[MCOH-EH] MCOH-EH Digest, Vol 251, Issue 56

Shirey, Eric Eric.Shirey at kingcounty.gov
Wed Jul 13 16:06:29 PDT 2016


Sorry for the late reply on this thread, but the VanishPoint Ref#15271 may suit your needs for an insulin syringe with a short needle.  The needle's not quite as short as what you seek (5/16" or 8mm rather than the 6mm you requested), but it's a 30G, nice and small, and I think the VanishPoint system is far safer than most competing safety devices.  I use them for my TST's as well since I have no use for the larger needles found on "TB syringes" and have not had any blood splattering with thousands of uses.  It does take same user education since they're prone to more bubbles in the barrel, but one must also realize that the bubbles can be managed, since ones smaller than the last line at the needle end will be caught in the dead zone and not injected.

~Eric

Eric Shirey, PHN
Occupational Health Nurse,
King County Correctional Facility
and Regional Justice Center

Jail Health Services and 
Department of Adult and Juvenile Detention, Adult Division
500 Fifth Avenue, Room 600
Seattle, WA   98104,  Mail Stop  KCF-PH-0600
Phone: 206-477-2293,  Fax: 206-296-0579,
Pager: 206-340-3467
email:  eric.shirey at kingcounty.gov

Privileged/Confidential information may be contained in this message. The information is intended only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission; rather, promptly notify the sender by reply email, and then destroy all copies of the message and its attachments, if any.
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+eric.shirey=kingcounty.gov at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Friday, May 06, 2016 6:31 AM
To: mcoh-eh at mylist.net
Subject: MCOH-EH Digest, Vol 251, Issue 56

Send MCOH-EH mailing list submissions to
	mcoh-eh at mylist.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://mylist.net/listinfo/mcoh-eh
or, via email, send a message with subject or body 'help' to
	mcoh-eh-request at mylist.net

You can reach the person managing the list at
	mcoh-eh-owner at mylist.net

When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."


Today's Topics:

   1. Re:  Safety devices for shorter insulin needles? (Swift, Melanie)
   2. Re:  Safety devices for shorter insulin needles? (Thrasher, Terri)
   3. Re:  Safety devices for shorter insulin needles?
      (Sampson, Deborah)


----------------------------------------------------------------------

Message: 1
Date: Thu, 5 May 2016 21:11:29 +0000
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
Message-ID:
	<984BE23843F0DE4EBE652D6EE07600BE635EEB4C at ITS-HCWNEM104.ds.vanderbilt.edu>
	
Content-Type: text/plain; charset="iso-8859-1"

Got it. That is really helpful info!
Thank you Amber

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic http://occupationalhealth.vanderbilt.edu


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Dr Amber H Mitchell
Sent: Thursday, May 05, 2016 1:41 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

No.  Q 11 is when during the clinical use of the device did the injury occur.  In this case, 41.4% occurred in situations like you describe - when the person is actually giving the injection and patient moves or they are pinching skin and injure their other hand.

The next set of percentages is different.  It asks, if you were using a safety device (in this case, I pulled ONLY injuries with a safety syringe) did you have an injury with that safety feature before, during, or after activating the safety feature.  In this case, 41.4% (a pure coincidence to same percentage above) occurred while actually activating the safety feature after the injection was given and done.



On 5/5/16, 2:05 PM, "Swift, Melanie" <melanie.swift at Vanderbilt.Edu> wrote:

