Launching Today: The New Universal Medical Online Store

It’s Launch Day

Are you ready for liftoff?

Today is the big day. We’ve been working hard to bring you a mobile-friendly site that is faster, easier to navigate and more user-friendly. And that day is finally here.

How do I prepare for launch?

To begin using our newly designed site, you’ll need to reset your current account password. The example below shows you what the password reset page will look like. Once you have navigated to the “Forgot Your Password” page, you can enter your email address in the “Email Address” box and press submit.

Watch Our Screencast

We’ve recorded a screencast to help walk you through the password reset process. Click on the image below to watch the screencast.

 

Password-Reset-Screen

 

Resetting Your Password Is Easy

To reset your password, simply click on the orange “Reset My Password” button below and enter your existing account email address in the box of the example “Forgot Your Password” page shown above.

 

Have you visited our new site yet?

Over the past several months, we’ve been working hard to bring you a mobile-friendly site that is faster, easier to navigate and more user-friendly. We can all agree that technology moves fast. And to keep up, we’ve redesigned the site from the ground up with a clean and modern design that provides you with an optimal viewing experience across a wide range of devices. We want you to enjoy your shopping experience across all your devices (from desktop monitors to mobile phones and tablets).

Why not take a look?

We couldn’t be more excited about our newly redesigned site and how it will make shopping faster, easier, and more enjoyable for our customers. Visit www.universalmedicalinc.com or simply click on the screenshot below to see our new eCommerce site for yourself.

 

New-Site-Screen

 

Do You Have Any Questions?

We’re here to help. You can call, email or live chat with us during our normal business hours (M-F 9AM to 5PM EST) with any questions, issues or comments.

The New Universal Medical eCommerce Site Is Coming Soon

We’re excited to announce that in the coming weeks, we’ll be launching our newly redesigned Universal Medical online store, revamping familiar features and introducing new ones. In this post, we’ll share some of the details of the new UniversalMedicalInc.com and how it will improve your overall shopping experience.

So what’s new?

A Cleaner, Bolder, And More Modern Design

Over the past several months, we’ve been working hard to bring you a mobile-friendly site that is faster, easier to navigate and more user-friendly. We can all agree that technology moves fast. And to keep up, we’ve redesigned the site from the ground up with a clean and modern design that provides you with an optimal viewing experience across a wide range of devices. We want you to enjoy your shopping experience across all your devices (from desktop monitors to mobile phones and tablets).

What should I expect?

A Faster and Easier Site to Navigate

If you’ve been a customer of ours for a while, you’ll immediately notice the new design of our Homepage. We’ve revamped our Homepage by making it simpler and easier for you to navigate. With the newly designed site, you’ll be able to find the products you’ve been searching for quickly and easily. Additionally, we’ve enhanced the site search functionality to quickly provide you with relevant products related to your initial search query.

Richer Visuals

Redesigned Logo

One of the first changes you’ll probably notice is the updated Universal Medical logo. We’ve kept the core elements of our logo and made a few minor tweaks to the typography to reflect the clean and modern design of our new site.

Improved Site Search

Another improvement we are really excited about is the search bar. You’ll immediately notice the new location of the search bar, previously, the smaller search bar was located in the upper right corner, now the larger search bar takes center stage, making it much more accessible. Additionally, you’ll no longer have to click away from the Homepage to see the search results. And last but certainly not least, the search results have become visual. Immediately after you start typing, products will begin to display on the search bar drop-down menu – no more clicking away from the Homepage to see your search results – making it faster and easier to find what you’re looking for on our site.

Stay Tuned for Even More Features to Come

There are many more features that we didn’t discuss in this post, as we approach launch day we’ll be rolling out more information. We couldn’t be more excited about our newly redesigned site and how it will make shopping faster, easier, and more enjoyable for our customers. Keep an eye on your inbox for our pre-launch and launch day notification emails. We look forward to having you check out the New Universal Medical eCommerce site.

The Importance Of Radiopaque Markers In Digital X-Ray

Radiopaque Anatomical Markers

Radiographers are taught from day one in school to place radiopaque anatomical markers within the primary beam of radiographs.  We do so as a method of “best practice” to properly distinguish the patient’s right from left on the radiographic image per legal requirements. Conditions like dextrocardia (when the heart is positioned on the right instead of the left) and situs inversus (when all of the internal organs are on the opposite side compared to normal anatomy) exist which can easily be misinterpreted and would normally cause a technologist to inappropriately orient the image to appear similar to normal anatomy.  But when radiographs misrepresent right from left, this presents a huge risk for medical errors.

Computed Radiography & Digital Radiography

When Computed Radiography and Digital Radiography entered the scene, radiologic technologists were provided with a method of digitally annotating right and left.  This further led some to question the necessity of placing radiopaque anatomical markers within the primary beam of each radiograph.  If you’re like me, you’ve more than likely witnessed a decline in the use of markers in your radiology department but make no mistake; they are more necessary now than ever with the introduction of digital radiography.

A Cautionary Tale

Several years ago when I was working with a new Computed Radiography system in a hospital, I was on portable-duty which consisted of 50-60 portable chest and abdomen exams per day on average.  Another technologist, who was assigned the “float” shift, was asked to rotate where needed within the department.  I asked this technologist for help with a STAT portable chest x-ray in ICU around mid-morning, and by mid-afternoon I found myself in the Chief Radiologist’s office with the Radiology Director and Manager.  The door was closed, faces were red, and it was uncomfortably quiet.

