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| Sharps \ MadaJet Needleless Injector |
Madajet XL Manual
| MADAJET XL
MEDICAL PRESENTATION
Technical Information
8-1-89
Table of Contents
Page 1 Comments and Purpose
Page 1 Diagram (A) Physical Tissue Patterns
Page 2 Unique Features of Madajet XL
Page 2 List of Medical Specialties related to product
Page 2 Plastic Surgery applications
Page 2 Dermatologists
Page 3 Dermatology continued
Page 3 Notes on steroids and local anesthetic agents
Page 3 Otolaryngology
Page 4 Colon-Rectal (Proctology)
Page 4 OB/GYN
Page 4 Breast and Tissue Biopsy
Page 4 Emergency Room Physicians
Page 4 Veni and Arterial punctures
Page 5 Orthopedic Surgeons
Page 5 Urology
Page 5 Anesthesiology
Page 6 Major parts of the Madajet XL
Page 6 Functions of the parts
Page 6 Literature with each Madajet XL
Page 7 Some reference literature
COMMENTS:
We fully realize that most physicians can frequently put a needle into a patients tissues with minimal pain, however, it is not so much the pain from the needle that bothers the patients, IT IS THE NEEDLE ITSELF that patients fear. "PATIENTS HATE NEEDLES" "Needle Phobia" is a real thing that any physician has to contend with.
The Madajet XL, a fine precision instrument has the unique capability to not only function as an injection device to inject skin tissue with local anesthetic agents, but also is the ONLY jet injection device that allows the physician to inject through ALL BODY ORIFICES for deep tissue infiltration, i.e. oral cavity and laryngeal areas, the vagina and cervix, rectum, ear and nasal areas, open wounds and surgical openings.
The physiological advantages in injections to the above areas is that the physician can provide excellent anesthesia levels using small volumes of local anesthetic agents, accomplishing this with minimal patient discomfort in contrast to the needle and syringe technique.
Another interesting physiological advantage is that by jet injection technique, a very small amount by volume (0.1 cc of 2% anesthetic) will provide unusually high levels of tissue anesthesia.
This advantage allows for the absence or minimal blood levels of any medication injected with the Madajet XL. The controlled depth of anesthetics, or other aqueous medicaments into the intradermal tissue is seen in the following diagram.
In contrast to "pooling" of medication by syringe/needle, the Madajet XL disperses the medication into the tissue in tiny droplets, producing immediate effect and greater intensity of the drug used.
Unique Feature of the Madajet XL
The Medical Madajet XL is available with Extenda Tips varying in length from 3/4" (19.05 mm) to 6.5" (165.1 mm) and these lengths are selected by the physician according to the applications required.
The Extenda Tips are removable and interchangeable between patient use. They can be sterilized by autoclaving, cold sterilization and other normal sterilizing procedures. Each Extenda Tip comes with a protective sheath which is normally placed gently on the tissues to be injected. The sheath should be left on the Extenda Tips at all times.
General Information regarding Medical Specialties
A. Plastic/Reconstructive Surgeons
B. Dermatologists
C. Otolaryngologists
D. Colon Rectal Surgeons
E. Anesthesiologist
F. O.B./Gyn
G. Emergency Room Physician
H. Orthopedic Surgeons
I. Urologist
A. Plastic Surgeons/Reconstructive Surgeons:- Local anesthetics into skin tissues for biopsies, keloids, minor surgical procedures, hair transplants.
- Capabilities of injecting into the inner nasal and ear (otic) tissues.
- Pinpointing tissues around the eyes.
- Suturing or removal of sutures.
NOTE: The Madajet XL with its unique capabilities of producing excellent tissue anesthesia without producing the "ballooning" effect caused by syringe and needle technique is of great value in both allowing the surgeon to suture the proximal edges of the wound or incision without distortion of these tissues which minimizes scar tissue, and also greatly minimizing tissue artifacts (abnormal histological tissue changes) in doing biopsies etc.
- Infiltration of steroids into tissues to reduce inflammation and pain which normally occurs in many cases where simple non-infectious inflammatory conditions can exist.
B. Dermatologists:
The longest history of use has been with this specialty. The Madajet XL with the 3/4" Extenda Tip provided is an excellent instrument to inject dermatological lesions, with great advantages for the patient;- Far less painful than the use of a needle and syringe.
- Allows for minimal volumes of steroids to be used while producing much better control and treatment of these dermatological lesions.
- Reduces greatly the possibility of causing blood levels (titers) of the steroids used.
- Greater control of depth of penetration (4-4.5 mm) below the epithelium in the intradermal areas.
- Allows physician to mix the steroid to be used in much smaller volumes, with 2% Lidocaine as the diluent. This procedure provides much better patient acceptability by reducing the ache or pain from the steroids hours after treatment.
NOTE: Always keep the steroids cold before treatment to prevent crystal growth in the vial and always keep the anesthetic at body temperature to prevent burning and discomfort from use of cold anesthetic agents.
A suggestion regarding the dilution mixture of the steroid with 2% Lidocaine is to initially use 1/3 part by volume of the anesthetic and 2/3 parts by volume of the steroid. The concentration of the steroid can be increased after the first or second treatment. The steroid often successfully used is Celestone Soluspan by the Schering Company.
See Medical Applications brochure for general dermatological uses.