>Amber, to clarify, in this database, is all "during use" activation of 
>the safety? We use "during use" when the person is actually giving the 
>injection and sticks themselves because the patient moved, for instance.
>We track "while activating safety device" separately and find it's a 
>much lower number.
>
>Melanie Swift, MD
>Director, Vanderbilt Occupational Health Clinic 
>http://occupationalhealth.vanderbilt.edu
>
>
>-----Original Message-----
>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Dr Amber 
>H Mitchell
>Sent: Thursday, May 05, 2016 12:50 PM
>To: MCOH/EH
>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>
>If it helps the group, we did some advanced data extraction from our 
>EPINet aggregate of hospitals (2010-2014).
>
>This data is from sharps injuries that were reported to employee health 
>from ONLY safety devices used ONLY during injection and ONLY among nurses.
> I have blood collection device data too, if anyone feels it would be 
>useful send me an email.
>
>11. Did the injury occur?
>
>	1 Before use of item							4				0.7%
>	2 During use of item							232				41.4%
>	3 Between steps of a multi-step procedure			13				2.3%
>	4 Disassembling device or equipment				15				2.7%
>	5 In preparation for reuse of reusable instruments	1				0.2%
>	6 While recapping a used needle					31				5.5%
>	7 Withdrawing a needle from rubber or other resistance	4			0.7%
>	8 Other after use, before disposal					159				28.4%
>	10 While putting the item into the disposal container	21			3.8%
>	11 After disposal, stuck by item protruding from disposal
>container		4		0.7%
>	13 After disposal, item protruding from trash bag or inapp
>container		2		0.4%
>	14 Other, describe								66				11.8%
>	15 Restraining patient							1				0.2%
>	16 Device left on floor, table, bed or other inappropriate place	7	1.3%
>Total records:	560
>
>
>
>And this is when they are occurring during the use of safety syringes.
>Q13b.
>1  Before activation			241			48.0%
>	2  During activation			208			41.4%
>	3  After activation				52			10.4%
>	4  Unknown					1			0.2%
>
>
>
>You?ll note that more than 40% of injuries occur during activation of 
>the safety feature.  Again, this is skin injection only and the use of 
>safety devices only.
>
>
>Amber
>
>Amber Hogan Mitchell, DrPH, MPH, CPH
>President | Executive Director
>International Safety Center
>Email: amber.mitchell at internationalsafetycenter.org
>
>
>
>
>On 5/5/16, 11:14 AM, "Sampson, Deborah" <Deborah.Sampson at snhhs.org> wrote:
>
>>Haven't seen that. What I am identifying is that most sticks in the 
>>last
>>6 months were due to inattention during clean up, during disposal or 
>>safety activation such as speaking with the patient, family, or a 
>>colleague.
>>We are considering suggesting a " Watch that needle" campaign.
>>Deb
>>Deborah A. Sampson, PhD, APRN, COHN-S, FAANP Director Employee Health 
>>and Wellness Services
>>Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street
>>Nashua, NH 03060
>>p(603) 281-8583  f (603) 577-5665
>>deborah.sampson at snhhealth.org
>>
>>
>>
>>
>>
>>-----Original Message-----
>>From: MCOH-EH
>>[mailto:mcoh-eh-bounces+deborah.sampson=snhhs.org at mylist.net] On 
>>Behalf Of Hudson, T. Warner
>>Sent: Thursday, May 05, 2016 11:00 AM
>>To: MCOH/EH
>>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Melanie - I know when we replaced all 350,000 per year re-sheathing 
>>butterflies here in 2012 with the BD retractable butterfly ,ones we 
>>heard about the peds insulin needle issue and have not had a solution 
>>so very interested in how this plays out.
>>
>>An on another note we are seeing 2-5 incidents where people report the 
>>needle in the BD retractable butterfly needle did not retract.  We 
>>spoke with BD a couple years ago and they were skeptical, said they 
>>checked with their quality folks, and et we keep getting reports of 
>>this; it think 4 last year. It is possible to touch so lightly the 
>>needle does not retract before removing from the vein but to me this 
>>is a training issue as there is an audible click when the little 
>>triangle is pressed correctly.  But I want to be open to the 
>>possibility of a manufacturing problem too.  Is anyone else seeing 
>>these reports of non - retraction?
>>
>>Thanks,
>>
>>Warner
>>
>>T. Warner Hudson, MD FACOEM, FAAFP
>>Medical Director, Occupational and Employee Health UCLA Health System 
>>and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID
>>27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org
>>
>>
>>-----Original Message-----
>>From: MCOH-EH
>>[mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf 
>>Of Sampson, Deborah
>>Sent: Thursday, May 05, 2016 4:44 AM
>>To: MCOH/EH
>>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Haven't dealt with this peds population issue yet.
>>What I do know is that our patient care staff developed a way to use a 
>>table top to engage the caps on BD syringes because we were getting 
>>needle sticks when staff tried closing the safety cap.
>>
>>Now the only time we get sticks from engaging the cap is when staff do 
>>not use the table top technique.
>>
>>
>>
>>-----Original Message-----
>>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, 
>>Melanie
>>Sent: Wednesday, May 04, 2016 9:29 PM
>>To: MCOH/EH
>>Subject: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Need your collective wisdom, MCOH peeps!
>>
>>Our pediatric diabetes team is looking for an insulin syringe with a 
>>6mm needle. They believe that  pediatric Type I DM pts are at risk for 
>>getting their insulin IM with the standard 1/2 inch needle, and they 
>>send patients home with a 6mm needle (which is a nonsafety needle for 
>>home
>>use.)
>>
>>Problem: the only safety device we've found in this length is a BD 
>>safety glide product that is basically a little hard cap on a sliding 
>>stick. It does not cover the entire needle, just bobbles out there 