After what seemed like an eternity, the Chief Radiologist displayed a portable chest radiograph on his monitor and asked “do you recognize this exam?”  I looked for several seconds and said, “No, I actually don’t.”  They looked at one another confused, and then asked me to critique the image.  I started to go through my image critique steps learned in school one by one, noting the presence of what I thought might be a pneumothorax, and they stopped me when I said there was no marker present.  The radiologist then asked me, “How would you know if this exam was oriented properly on the screen?”  I rattled off some details that would give anyone clues, but when I discussed the location of the heart, he stopped me again.  He horizontally flipped the image and stated “is this hung correctly?”  Ultimately, I concluded that there was no way to know whether the exam was hung appropriately due to lack of a radiopaque anatomical marker or a blocker (which we could use in film/screen imaging to determine if we knew the projection – PA vs. AP).

They all looked at one another again and the radiologist asked me “Did you perform this radiograph?”  I did not remember viewing an image similar to that one during my exams performed that day, so I let them know I didn’t remember performing it.  They asked me if anyone was helping me throughout the day, and my heart sunk, knowing I had to name the only person I had asked for help that day.  They invited me to exit the room and resume my shift.  My manager encouraged me to continue using my markers, and he informed me he would follow up with me before I left for the day.  The door closed behind me.

Later that afternoon, I was called back into the same room that displayed the same chest radiograph.  The radiologist was a bit less intimidating, but not much.  He explained to me that the radiograph indeed displayed a pneumothorax… a “tension pneumothorax.”  He asked if I knew what that was, and at the time I did not.  A tension pneumothorax occurs when one lung is punctured and air enters the pleural cavity around the punctured lung.  The “tension” portion occurs because air entering is not allowed to escape the pleural cavity, and the mediastinal structures as a result are shifted to the opposite side (in this case, from the patient’s left to their right).

After their investigation, it was concluded that the technologist exposed the image without placing a radiopaque marker within the primary beam.  When the image displayed at the computer terminal during processing, it was most likely appropriately displayed.  Due to the appearance of the mediastinal organs on the patient’s right side, the technologist viewed prior radiographs to ensure the patient had normal anatomy (which he confirmed).  He then mistakenly flipped the image horizontally so that the heart appeared on what he thought was the patient’s left side, digitally annotated a “left” marker, then sent the image to the radiologist for dictation.

The radiologist, upon viewing this STAT exam, called the physician who was in ICU and informed them that the patient had a pneumothorax on the right side, although it was actually a tension pneumothorax on the patient’s left.  Because the technologist had inappropriately flipped the image, the ordering physician inserted a chest tube on the wrong side, into the unaffected lung, causing further complication which lead to a Code Blue being called and a much longer recovery process for the patient who was already undergoing treatment for several other problems.

I found out I was originally called into the Chief Radiologist’s office immediately following a 30-minute scolding by that patient’s physician who inserted the chest tube on the wrong side because of an error made in the radiology department.  The patient eventually recovered, but imagine what could have happened as a result of the technologist’s error.  I was glad to be off the hook, but I never found out if the technologist was disciplined or if charges were ever pressed against the hospital.

Lessons Learned

Having experienced something like this, it is easy to see the importance of radiopaque markers on a radiograph.  It is discouraging to know that many departments see a decline in their usage simply because we can place one there after the image is processed; because it’s easy.  It may be true that it is more difficult to remember to place a marker or to remember to simply bring your markers to work with you, however, It is my opinion that allowing this to happen not only encourages error, but causes liability for the technologist, radiologist, and institution that is providing radiographic services.  It should be a goal to have radiopaque anatomical markers on 100% of radiographs.  It is required for images to be admissible in a court of law, and it truly is “best practice.”

Risks vs. Benefits

Whether images need to be repeated if a marker is occasionally not visible on an image, warrants a risks vs. benefits discussion with on-site personnel including the radiologist/s.  Technologists can be held accountable, however, during evaluations and upon the occurrence of failure to use these markers.  Furthermore, it is important for employers to encourage and enable technologists to use these markers and have a quality assurance process with follow-up.  It would also be wise to consider other options such as purchasing disposable, single-use markers which can be utilized for isolation cases which infection control becomes an issue, or for when a technologist misplaces their markers.  There are tools at our disposal which are cost-effective that can prevent situations like the one mentioned earlier.

About the Author 

Jeremy Enfinger is an experienced Radiologic Technologist, Radiography Program Instructor, and published author. He has served in leadership roles in hospital, outpatient and academic settings. His experience includes writing examination questions for the national ARRT Radiography Exam and multiple – modality training. He continues to pursue excellence in education and patient care. An avid blogger, Jeremy strives to promote standards of excellence in imaging through his online community with the sharing of veteran tips and techniques for high-quality imaging.

Free eBook

 

For any radiologic technologist looking to make improvements and fine-tune their image critique skills; this is a must-have resource. To receive your copy first, sign-up for the “Topics in Radiography” email list and you’ll be able to download the book for free on April 18, 2015.

 

 

 

Gold Standard Cleaning For X-Ray Aprons & Lead Wearables

What Does Gold Standard Cleaning Look Like For X-Ray Aprons And Lead Wearables?

Thus far in this lead apron based blog series, we have examined the infection issues and concerns associated with contaminated lead x-ray aprons and the science behind how staff members can easily test such surfaces for contamination using ATP testing.

This third blog entry will examine methodologies and practices utilized by clinical staff and facilities in the “cleaning” and maintenance of these protective lead wearables, and also explore what “cleaning” such a surface really entails. In discussing bioburden levels in the previous blog, we addressed how one cannot judge cleanliness on a surface by appearance alone.  Let’s take a deeper dive into what it means to truly clean and sanitize these protective, lead garments.

