waste associated with cefazolinsince switching from piggybacks to PharMEDium’s push Cost Considerations
syringes, due to the elimination of the tubing. In addition, inven- The cost of a PharMEDium syringe is considerably higher than the tory control has been simplified. Our buyer places a weekly cost of preparing a product in-house, even with the associated labor order, and we currently stock five boxes of 25 cefazolin syringes reduction. However, with just 24-hour dating on products com- and two boxes of 25 each of the other products. Because of the pounded in-house and the syringe quantities anesthesia required to success of this program, we have asked PharMEDium to consid- be on-hand, we were destroying 60-plus syringes daily. This made the er compounding additional syringes, such as ceftriaxone with premium PharMEDium charges for its syringes financially feasible lidocaine for IM injections given in the emergency department ■ for our organization, as we stood to waste fewer syringes with theirextended beyond-use dating. Furthermore, in using PharMEDium’s Dennis E. Roberts, DPh, is the assistant director of pharmacy oper- cefazolin syringes as a push, we eliminated the cost of piggyback tub- ations at the Regional Medical Center in Memphis. He is a gradu- ing, which is actually more expensive than the drug itself. ate of the University of Tennessee School of Pharmacy. Reprinted with permission from Pharmacy Purchasing & Products, Vol. 5 #7. 2008 Ridgewood Medical Media, LLC, Ho-Ho-Kus, NJ. All rights reserved.
O uso da vírgula na construção social de Faculdade Unida de Suzano - UNISUZPaula Barbosa Pudo Fatec de Itaquaquecetuba ( email@example.com)O presente trabalho não tem como foco a aplicação e explicação do uso da vírgula nos estudos da gramática normativa em nossa língua materna, mas, sobretudo, de acordo com a Pragmática, a Semântica e a Linguísti-ca Aplicada. Há construçõ