>>like a tiny hard hat on the tip of the needle. I tried to activate and 
>>slid the thing out but it didn't catch - it slid back onto the needle, 
>>bending it sideways, then when I did get it to lock I had a completely 
>>exposed tip sticking out sideways.
>>
>>Anyone use this product and have experience with how it performs in 
>>terms of injury?
>>Anyone know of another short safety-engineered insulin needle?
>>Has anyone dealt with this pediatric issue of making sure the SQ 
>>injection isn't too deep?
>>
>>Thanks!!
>>Melanie Swift, MD
>>Medical Director, Vanderbilt Occupational Health Clinic 
>>occupationalhealth.vanderbilt.edu
>>
>>Excuse any typos please - Sent from my iPad.
>>---------------------------------------
>>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>>List membership is free, but only subscribers may post to the list.
>>To post send messages to: mcoh-eh at mylist.net To become a subscriber, 
>>or to change your subscription options (turn off
>>email while you're on vacation, etc):   http://www.mcoh-eh.net
>>MediTrax / Occupational Health Systems, Inc. provides financial 
>>support to ensure the list remains a free resource for the 
>>occupational health community.
>>---------------------------------------
>>List archives (public): http://mylist.net/archives/mcoh-eh/
>>---------------------------------------
>>Send administrative requests to: drjoe at meditrax.com
>>---------------------------------------
>>
>>Email secured by Check Point
>>
>>---------------------------------------
>>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>>List membership is free, but only subscribers may post to the list.
>>To post send messages to: mcoh-eh at mylist.net To become a subscriber, 
>>or to change your subscription options (turn off
>>email while you're on vacation, etc):   http://www.mcoh-eh.net
>>MediTrax / Occupational Health Systems, Inc. provides financial 
>>support to ensure the list remains a free resource for the 
>>occupational health community.
>>---------------------------------------
>>List archives (public): http://mylist.net/archives/mcoh-eh/
>>---------------------------------------
>>Send administrative requests to: drjoe at meditrax.com
>>---------------------------------------
>>
>>________________________________
>>
>>UCLA HEALTH SCIENCES IMPORTANT WARNING: This email (and any
>>attachments) is only intended for the use of the person or entity to 
>>which it is addressed, and may contain information that is privileged 
>>and confidential. You, the recipient, are obligated to maintain it in 
>>a safe, secure and confidential manner. Unauthorized redisclosure or 
>>failure to maintain confidentiality may subject you to federal and 
>>state penalties.
>>If you are not the intended recipient, please immediately notify us by 
>>return email, and delete this message from your computer.
>>
>>---------------------------------------
>>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>>List membership is free, but only subscribers may post to the list.
>>To post send messages to: mcoh-eh at mylist.net To become a subscriber, 
>>or to change your subscription options (turn off
>>email while you're on vacation, etc):   http://www.mcoh-eh.net
>>MediTrax / Occupational Health Systems, Inc. provides financial 
>>support to ensure the list remains a free resource for the 
>>occupational health community.
>>---------------------------------------
>>List archives (public): http://mylist.net/archives/mcoh-eh/
>>---------------------------------------
>>Send administrative requests to: drjoe at meditrax.com
>>---------------------------------------
>>
>>Email secured by Check Point
>>
>>---------------------------------------
>>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>>List membership is free, but only subscribers may post to the list.
>>To post send messages to: mcoh-eh at mylist.net To become a subscriber, 
>>or to change your subscription options (turn off
>>email while you're on vacation, etc):   http://www.mcoh-eh.net
>>MediTrax / Occupational Health Systems, Inc. provides financial 
>>support to ensure the list remains a free resource for the 
>>occupational health community.
>>---------------------------------------
>>List archives (public): http://mylist.net/archives/mcoh-eh/
>>---------------------------------------
>>Send administrative requests to: drjoe at meditrax.com
>>---------------------------------------
>
>
>---------------------------------------
>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>List membership is free, but only subscribers may post to the list.
>To post send messages to: mcoh-eh at mylist.net To become a subscriber, or 
>to change your subscription options (turn off
>email while you're on vacation, etc):   http://www.mcoh-eh.net
>MediTrax / Occupational Health Systems, Inc. provides financial support 
>to ensure the list remains a free resource for the occupational health 
>community.
>---------------------------------------
>List archives (public): http://mylist.net/archives/mcoh-eh/
>---------------------------------------
>Send administrative requests to: drjoe at meditrax.com
>---------------------------------------
>
>---------------------------------------
>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>List membership is free, but only subscribers may post to the list.
>To post send messages to: mcoh-eh at mylist.net To become a subscriber, or 
>to change your subscription options (turn off
>email while you're on vacation, etc):   http://www.mcoh-eh.net
>MediTrax / Occupational Health Systems, Inc. provides financial support 
>to ensure the list remains a free resource for the occupational health 
>community.
>---------------------------------------
>List archives (public): http://mylist.net/archives/mcoh-eh/
>---------------------------------------
>Send administrative requests to: drjoe at meditrax.com
>---------------------------------------