Survey Says…

In researching the topic, speaking with professionals at symposiums and inquiring with colleagues and peers, there is little consistency across the continuum of care with how these garments are cleaned and/or serviced. Shockingly, a number of Radiology, Cath Lab and Operating Room staff have lamented that such surfaces “never” get cleaned, while other staff and administrators have shared that such surfaces are sometimes cleaned, “when the case load is light on a Friday” or “on the midnight shift by the environmental services department.” Both patient and staff safety are at risk due to lack of staff compliance and clinical efficacy issues posed through improper cleaning practices.

Online research lead to a few administrators sharing that they ran these lead aprons through a cart washer, which lead manufacturing companies clearly advise not to do. Clinicians have also shared that they try to use products such as Lysol or Febreeze to “eliminate the odors” yet admit the lead wearables still aren’t “clean.” One of the more popular concepts considered in attempting to clean and service these wearables entails the discussion of “using sanitizing wipes” on such high-touch surfaces.  Unfortunately, the use of these wipes alone does not properly clean and sanitize the garments.

Pesky Directions

There are a number of sanitizing/disinfecting wipes on the market that some clinicians claim to use on lead aprons and wearables. When taking a closer look at the labels on these products, one may very well discover that most wipes are actually not recommended for use on lead wearables. Additionally, some wipes contain bleach and corrosive agents, which are both advised not to be used on aprons, according to the companies that manufacture them. A majority of the wipes on the market today are indicated for use on “non-porous” surfaces such as tables, bed rails, door handles, etc. rather than a porous surface such as a nylon covering of a lead wearable. Though the use of wipes might afford convenience to the user, the real issue with doing so lies in their clinical inefficiency in successfully cleaning the surface, not to mention completely removing any bioburden.

Wax Then Wash?

If your car had dirt, road tar and bird droppings on it, would you attempt to wax it in that condition?

For best outcomes, you would first clean and remove those elements before attempting to wax the car.  The same is true for other surfaces, including lead wearables.  Professionals who routinely assess bioburden understand the importance of a proper cleaning before sanitizing or disinfecting an item.  If an item is not properly cleaned and organic matter remains, nutrients also  remain to better foster the growth of surviving bacteria or future bacterial contamination.  This is by definition a risk factor for increased hospital associated infections.

All You Can Eat Buffet

In watching the news of late, one can gather that the world of microbiology is ever changing.  Bacteria are highly adept at persisting.  Through changes in their DNA they can gain antibiotic and/or antiseptic resistance, and these changes can happen through mutations or through integration of foreign DNA, but where would they find foreign DNA?  When bacteria die and the cells break open, then the DNA is accessible to the remaining bacteria.

The Problem with Sanitizing and Disinfecting Wipes

When facilities only use wipes on a surface and don’t completely remove the debris, they are in essence creating an “all you can eat buffet” for the surviving bacteria to thrive upon. If the dead bacteria had antibiotic or antiseptic resistance markers, now that DNA is fair game for susceptible bacteria to gain resistance!   In fact, numerous studies have shown that certain bacteria can pick up various genes from different species that makes them more pathogenic (either by making it antibiotic resistant, antiseptic resistant, or by allowing it to survive in a host better).

Layers Of Bacteria? Gross?

As if that wasn’t scary enough, what if I told you that some bacteria could gain antibiotic and antiseptic tolerance simply by growing?  (IT IS TRUE!)

Some bacteria can attach to a surface (particularly porous or textured surfaces such as lead wearables) and as they grow and form groups of bacteria (colonies) that can then form a biofilm.  Biofilms are clusters of bacteria that have attached and produced an extracellular polymeric substance (EPS) which are essentially a protective coating.

Extracellular Polymeric Substance (EPS)

EPS consists of DNA, proteins, lipids (fats) and polysaccharides (sugars).  This coating protects the bacteria inside the human body from cells that can either tag the bacteria for destruction or destroy the bacteria outright.  Externally (on a surface) it can protect the bacteria from anti-microbial drugs or antiseptic agents.  In fact, bacterial biofilms are 10 – 1,000 times more resistant to antibiotics than there standalone bacterial counterparts.  Their EPS is essentially a bacterial Teflon coating.  This Teflon coating only gets stronger when multiple species of bacteria co-inhabit the same biofilm, and if these attributes weren’t scary enough, bacteria in a biofilm can sense their microenvironment and may even produce toxins while in a biofilm that they wouldn’t normally produce.

Biofilm Life Cycle

Like all living things, biofilms have a life cycle, and a part of that life cycle involves dispersion of some bacteria that are then free to go and attach elsewhere, including in a human host. In 2007, the National Institutes of Health estimated that approximately 80% of chronic infections were biofilm related; thus, biofilms remain a serious problem in many facilities. When surfaces such as the nylon covering of a lead wearable are not cleaned properly, it allows different bacteria to begin to congregate.

Layers of Bacteria

Thinking this all sounds like something from a fictional book or movie, as if biofilms can only exist in some weird lab conditions or in some rare disease?  Nope!!!!

The most common example of a biofilm is one that everyone is probably familiar with, but may not realize is a biofilm, is dental plaque!  Biofilms are so hard to remove from surfaces that companies have spent millions of dollars trying to prevent their formation.  If you think about dental plaque, it makes sense.  We brush our teeth twice a day to best prevent plaque.  Unfortunately, when it comes to medical devices or any surface (particularly a porous or textured surface) in a medical treatment facility (such as lead wearables), biofilms can form once the surface is exposed to organic matter such as blood.  Now with the mental picture of layers of bacteria (such as plaque) on surfaces in medical treatment facilities, consider that some high-touch surfaces, such as radiological shields and aprons have not been properly cleaned for years (if ever!)

