CSTD Manufacturers and Efficacy, Closed System Transfer Device Comparisons and Studies, CSTD and USP 800 Regulations, Leur-Lock Compatibility and Assembly, Chemotherapy / Hazardous Drugs, NIOSH...
A closed system drug transfer device or "CSTD" is a drug transfer device that mechanically prohibits the transfer of environmental contaminants into a system and the escape of hazardous drug or vapor concentrations outside the system. Open versus closed systems are commonly applied in medical devices to maintain the sterility of a fluid pathway. CSTDs work by preventing the uncontrolled inflow and outflow of contaminants and drugs, preserving the quality of solution to be infused into a patient. Theoretically, CSTDs should enable complete protection to healthcare workers in managing hazardous drugs, but possibly due to improper handling or incomplete product design, contaminants can still be detected despite use of CSTDs.
Source: Miyake, Tomohiro; Iwamoto, Takuya; Tanimura, Manabu; Okuda, Masahiro (2013-06-21). "Impact of closed-system drug transfer device on exposure of environment and healthcare provider to cyclophosphamide in Japanese hospital". SpringerPlus. 2. doi:10.1186/2193-1801-2-273. ISSN 2193-1801. PMC 3698436. PMID 23853750.
A 44-page document that describes, in detail, the NIOSH testing protocols used for CSTDs. This document details which compounds were tested, what the conditions were, which CSTDs were tested, specifics on how they were tested. This document reads very similarly to a student lab report.Arisure CSTD by Yukon Medical
Arisure manufacturer website that describes the newest CSTD to enter the market. Website describes some features that are exclusive to the Arisure, as well as separate sets of specific reasons why this product is appealing to nurses and pharmacists.ChemoLock CSTD by ICU Medical
ChemoLock CSTD manufacturer website that describes all of the features of this device, especially focusing on its ease of use and safety for healthcare workers. This site also illustrates all of the available components.Chemotherapy Drugs in a Clinical Setting
This study's aim was to determine how HD might spread through touch after handling contaminated vials in simulated pharmacy and nursing environments. Results show residue from HD vials spread as vial was handled in a pharmacy environment in 4 of 5 CSTDs, contaminating pharmacy PPE, ancillary products, and nursing PPE. No HD residue was detected on PPE, ancillary products, or nursing PPE in the pharmacy after using the SEVA system, providing an effective means to contain HD for drug transfer from vial to delivery system. Call E, Bill B, McLean C, Call N, Bernkopf A, Oberg C. Hazardous Drug Contamination of Drug Preparation Devices and Staff: A Contamination Study Simulating the Use of Chemotherapy Drugs in a Clinical Setting. Hosp Pharm. 2017;52(8):551-558.Comparison of closed system transfer devices for turnaround time and ease of use. J Oncol Pharm Prac
A Saudi Arabian study, published in May 2018, that sought to compare 3 CSTD’s (PhaSeal, Equashield II and ChemoLock) on their compounding efficiency and ease of use among pharmacy technicians and nurses to determine which product would be most suitable to adopt into their hospital protocol. Nurgat ZA, Lawrence M, Elhassan TA, et al. Comparison of closed system transfer devices for turnaround time and ease of use. J Oncol Pharm Practice. 2018;0(0):1-10.Cost determination study of closed system transfer devices (CSTD) by ICU Medical
The purpose of this cost determination analysis is to appraise the direct and indirect costs of using a closed system transfer device (CSTD) to prevent occupational exposure to hazardous drugs. The data is from 2011, but is one of very few online resources about the cost of CSTDs. Barnachea L, Lee T, Gitler J. et al. Cost determination study of closed system transfer devices (CSTD). ICU Medical Inc. 2012.Effectiveness of a Closed-System Transfer Device in Reducing Surface Contamination in a New Antineop
The objective of this randomized, prospective and controlled study was to investigate the ability of a closed-system transfer device (CSTD; BD-Phaseal) to reduce the occupational exposure of two isolators to 10 cytotoxic drugs and compare to standard compounding devices. This study confirms that using a CSTD may significantly decrease the chemical contamination of barrier isolators compared to standard devices for some drugs, although it does not eliminate contamination totally.Simon N, Vasseur M, Pinturaud M, et al. Effectiveness of a Closed-System Transfer Device in Reducing Surface Contamination in a New Antineoplastic Drug-Compounding Unit: A Prospective, Controlled, Parallel Study. PLoS One. 2016;11(7).Equashield II CSTD by Equashield
Equashield device manufacturer website that illustrates the Equashield device and describes all of its available features. It also describes why CSTDs are necessary in the hospital and what exactly they do. It specifically details how the Equashield is better and different from the other marketable CSTDs.Halo CSTD by Corvida Medical
Halo device manufacturer website that illustrates the Halo device through a video and several pictures, and also describes this device and how it is superior to the other devices on the market.Halo CSTD | Short-Course/Training on COREreadiness
Learn about Corvida Medical's Halo CSTD and how it protects patients and healthcare providers from hazardous drug exposure.http://www.usmedicine.com/agencies/department-of-veterans-affairs/closed-system-transfer-device-redu
Short article that discusses how using CSTDs can save hospitals money by reducing waste, which is a point that hospitals will certainly consider when deciding which CSTD system to invest in. Boyle AM. Closed system transfer device reduces chemotherapy drug waste. US Medicine. October 7, 2013.Leakage from closed-system transfer devices as detected by a radioactive tracer.
A study of leakage from selected closed-system transfer devices (ChemoClave,, OnGuard, PhaSeal) under experimental conditions is described.Nine manufacturer-trained oncology pharmacists and pharmacy technicians volunteered to participate in an experiment to determine the degree of leakage of a liquid test agent (a radioactive technetium isotope [(99m)Tc] diluted in normal saline) during CSTD-assisted transfer of liquid from vials to syringes per standard practices. The volume of leakage was significantly less with PhaSeal than with OnGuard and ChemoClave when pharmacists and pharmacy technicians used the three CSTDs and (99m)Tc as a tracer. De Ausen L, Defreitas EF, Littleton L, et. al. Leakage from closed-system transfer devices as detected by a radioactive tracer. Am J Health Syst Pharm. 2013; 70(7): 619-623.Multicenter evaluation of a new closed system drug-transfer device in reducing surface contamination
Rigorous protocol study at 13 cancer centers across the United States on the effectiveness of the Halo in reducing surface contamination when compounding and simulated administering antineoplastic drugs, cyclophosphamide and fluorouracil. The Halo was found to effectively reduce surface contamination by cyclophosphamide and fluorouracil, and was also found to be easy to use by healthcare workers. Bartel SB, Tyler TG, Power LA. Multicenter evaluation of a new closed system drug-transfer device in reducing surface contamination by antineoplastic hazardous drugs. American Journal of Health-System Pharmacy. 2018;75(4):199-211. doi:10.2146/ajhp160948OnGuard CSTD by B. Braun Medical
OnGuard device manufacturer website that describes the OnGuard product and addresses the need for this device in the hospital in light of the upcoming, enforceablePhaSeal CSTD by BD
PhaSeal manufacturer website that describes the different components of the PhaSeal device. It details how this CSTD works for drug preparation, drug transport, IV administration and disposal. It also includes a mini-quiz that tests how knowledgeable you are about
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