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------



------------------------------

Message: 2
Date: Thu, 5 May 2016 22:31:24 +0000
From: "Thrasher, Terri" <Terri.Thrasher at cchmc.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
Message-ID:
	<6D0F651D183C00439FDA321943976C1349F6A88E at MCEXMB1.chmccorp.cchmc.org>
Content-Type: text/plain; charset="iso-8859-1"

So BD says their safety device is to be activated by the thumb ...they don't say to use a table top so we are not allow to train our staff to use the table top...

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Budnick, Lawrence
Sent: Thursday, May 05, 2016 1:23 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

VanishPoint.

Lawrence D. Budnick, MD, MPH
Director, Occupational Medicine Service
Associate Professor of Medicine
Rutgers University - New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107 tel 973.972.2900 fax 973.972.2904 lawrence.budnick at rutgers.edu

CONFIDENTIALITY NOTICE: This email communication may contain private, confidential, or legally privileged information intended for the sole use of the designated and/or duly authorized recipient(s). If you are not the intended recipient or have received this email in error, please notify me immediately by email and permanently delete all copies of this email, including all attachments without reading them. If you are the intended recipient, please secure the contents in a manner that conforms to all applicable state and/or federal requirements related to privacy and confidentiality of such information. Thank you.


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+budnicla=njms.rutgers.edu at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Thursday, May 05, 2016 12:33 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

We have only seen spattering with the BD retractable needles when the needle is removed from the vein before retraction...which you are not supposed to do...and caused us to do come retraining in the early year of the switchover.

Which brand/model retractable TB needle/syringe are you using?

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231? ID 27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org 


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Budnick, Lawrence
Sent: Thursday, May 05, 2016 8:15 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

We were seeing issues of non retraction with the TB syringe needles, but have switched to a different manufacturer. We have not had a problem with non-retraction with the BD butterfly needles, but the nurses report that blood may splatter when the needle retracts. 

Lawrence D. Budnick, MD, MPH
Director, Occupational Medicine Service
Associate Professor of Medicine
Rutgers University - New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107 tel 973.972.2900 fax 973.972.2904 lawrence.budnick at rutgers.edu

CONFIDENTIALITY NOTICE: This email communication may contain private, confidential, or legally privileged information intended for the sole use of the designated and/or duly authorized recipient(s). If you are not the intended recipient or have received this email in error, please notify me immediately by email and permanently delete all copies of this email, including all attachments without reading them. If you are the intended recipient, please secure the contents in a manner that conforms to all applicable state and/or federal requirements related to privacy and confidentiality of such information. Thank you.

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+budnicla=njms.rutgers.edu at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Thursday, May 05, 2016 11:00 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

Melanie - I know when we replaced all 350,000 per year re-sheathing butterflies here in 2012 with the BD retractable butterfly ,ones we heard about the peds insulin needle issue and have not had a solution so very interested in how this plays out.