Elbow Grease Helps Break Up Biofilms

Biofilms are so tolerant of antimicrobials and antiseptics, that even the CDC positions the best way to remove a biofilm is to disrupt it physically, and they have included the ‘use of friction’ in their definition for proper cleaning.  Studies have been done that show that physically disrupting the biofilm by using friction is the primary means for destruction of the layers and thus removal of the biofilm.  (In the example of dental plaque, this would be equivalent of one going to the dentist and having them scrape the teeth in order to remove the plaque.)  The procedural process and outcomes are different when looking at the process of “cleaning” and “sanitizing” and it takes both of these separate processes to eradicate biofilms from porous, high touch surfaces. The surface on a lead wearable first needs to be cleaned before it can then be sanitized.

  • Cleaning – According to the CDC, cleaning entails the use of EPA registered products, coupled with the use of friction to physically remove dirt, microorganisms and bioburden and then removing/rinsing them away from the surface. Though a vast majority of the bioburden is removed during this process, the cleaning process does not always remove 100% of all bioburden & microorganisms.
  • Sanitizing – This process then “inactivates” 99.9% of all remaining microorganisms on environmental surfaces if allowed to sit visibly wet or “dwell” on the surface for the recommended amount of “dwell time” as per manufacturer instructions and guidelines.

Cleaning and Sanitizing really can’t be done in one-step, let alone with just a wipe. When you go to the dentist, the first step in the process is to scrape the plaque from the teeth before they are polished, just like your car needs to be adequately washed and dried, before it can be then waxed. Cleaning and sanitizing of a neglected surface such as a lead apron cannot be accomplished in one step either. In an effort to address such biofilms “head on” X-Ray apron servicing companies, such as Radiological Care Services (IN) are implementing multi-step, cleaning and sanitization programs for X-ray aprons and lead wearables. These programs are built in accordance with governing bodies, such as the CDC, JCAHO, AORN and HFAP, which position that surfaces should first be cleaned, before attempting to sanitize or disinfect them.

Stay Tuned For The Next Post

Stay tuned for the next follow up blog post, as we look specifically at what policies, regulations and expectations these governing bodies have of high touch surfaces, such as X-ray aprons and lead wearables. Between now and then, go brush your teeth and think about the layers of bacteria building up on lead wearables and aprons as they continue to invite bacteria to the biofilm party!

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

How Do I Select The Right Laser Eye Protection?

LASER stands for Light Amplification by Stimulated Emission of Radiation. Lasers emit a narrow beam of light and that beam of light is emitted in short bursts and focuses precisely on the desired target. The energy emitted by the laser can be absorbed, scattered, transmitted or reflected. When used in medical procedures, lasers transmit most of their energy to the intended target and that is why proper laser eye protection is so important.

The Eye is Vulnerable to Laser Radiation

The human eye is extremely vulnerable to laser radiation. When working with medium to high-powered laser systems, it is vital to wear the correct laser eye protection for the specified laser type. Unprotected exposure to lasers can result in the development of cataracts or even a corneal burn, which can ultimately result in vision loss. By selecting and wearing the appropriate pair of laser safety glasses, medical personnel can keep their eyes protected from applications and procedures that require a laser system. Protective laser safety glasses must be matched in terms of wavelength frequency and the type of laser being used (e.g., YAG laser glasses, Holmium laser glasses) for your specific application. That is why it is important to understand the consequences of laser radiation exposure.

3 Ways Lasers Can Damage Your Eyes

There are three ways that lasers can damage your eyes including thermal, photochemical, and mechanical damage. Laser safety glasses provide valuable laser eye protection by shielding vulnerable eye tissue from the high-intensity radiation emitted. Laser safety glasses are not only a vital safety component, they are also required in all facilities where medical, surgical, cosmetic or dental laser procedures are performed. Laser safety glasses are also used in research and forensic laboratories.

What Types of Eye Protection are Available?

There are several levels of laser eye protection available. Laser safety glasses are measured in optical density and this number reflects the ability of the filter to block the light that is transmitted at a particular wavelength. The higher the optical density, the more light from the wavelength is blocked. For example, laser safety glasses with an optical density of seven will block all but 0.00001% of the laser frequency.

How Do I Select the Right Laser Eye Protection?

Selecting the right laser eye protection may seem overwhelming; we have simplified the selection process for you by creating a white paper that discusses the eight key factors you’ll want to consider when selecting the right laser eye protection. It is extremely important to protect your eyes and yourself from the harmful effects of laser radiation. Remember, the damage done to your eyes from laser radiation exposure can be permanent. If you have any additional questions regarding how to select the right laser eye protection please comment below or email us at info@universalmedicalinc.com.

 

 

 

 

Evaluating Microorganism Levels On X-Ray Aprons And Lead Wearables: The Science Of ATP Testing

How Have Microorganisms and Bioburden Been Measured?

In the previous blog post regarding X-Ray lead aprons, we explored the history of healthcare associated infections or HAIs, and how transmission risks are posed to patients and staff via contaminated “high touch, non-critical surfaces,” including X-Ray aprons and protective lead wearables.  In laying out the content of this blog, I was reminded of the phrases, “things aren’t always as they appear” and “don’t judge a book by its cover.” Is it possible that newer (clean looking) X-Ray aprons can carry a higher level of biological contamination when tested in comparison to older X-Ray aprons (which are dirty looking & smelling)? It is completely possible and plausible due to the concept of bioburden.

What is Bioburden?

Bioburden is defined in numerous medical dictionaries as the number of microorganisms contaminating an object.  So how does one assess for bioburden?  The gold standard for assessing for bacterial/fungal contamination has been to assess for colony forming units or CFUs.  A CFU equals one viable bacterium that has the ability to spread and replicate.