C. Otolaryngologists:
In this specialty there is no other instrument available that can perform as well as the Madajet XL. - Injections of anesthetics or steroids into the tissues of the oral cavity for biopsies.
- Injections into tissues into the posterior portions and the nasalpharyngeal areas are easily done with much less pain for the patient, and if larger volumes of anesthetics are needed by using the needle and syringe, the patient will have minimal discomfort from this procedure.
- Many otolaryngologists are also involved in facial plastic reconstructive surgery including installation of adipose (fat) tissue from other parts of the body as well as the infiltration of collagen materials or similar medicaments for facial wrinkles. The Madajet XL has been clinically used for this later procedure.
NOTE: A 6.5" (165.1 mm) Extenda Tip is available for reaching the pharyngeal areas.
D. Colon-Rectal (Proctology):
The areas around the anal sphincter are often injected, as are the tissues internally and adjacent to the sphincter tissues. This is normally a quite painful procedure and the Madajet XL can be an excellent and far less painful method of providing adequate anesthetics (2% Lidocaine).
It has been reported that injections directly into hemorrhoidal tissues have been successfully done.
NOTE: Various lengths of Extenda Tips are available to reach deeper areas up to 6.5" posteriorily to the sphincter area.
E. OB/GYN:
A common procedure is cervical biopsy by this specialty. This often painful procedure is an excellent place where a simple injection of local anesthetic (2% Lidocaine) with the Madajet XL will facilitate the physicians test, and most certainly add to the patients comfort.
Breast tissue biopsy - as previously discussed the injections of 2% Lidocaine adjacent to the tissues to be biopsied with the Madajet XL is an excellent needless method of anesthetizing these tender tissues. From 1-4 injections should be made at 90 degree points to the area involved.
Each of the injections should be approximately 1/4" away from the periphery of the nodule. The depth of injection will be 4.5 mm below the epithelium, and will produce a 6mm wheel at the base of each Madajet XL injection. The Madajet XL can be autoclaved if it is to be used in the delivery room for use during episiotomy procedures.
F. Emergency Room Physicians:
Lacerations of the face and other parts of the body, especially with children, often requires painful injections of local anesthetics causing the psychological trauma of "needle phobia". The Madajet XL provides two (2) major advantages;- Eliminates the use of the needle and syringe.
- Will not balloon the tissues. This makes it easier to suture the proximal edges, and also prevents undue amounts of scar tissue from forming from the suture line.
Venipuncture or arterial punctures for blood samplings can be painlessly done by injecting 2% Lidocaine adjacent to the vessel or where needle penetration is done. When attempting to do this directly over the blood vessel, simply "hump" the skin tissue between the first finger and thumb and inject into this area.
NOTE: When injections of anesthetic are required into the deeper tissue areas, this can easily be done by injections with the Madajet XL and using a 4 X 4 gauze pad to prevent splattering of blood or fluids from the wound.
G. Orthopedic Surgeons:- Arthroscopy procedures requires injections in the knee of local anesthetics, which can be greatly facilitated by using the Madajet XL. Several prominent Sports Physicians employ the se of the Madajet XL. Injections at the site where the scope is to be inserted with the Madajet XL is recommended using 2/5 Lidocaine/1:1,000,000 epi.
- Bursal infiltrations - This frequently painful procedure can be greatly helped by first injection 2% Lidocaine at the site where "deep needle" insertion is to be made
H. Urologists:- Injections in the upper and lateral areas of the scrotum with 2% Lidocaine for vasectomies has been successfully performed. 3-4 injections spaced approximately 1/4" apart in a descending line on each lateral surface of the scrotal sac is recommended.
- Bent Spike Syndrome (Pyronees Disease)
Here injections directly intraurethral through the head of the penis using a mixture of steroids and 2% Lidocaine can be done. Various size Extenda Tips are available up to 6.5" in length. This allows the physician to inject directly into the keloids or scar tissue of the patients urethral tissue.
I. Anesthesiologist:- Anesthetizing the site for spinal injections
- Anesthetizing the site for arterial or venous punctures.
- Similiarily for insertion of catheters.
- Biopsies
The Medical Madajet XL is a fine precision instrument and most unique as a Jet Injection Device. No other instrument available can perform the functions or provide the technical advantages of the Madajet XL. There are several important facts concerning the operation and care of the Madajet XL which are important to provide maximum benefits and minimize problems for the physician.
A. Physical Aspects: (See Product Manual)
Please note the diagram of the major parts of the Madajet XL.
The major parts are:a. Release Button
b. Cocking Lever
c. Finger Rest
d. Shaft
e. Body of Madajet XL&
f. Madajet Stand&
g. Pyrex Fill Chambers
h. Head Assembly
i. Sheath
j. Extenda Tip
k. Orifice
l. Hex Nozzle B. Function: (See Product Manual)- Cocking & Firing
- Holding the Madajet
- Priming Action
- Filling the Fill Chamber
- Placing Madajet XL on tissue
To familiarize yourself with the Madajet, all of the functions should be practiced before using.
NOTE: Each Madajet XL has enclosed with it 4 pieces of information.- Warranty
- Medical Applications
- Product Manual
- Care of the Madajet XL
The Product Manual will take you step by step through the operational use. The single instruction card "Care of the Madajet" is most important, and although it is simple to perform and takes only a few seconds to do, most of the problems the physician will encounter is due to the fact that these simple directions are not followed. |
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