An on another note we are seeing 2-5 incidents where people report the needle in the BD retractable butterfly needle did not retract.  We spoke with BD a couple years ago and they were skeptical, said they checked with their quality folks, and et we keep getting reports of this; it think 4 last year. It is possible to touch so lightly the needle does not retract before removing from the vein but to me this is a training issue as there is an audible click when the little triangle is pressed correctly.  But I want to be open to the possibility of a manufacturing problem too.  Is anyone else seeing these reports of non - retraction?

Thanks,

Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID 27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Sampson, Deborah
Sent: Thursday, May 05, 2016 4:44 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

Haven't dealt with this peds population issue yet.
What I do know is that our patient care staff developed a way to use a table top to engage the caps on BD syringes because we were getting needle sticks when staff tried closing the safety cap.

Now the only time we get sticks from engaging the cap is when staff do not use the table top technique.



-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Wednesday, May 04, 2016 9:29 PM
To: MCOH/EH
Subject: [MCOH-EH] Safety devices for shorter insulin needles?

Need your collective wisdom, MCOH peeps!

Our pediatric diabetes team is looking for an insulin syringe with a 6mm needle. They believe that  pediatric Type I DM pts are at risk for getting their insulin IM with the standard 1/2 inch needle, and they send patients home with a 6mm needle (which is a nonsafety needle for home use.)

Problem: the only safety device we've found in this length is a BD safety glide product that is basically a little hard cap on a sliding stick. It does not cover the entire needle, just bobbles out there like a tiny hard hat on the tip of the needle. I tried to activate and slid the thing out but it didn't catch - it slid back onto the needle, bending it sideways, then when I did get it to lock I had a completely exposed tip sticking out sideways.

Anyone use this product and have experience with how it performs in terms of injury?
Anyone know of another short safety-engineered insulin needle?
Has anyone dealt with this pediatric issue of making sure the SQ injection isn't too deep?

Thanks!!
Melanie Swift, MD
Medical Director, Vanderbilt Occupational Health Clinic occupationalhealth.vanderbilt.edu

Excuse any typos please - Sent from my iPad.
---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

Email secured by Check Point

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

________________________________

UCLA HEALTH SCIENCES IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------


---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------


---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e= 
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------




------------------------------

Message: 3
Date: Fri, 6 May 2016 13:30:28 +0000
From: "Sampson, Deborah" <Deborah.Sampson at snhhs.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
Message-ID:
	<D482F4A6B9121A4783250D7A0FEE17A51B2A9C69 at IFMBOX1V.snhmc.org>
Content-Type: text/plain; charset="iso-8859-1"

I understand- but the table top results in better engagement and fewer injuries for us.
D

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thrasher, Terri
Sent: Thursday, May 05, 2016 6:31 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

So BD says their safety device is to be activated by the thumb ...they don't say to use a table top so we are not allow to train our staff to use the table top...

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Budnick, Lawrence
Sent: Thursday, May 05, 2016 1:23 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

VanishPoint.

Lawrence D. Budnick, MD, MPH
Director, Occupational Medicine Service
Associate Professor of Medicine
Rutgers University - New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107 tel 973.972.2900 fax 973.972.2904 lawrence.budnick at rutgers.edu

CONFIDENTIALITY NOTICE: This email communication may contain private, confidential, or legally privileged information intended for the sole use of the designated and/or duly authorized recipient(s). If you are not the intended recipient or have received this email in error, please notify me immediately by email and permanently delete all copies of this email, including all attachments without reading them. If you are the intended recipient, please secure the contents in a manner that conforms to all applicable state and/or federal requirements related to privacy and confidentiality of such information. Thank you.


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+budnicla=njms.rutgers.edu at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Thursday, May 05, 2016 12:33 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

We have only seen spattering with the BD retractable needles when the needle is removed from the vein before retraction...which you are not supposed to do...and caused us to do come retraining in the early year of the switchover.

Which brand/model retractable TB needle/syringe are you using?

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231? ID 27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org 


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Budnick, Lawrence
Sent: Thursday, May 05, 2016 8:15 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

We were seeing issues of non retraction with the TB syringe needles, but have switched to a different manufacturer. We have not had a problem with non-retraction with the BD butterfly needles, but the nurses report that blood may splatter when the needle retracts. 