3 Main Ways to Measure CFUs: 

  1. A scientist could dilute the sample and count the bacteria by microscopic examination or through the use of a cell counter.  However, if bacteria are too small or clump together, then this method is problematic.  This method will yield total bacteria counts, both living and dead.
  2. A scientist could use Optical Density (OD) to estimate the number of viable bacteria in a sample.  This is where the scientist measures how cloudy a liquid culture of bacteria is.  While the bacteria are actively growing the liquid culture should continually become more and more cloudy.  Again, this method will yield total bacteria counts, both living and dead.
  3. A scientist could make serial dilutions of a liquid culture and plate out the bacteria in known dilutions until they can count single colonies and extrapolate back to figure out total CFU in a sample. This method only yields viable bacteria totals.

4 Challenges Associated with Bioburden Assessment

Assessing for bioburden (microorganisms) by calculating CFUs is not as easy or straight forward as one might imagine.

  1. The first challenge posed is that one needs to have a lab in which to grow bacteria, and depending on the bacteria one is dealing with there are different governmental regulations to follow.
  2. The second challenge presented is that of time, one needs to have the time and equipment to properly grow the bacteria/fungus.  Different species of bacteria or fungus grow at different rates, for example, culturing of bacteria on plates can take anywhere from overnight to multiple days.
  3. A third and very important challenge is posed by the bacteria and fungus themselves.  They are similar to people in the fact that not all of them grow and thrive under the same conditions.  In lab work, if only one kind of food source is used, one will only be able to assess for bacteria that grow on that particular food source.
  4. Finally, one needs to have a trained technician who knows how to assess which bacteria to grow under the correct conditions and then also how to properly count the bacteria.

While assessing for CFUs has traditionally been viewed as the gold standard for assessing bioburden, and it is vitally important for various microbial studies, it is not a good way to assess bioburden in real time.  It can be complicated.

What is ATP and How is it Evaluated?

What if there was an easier way to determine surface levels of biological contamination?

What if there was an easier way to assess for a molecule that is found only in living cells, both bacterial and human living cells?

There IS an easier way to evaluate for this molecule in real time (by using a simple swab and handheld reader), and it can be used by any hospital staff member as a surrogate for such complicated CFU work.  Let me introduce you to the molecule known as the “molecular workhorse,” called adenosine triphosphate (ATP).

Adenosine Triphosphate (ATP)

ATP is an energy molecule utilized by cells. It is present in humans, animals, plants and microbial cells.  ATP levels rise as a cell is undergoing apoptosis (programed cell death), but is generally consider to be completely degraded within 30 minutes of cell death (1).  This makes ATP a useful marker for the presence of unwanted biological contamination, including organisms that can cause infection and disease.

Okay – Get to the Point!

An increase in biological cells on a surface results in an increase in the amount of ATP present on that surface, thus making ATP an effective marker for the assessment of the hygienic status of an environmental surface. Simply stated, the amount of ATP present on a testing swab is a quantitative measurement of the cleanliness of the surface tested! In fact, ATP cell viability assays were determined to be the fastest, most sensitive, and least prone to artifacts, partially due to a lack of an incubation period (2).  The sensitivity of laboratory cell based ATP cell viability assays can detect fewer than 10 cells per well (2).  This technology has been modified to create a portable, ATP bioluminescence test, using a swab instead of plated cells.  This now allows for a real time assessment of bioburden on site.  These tests have been used to assess bioburden in many healthcare settings, including the ICU (3).  ATP measuring units, called luminometers, are handheld, user friendly, and display the results in seconds. (It doesn’t take a scientist to use an ATP luminometer!) The read out of an ATP bioluminescence test is not in CFUs, but is in relative light units or RLUs.  In the past, some scientists have questioned the validity of using a bioluminescence test instead of assaying for CFU.

Is There a Correlation Between CFUs & RLUs? 

Like most assessments, ATP bioluminescence assays also have limitations, but they are an excellent surrogate that allows the everyday staff member to assess bioburden in real time.  Those new to ATP bioluminescence testing often inquire about a correlation between CFUs and RLUs.  (Most laboratory microbiologists have the capability to perform CFU testing, and are not confined to real time assessment of bioburden.)  The most controlled way to achieve this is to look at different known amounts of CFUs and assess whether or not the RLUs increase accordingly.  That is exactly what Dr. Sciortino’s group did when they assessed three different portable ATP bioluminescence kits for their ability to detect various CFUs of two different HAI relevant bacteria (Staphylococcus aureus and Acinetobacter baumannii) and one strain of fungus (Candida albicans).

What they discovered was there was a linear relationship between bacterial CFUs and RLUs for all three luminescence kits, and for two of the three kits between fungal CFUs and RLUs (1).  Such research validates that the use of ATP luminometers can be used to assess for bioburden on surfaces in real time.  This research, plus Dr. Jaber’s study, in which 25 lead aprons were cultured for CFUs and showed that 21 were colonized with Tinea species (the family of fungus that causes ringworm) and 21 were colonized with Staphylococcus aureus, of which 3 aprons were colonized with MRSA (4), validates the ATP bioluminescence results for X-ray aprons and protective lead wearables.

In fact, these X-ray aprons and protective lead wearables, which are worn throughout many different areas within a healthcare system, including the operating rooms, cath labs, radiology/imaging areas, emergency rooms and beyond are regularly testing with RLU readings in the THOUSANDS to HUNDREDS OF THOUSANDS (5), which is scary. The bottom line is regardless if you are a classically trained microbiologist used to looking at CFUs or a hospital staffer looking at luminometer readouts in RLUs, when surfaces inside an OR or Cath Lab are testing in the hundreds of thousands range, it is a problem!

Is ATP Testing Growing in Use?

Through utilization of ATP luminometer testing systems, companies like Radiological Care Services (Indianapolis) are able to enter a facility’s Cath Lab, OR or Radiology Department and test lead apron inventories on site, providing real time numbers (bioburden levels) in a matter of seconds. An advocate for ATP luminometer testing, Dr. Sciortino even states, “ATP system monitoring may uncover the need for new disinfectant designs that adequately remove hospital surface biofilms, rendering used hospital equipment to its native state whereby a zero reading by ATP monitoring can be achieved” (1).  If you look back at the first blog post, “Contaminated X-Ray Aprons and The Risk of HAIs”, I positioned that “using wipes alone” was insufficient and through the use of ATP testing, Dr. Sciortino could be inferring a similar position.

Looking Ahead…

In the next blog post, we’ll specifically look at the science/methodology behind the use of sanitizing wipes and we’ll further explore the differences between true “cleaning” and “sanitization.” We’ll later examine what the governing bodies, such as AORN, CDC, HFAP and JCAHO state regarding their expectations of such surfaces within healthcare facilities. Understanding the science behind HAIs, testing for biological contaminants on surfaces, biofilms, and the difference between “cleaning” and “sanitization” will help us understand that current healthcare protocols in regards “non-critical, high touch surfaces” need to be changed in order to better protect hospital patients and staff.

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

Sources:

  1. Sciortino, C. V. and R. A. Giles.  2012. Validation and comparison of three adenosine triphosphate luminometers for monitoring hospital surface sanitization: A Rosetta Stone for adenosine triphosphate testing.  AJIC.  40 (e233-9)
  2. Riss T.L., R.A. Moravec, A. L. Niles, H.A. Benink, T.J. Worzella, L. Minor. Minor, L, editor.  2013,  Cell Vialblity Assays. In: Sittampalam G.S., N.P. Coussens, H. Nelson, et al., editors. Assay Guidance Manual [Internet]. Bethesda (MD): Eli Lilly & Company and the National Center for Advancing Translational Sciences; 2004-. Available from: http://www.ncbi.nlm.nih.gov/books/NBK144065/
  3. Moore, G., D. Smyth, J. Singleton, P. Wilson. 2010. The use of adenosine triphosphate bioluminescence to assess the efficacy of a modified cleaning program implemented within an intensive care setting.  AJIC. 38(8):617-622 DOI: http://dx.doi.org/10.1016/j.ajic.2010.02.011
  4. Jaber, M., M. Harvill, E. Qiao.  2014.  Lead aprons worn by interventional radiologists contain pathogenic organisms including MRSA and tinea species.  Journal of Vascular and Interventional Radiology.  25:3:S99-S100.  DOI: http://dx.doi.org/10.1016/j.jvir.2013.12.279
  5. “Outcomes: What do your numbers look like?” Radiological Care Services. Nov 20, 2014. http://www.radcareservices.com/radiolgical-care-services-outcomes.html

Why Global Handwashing Day Is Important

Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infection like pneumonia. Handwashing is a simple and inexpensive method of effectively removing germs from your hands. Global Handwashing Day is celebrated annually on October 15 worldwide.

What is Global Handwashing Day?

Starting in 2008, “Global Handwashing Day is a way to support a global and local culture of handwashing with soap, shine a spotlight on the state of handwashing in each country, and raise awareness about the benefits of handwashing with soap.” Founded by the Global Public-Private Partnership for Handwashing with Soap, Global Handwashing Day encourages school children, teachers, and families to get involved.

Did You Know?

There are 1,500 bacteria living on each square centimeter of your skin right now. Our hands spread germs; people frequently touch their eyes, nose, and mouth without even realizing it – spreading germs that can make us sick.

“Handwashing with soap is one of the cheapest, most effective ‘vaccines’ against viral diseases, from the seasonal flu, to the common cold,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene (WASH) programmes.

Are You Washing Your Hands Long Enough?

Take a look at our helpful video on proper handwashing to learn more.

Most people do not wash their hands long enough. It is recommended that you wash your hands for a minimum of 20 seconds to properly remove germs.

Handwashing Saves Lives

“Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more effectively.”

  • Millions of children under the age of 5 years die from diarrheal diseases and pneumonia, the top two killers of young children around the world.
  • Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infection like pneumonia.
  • 2.2 Million children die per year from diseases often prevented by proper hygiene

According to the Centers for Disease Control and Prevention “Handwashing is not only simple and inexpensive, but remarkably, handwashing with soap can dramatically cut the number of young children who get sick.”

How Can You Participate?

There are a variety of ways that you can participate in Global Handwashing Day including:

  • Make sure you and your family know when and how to properly wash your hands.
  • Visit Facebook and Twitter to learn more about Global Handwashing Day games and activities.
  • Download handwashing resources from: http://globalhandwashing.org/ghw-day/tools
  • Get social by searching for and using the hashtag #iwashmyhands on Twitter, Facebook, and other social media platforms.

Remember that properly washing your hands (for at least 20 seconds) is a simple and effective method of preventing the spread of germs that should be practiced daily. For more information on handwashing, visit the CDC’s handwashing website.

What is FluoroSafety?

Identifying Important Risks Associated with FGI

In 1994 the FDA released a public health advisory warning of the potential for serious radiation-induced skin injuries to patients resulting from fluoroscopically guided interventions (FGI).  In the 20 years since this advisory, there have been hundreds of published cases of skin injury resulting from FGI, and the number is steadily increasing even today.  As the scope of disease that can be diagnosed and treated using FGI increases, so does the complexity of these procedures and the radiation doses to patients, physicians, and staff.  While these procedures provide an incredible benefit to the patient compared to open-surgical alternatives, there are important risks that must be understood by the performing physician.