Lawrence D. Budnick, MD, MPH
Director, Occupational Medicine Service
Associate Professor of Medicine
Rutgers University - New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107 tel 973.972.2900 fax 973.972.2904 lawrence.budnick at rutgers.edu

CONFIDENTIALITY NOTICE: This email communication may contain private, confidential, or legally privileged information intended for the sole use of the designated and/or duly authorized recipient(s). If you are not the intended recipient or have received this email in error, please notify me immediately by email and permanently delete all copies of this email, including all attachments without reading them. If you are the intended recipient, please secure the contents in a manner that conforms to all applicable state and/or federal requirements related to privacy and confidentiality of such information. Thank you.

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+budnicla=njms.rutgers.edu at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Thursday, May 05, 2016 11:00 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

Melanie - I know when we replaced all 350,000 per year re-sheathing butterflies here in 2012 with the BD retractable butterfly ,ones we heard about the peds insulin needle issue and have not had a solution so very interested in how this plays out.

An on another note we are seeing 2-5 incidents where people report the needle in the BD retractable butterfly needle did not retract.  We spoke with BD a couple years ago and they were skeptical, said they checked with their quality folks, and et we keep getting reports of this; it think 4 last year. It is possible to touch so lightly the needle does not retract before removing from the vein but to me this is a training issue as there is an audible click when the little triangle is pressed correctly.  But I want to be open to the possibility of a manufacturing problem too.  Is anyone else seeing these reports of non - retraction?

Thanks,

Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID 27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Sampson, Deborah
Sent: Thursday, May 05, 2016 4:44 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

Haven't dealt with this peds population issue yet.
What I do know is that our patient care staff developed a way to use a table top to engage the caps on BD syringes because we were getting needle sticks when staff tried closing the safety cap.

Now the only time we get sticks from engaging the cap is when staff do not use the table top technique.



-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Wednesday, May 04, 2016 9:29 PM
To: MCOH/EH
Subject: [MCOH-EH] Safety devices for shorter insulin needles?

Need your collective wisdom, MCOH peeps!

Our pediatric diabetes team is looking for an insulin syringe with a 6mm needle. They believe that  pediatric Type I DM pts are at risk for getting their insulin IM with the standard 1/2 inch needle, and they send patients home with a 6mm needle (which is a nonsafety needle for home use.)

Problem: the only safety device we've found in this length is a BD safety glide product that is basically a little hard cap on a sliding stick. It does not cover the entire needle, just bobbles out there like a tiny hard hat on the tip of the needle. I tried to activate and slid the thing out but it didn't catch - it slid back onto the needle, bending it sideways, then when I did get it to lock I had a completely exposed tip sticking out sideways.

Anyone use this product and have experience with how it performs in terms of injury?
Anyone know of another short safety-engineered insulin needle?
Has anyone dealt with this pediatric issue of making sure the SQ injection isn't too deep?

Thanks!!
Melanie Swift, MD
Medical Director, Vanderbilt Occupational Health Clinic occupationalhealth.vanderbilt.edu

Excuse any typos please - Sent from my iPad.
---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

Email secured by Check Point

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

________________________________

UCLA HEALTH SCIENCES IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e=
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------


---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e= 
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e= 
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------


---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mcoh-2Deh.net&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=6JxJAYjn_ooJAC5YgOQ8NrETUzUPodv9R_6uNt4u66w&e= 
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): https://urldefense.proofpoint.com/v2/url?u=http-3A__mylist.net_archives_mcoh-2Deh_&d=CwIFAw&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=6Yw_nOo_6PRNsDe-LHQhpNyCB1nY7KFLwQKWlXMy9dw&s=LneMUImztSnjkef0VOTGOqc-awPW0e5d3e7AE8akRT0&e= 
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------


---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------

Email secured by Check Point



------------------------------

Subject: Digest Footer

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------
When replying to a message, PLEASE delete all footers, and all messages to which you're NOT replying, so the topic of your reply is immediately clear to other list members.

------------------------------

End of MCOH-EH Digest, Vol 251, Issue 56
****************************************



More information about the MCOH-EH mailing list