The Need for Effective Training

In 2010, frustrated by the lack of user-friendly, accessible, and effective training focused on this topic, two diagnostic medical physicists started Fluoroscopic Safety, LLC [http://www.fluorosafety.com]. Understanding the need for a balanced perspective and considering that radiation is not the only risk from FGI, they collaborated with an experienced board certified interventional radiologist well-known for his work in quality improvement.  Because of the multi-disciplinary M.D. and Ph.D. backgrounds of the authors of FluoroSafety courses, we understand that when a physician is performing an FGI, managing radiation dose is not the first thing on his mind.  Instead, practitioners are thinking about the patient-specific technical challenges associated with these procedures.  The training programs from FluoroSafety are developed with this in mind.  While our courses do provide instruction on the fundamental physics of fluoroscopy and radiation biology, we focus on simple methods for managing patient and staff radiation dose.  Using videos and animations, our courses provide an easy to remember and easy to execute set of practices which benefit both the physician and their patients.  This is one of the key features of our courses, designed by physicians and physicists together.

Fluoro CME Training and Education

The educational programs from FluoroSafety also help providers satisfy state regulatory requirements. Through a joint sponsorship with The University of Texas MD Anderson Cancer Center, our courses have been approved for up to 10.5 hours of AMA PRA Category 1 CreditTM.   Our programs meet the training requirements for practitioners who use fluoroscopy in Oregon, California, and Texas.  In addition, board certified providers who complete these courses are eligible to claim self assessment CME (SA-CME), as required for Maintenance of Certification (MOC) by members of the American Board of Medical Specialties (ABMS).

Interactive and Engaging Content

The educational programs from FluoroSafety are tailored to the needs of busy healthcare professionals and feature on-demand Flash-based learning rich in animations and videos.  Our courses also feature optional narration.  Course content can be accessed at the convenience of the physician from any computer, smartphone, or tablet with Internet access.

Meet State Requirements

Whether you are trying to meet state regulatory requirements or are simply interested in improving the care you provide to your patients, FluoroSafety has a course for you.  The most common feedback we have received from physicians who have taken our course is that they were surprised by how much they didn’t know about the safe use of fluoroscopy—you may be surprised too!

FluoroSafety.com

A. Kyle Jones, PhD

Alexander S. Pasciak, PhD

Joseph Steele, MD

Fluoroscopic Safety, LLC

3 Different Types Of Prescription Lead Glasses

For those who wear corrective lenses and need to protect their eyes from radiation, we offer three different prescription lens types for our lead glasses. After reading this post you will understand the different types of prescription lens types that we offer, eyeglass prescription terminology, and what prescription information is needed to properly place your order.

Before placing your order, it is important for you to understand the differences between the various corrective lenses before making your decision. Lead glasses provide you with the necessary eye protection to help reduce your risk of developing cataracts from prolonged exposure to ionizing radiation. In the past, those who wore corrective lenses would often be required to wear bulky radiation safety goggles or fit over lead glasses. However, a number of the lead glasses that we now offer are available with various types of prescription lens.

Prescription lens types:

  • Single vision prescription lenses
  • Lined bifocal prescription lenses
  • Progressive bifocal lenses

Single Vision

Single vision prescription lenses have the same magnification throughout and correct for only one distance. These lenses are designed to correct conditions such as myopia (nearsightedness¹), hyperopia (farsightedness), and astigmatism². Our single vision prescription radiation safety lenses offer the industry standard 0.75mm lead equivalency and are manufactured using SCHOTT SF-6 HT radiation resistant glass.

How do I know if I have a single vision prescription?

To illustrate, an example of a single vision prescription is shown below. While reviewing the sample prescription, you may notice several abbreviations, listed below are common terms found on eyeglass prescriptions. If your prescription doesn’t have any values or abbreviations in the ADD column, you have a single vision prescription.

 Single Vision Prescription Lenses
RxSPHERICALCYLINDRICALAXIS
O.D.-2.00-0.5040
O.S.-1.75
Pupillary Distance65

Prescription Abbreviations & Terminology 

  • OD – Oculus Dexter, from the Latin word dexter meaning “right”, means the right eye.
  • OS – Oculus Sinister, sinister which is derived from the Latin word sinistra meaning “left hand”, means the left eye.
  • SPH – Spherical, is the main strength of the lens prescription, and is written in 0.25 increments. It is also referred to as power and is abbreviated as PWR.
  • CYL – Cylinder, this will only appear on your prescription if you have an astigmatism, and is written in 0.25 increments. It is possible that this will only apply to one eye. If you don’t have an astigmatism, your doctor may leave this field blank, or they may choose to put ‘00’, ‘DS’, SPH’, or ‘Plano’ in this field. If the field has one of those abbreviations you will know that you don’t have an astigmatism correction in one or both eyes.
  • AX – Axis can be abbreviated as AX, or simply X. If the cylinder field is left blank or has any of the following abbreviations including ‘00’, ‘DS’, SPH’, or ‘Plano’, this field will be left blank or have an ‘0’.
  • PD – Pupillary distance or interpupillary distance (IPD) is the distance (industry standard is in millimeters) between your right pupil and left pupil. The PD is usually written in the lower row labeled P.D. on your prescription.

Single-Vision Pupillary Distance

  • Binocular P.D. – 65
  • Monocular P.D. – 30/30.5  (OS/OD)

Bifocal/Progressive Pupillary Distance Binocular

  • Near/Reading P.D. – 62
  • Distance P.D. – 65

The American Optometric Association states that Astigmatism is a vision condition that causes blurred vision due either to the irregular shape of the cornea, the clear front cover of the eye, or in other cases the curvature of the lens inside the eye. Astigmatism is a particularly common vision condition.

Lined Bifocal

Bifocal prescriptions are for patients who have difficulty seeing both far and near. They are commonly prescribed to individuals with presbyopia who also require a correction for myopia, hyperopia, and/or astigmatism. As their name suggests, lined bifocals offer distance correction on the upper portion of the lens, and near vision correction on the bottom portion of the lens. Lined bifocal lenses, provide two distinct optical powers with different focal lengths – one for distant vision and one for near vision. The near vision lens has a semicircle (bottom) that measures 28mm wide and has a flat-top (top). Traditional lined bifocal lenses are separated by a visible line.

Progressive Bifocal

Progressive bifocals, or simply progressive lenses, allow you to experience bifocal vision without the traditional bifocal lines. Progressive lenses provide you with a more natural way of seeing. Presbyopia³ is a common vision condition for those over the age of 40 where the eye has difficulty focusing on near-field objects. Individuals who have worn traditional bifocals in the past may have experienced “image jump”, this occurs when there is an abrupt break from distance to near-field vision. Progressive bifocal lenses provide  you with optimum vision and a seamless progression of lens strength.

How do I know if I have a bifocal prescription?

If you notice that there are numbers in the ADD column of your prescription, you have a bifocal prescription.

 Lined Bifocal/Progressive Bifocal Prescription Lenses
RxSPHERICALCYLINDRICALAXISADD
O.D.-2.00-0.5040+1.75
O.S.-1.75+2.00 PAL
Pupillary Distance65

ADD – ADD is the value commonly used for bifocal or progressive lenses. ADD indicates how much power is added to the distance prescription to create the reading-only prescription. ADD corrections will usually have the same value for both eyes. The abbreviation PAL may appear next to one of the numbers in the ADD field, or it may be written elsewhere on your prescription, this indicates that your doctor determined that you will need a different ADD correction for progressive lenses.

PAL– Progressive additive lens (ADD value specifically for progressive bifocal lenses).

Ordering Information

We hope that this post has provided you with helpful information that you will assist you during your research. To review, we covered the different types of prescription lead glasses that we offer, common terminology and abbreviations found on your prescription, and what prescription information we need to properly place your prescription lead glasses order. When ordering, please fax or email your prescription (Rx) including your pupillary distance (PD). For your convenience, prescription information can also be noted in the “Order Comments/Special Instructions” section under “Payment Information” while checking out.

Please note: Lens enhancements options are not available in combination with prescription lenses. 

Questions? Comments?

If you have any questions regarding the different types of prescription lead glasses that we offer, please feel free to contact us via live chat or simply leave a comment below.

Sources:

American Optometric Association – Eye & Vision Problems

 

How Do I Order Prescription Lead Glasses?

Question: How Do I Order Prescription Lead Glasses?

This is a frequently asked question that we receive from our new and existing customers. This post will walk you through the necessary steps to ensure that your order is processed in a timely manner. It is our goal to make your experience as painless as possible.

We currently offer over 75 different styles of lead glasses available with different types of enhancements. There are three prescription lens types available, including single vision, lined bifocal, and progressive bifocal (progressive lenses). Please note that the availability of Rx lenses will vary by frame type.

Step 1 – Find your pair of lead glasses

Step 2 – Determine prescription type

  • Single vision
  • Lined bifocal
  • Progressive bifocal (no-lines)

Step 3 – Choose Your Lens Style

Please note that options will vary by frame style and manufacturer. Due to the custom nature of prescription lead glasses they cannot be returned.

  • Standard
  • Anti-reflective (not available with prescription lens)
  • Fog free (not available with prescription lens)
  • Single vision Rx
  • Lined Bifocal Rx
  • Progressive bifocal Rx

Pricing adjusts in real-time as you add enhancements to the frames. The single vision, lined bifocal, and progressive bifocal prescription radiation safety lenses all offer the industry standard 0.75mm lead equivalency and are manufactured using SCHOTT SF-6 HT radiation resistant glass.

Step 4 – Choose frame color

Please note that color options will vary by frame style and manufacturer

Step 5 (Optional) – Add frame imprint text

  • Frames will be laser engraved
  • Imprint limit is 35 characters (may vary by model)
  • Engraved glasses are non-returnable

 Step 6 – Select desired quantity and click “add to cart”

Step 7 – Review your order

  • Review your order for accuracy

 

Step 8Proceed to checkout

  • Returning customers can sign in for faster checkout
  • New customers can create a personal account (Benefits of registering: quick checkout on future orders, easy order tracking, and special offers)

Step 9 – Enter billing and shipping information

  • Enter your billing information
  • Enter your shipping information
  • Choose your shipping method (Selecting Next Day or 2nd Day Air will only change the shipping transit time, as prescription lenses are made to order)
  • Enter payment information

Step 10 – Add Prescription Information

Please note that the manufacturer will contact us if they have any additional questions regarding the prescription after their initial review to ensure accuracy.

  • Add prescription information in the “Order Comments/Special Instructions” box
  • Include OD/OS values from prescription
  • Include Pupillary Distance (PD)
  • Prescriptions can be faxed to 1-800-535-6229
  • Prescriptions can be emailed to order@universalmedicalinc.com

Ordering Information

Prescription lead glasses normally take at least two weeks to produce (may vary depending on item availability). If you need prescription lenses before a certain date contact, please customer service for specific information regarding frame availability and production time. As mentioned above, selecting priority shipping will only expedite the transit time of the package. Since the prescription lenses are made for your unique eye prescription, production times will vary. In an upcoming post, we will discuss the different prescription lens types that we offer in more detail. If you’re curious as to how prescription lead glasses are made, you’ll want to make sure and check out our video.

Questions? Comments? 

Not sure what type of frame is right for you? Many of our lead glasses have product demonstration videos to help you find the right style. If you have any additional questions, please feel free to contact us or leave a comment in the box below.