What is a Tuberculin Syringe? Uses & Guide (2024)

A tuberculin syringe, a small and precise instrument, is essential in administering minute doses of medication, particularly purified protein derivative (PPD) for Mantoux tests, which are critical diagnostic tools in identifying tuberculosis infections. Developed to meet the stringent requirements of intradermal injections, the fine gauge needle of a tuberculin syringe ensures accurate placement of the injected substance, a vital factor in vaccine administration and allergy testing. The Centers for Disease Control (CDC) provides guidelines on proper injection techniques and safety protocols, emphasizing the importance of healthcare providers adhering to best practices when using this device. Understanding what is a tuberculin syringe and its proper application is crucial for medical professionals to ensure patient safety and the accuracy of diagnostic and therapeutic procedures.

The Tuberculin Syringe: A Cornerstone of Precise Medical Administration

The tuberculin syringe, a seemingly simple instrument, stands as a critical tool in modern healthcare.

Its primary function: the precise delivery of small volumes of medication and testing solutions.

It is an unsung hero that ensures accurate dosing, safeguarding patient well-being.

Defining the Tuberculin Syringe

A tuberculin syringe is a small-capacity syringe, typically holding 1 mL (or 1 cc), calibrated in hundredths of a milliliter (0.01 mL).

This fine gradation allows clinicians to administer minute, yet critical, doses with unparalleled accuracy.

Unlike standard syringes, the tuberculin syringe's design prioritizes precision over volume, making it essential in specific medical applications.

Historical Roots in Tuberculosis Management

The syringe's name, "tuberculin," reveals its origins. It was initially developed for administering tuberculin, a protein extract from Mycobacterium tuberculosis, in the Mantoux test.

The Mantoux test, a cornerstone in diagnosing latent TB infection, requires a precise intradermal injection of tuberculin.

The accuracy demanded by this test led to the creation of a specialized syringe designed for this purpose.

Although its applications have expanded, the historical association with tuberculosis remains embedded in its name and function.

The Paramount Importance of Accuracy

In medical practice, accuracy is non-negotiable.

The tuberculin syringe is indispensable when administering potent medications or diagnostic agents where even slight variations in dosage can have significant consequences.

Whether it's vaccines for infants, allergy testing, or delivering specialized medications, the precision offered by the tuberculin syringe is paramount.

Potential Consequences of Inaccurate Dosing

Inaccurate dosing, even with seemingly small deviations, can lead to a cascade of adverse effects.

Underdosing may render treatment ineffective, prolonging illness and potentially fostering drug resistance.

Overdosing, on the other hand, can trigger toxic reactions, causing severe harm or even life-threatening complications.

Therefore, healthcare professionals must understand the crucial role this little syringe can make in the healthcare and wellness journeys of their patients.

The stakes are high, making the accurate capabilities of the tuberculin syringe a central aspect of patient safety and effective medical interventions.

Who Uses Tuberculin Syringes? Key Stakeholders in Healthcare

Following the introduction of the tuberculin syringe, it's crucial to identify the key individuals who interact with this instrument. This section will explore the roles and responsibilities of these stakeholders in ensuring the accurate and effective use of tuberculin syringes.

Physicians, Doctors, and Healthcare Professionals: The Prescribers and Experts

Physicians and other prescribing healthcare professionals are instrumental in determining when and how tuberculin syringes are used.

They assess the patient's needs, determine the appropriate medication or test, and then prescribe the precise dosage to be administered.

This process requires a deep understanding of pharmacology, physiology, and injection techniques.

Furthermore, physicians must stay abreast of the latest guidelines and best practices to ensure patient safety and efficacy.

Their expertise extends to not only prescribing the medication but also understanding the potential adverse effects and how to manage them.

Nurses: The Frontline Administrators

Nurses are often the primary administrators of medications and tests that utilize tuberculin syringes.

Working across diverse healthcare settings, they are responsible for preparing the medication, educating the patient, and administering the injection according to the physician's orders.

Patient education is a key component of the nurse's role.

This involves explaining the procedure, potential side effects, and any necessary follow-up care.

Nurses also play a crucial role in monitoring patients after the injection for any adverse reactions or complications, acting as a critical safety net.

Their vigilance is essential in ensuring prompt intervention if needed.

Veterinarians: Precise Dosing for Animal Care

Veterinarians frequently use tuberculin syringes to administer medications and vaccines to animals.

Accuracy is paramount, particularly when treating smaller species where even slight variations in dosage can have significant consequences.

Veterinarians must possess a thorough understanding of animal physiology and pharmacology to determine the appropriate dosage for each species and individual animal.

Species-specific injection techniques are also crucial, as anatomical differences can influence the effectiveness and safety of the injection.

Patients: Informed Participants in Their Care

While patients are the recipients of the medications or tests administered via tuberculin syringes, they are vital stakeholders in their own care.

Informed consent is paramount.

Patients should receive clear and concise explanations about the procedure, the medication being administered, potential side effects, and any necessary follow-up.

Encouraging patients to ask questions and express concerns promotes shared decision-making.

This ultimately leads to improved adherence and better outcomes.

It’s also important for patients to report any unusual symptoms or side effects they experience after the injection to their healthcare provider, ensuring early detection and management of any potential complications.

Core Applications: When and Why Tuberculin Syringes Are Essential

Having established the key stakeholders, it's time to examine the specific scenarios where tuberculin syringes are not just useful, but indispensable. Precision in dosing is paramount in several critical applications, and this section will delve into these scenarios, detailing the procedures involved and the desired clinical outcomes.

Mantoux Test (Tuberculin Skin Test - TST)

The Mantoux test, or Tuberculin Skin Test (TST), stands as the gold standard for detecting latent Tuberculosis (TB) infection. Its accuracy hinges on the precise intradermal injection of a purified protein derivative (PPD) of tuberculin.

The procedure involves injecting 0.1 mL of PPD solution into the inner surface of the forearm, creating a visible wheal (a small, raised bump). The injection must be intradermal, meaning it is placed between the layers of the skin.

This requires careful technique, using a fine-gauge needle (typically 27-30 gauge) and a shallow angle of insertion (5-15 degrees). If the injection is too deep, the test result may be falsely negative.

Reading the TST result is performed 48-72 hours after injection. A trained healthcare professional measures the diameter of the induration (a raised, hardened area) in millimeters. Redness without induration should not be measured.

Interpretation of the result depends on the size of the induration, the patient's risk factors (e.g., HIV status, recent contact with a TB patient), and other medical conditions.

Specific cut-off points for induration size vary depending on these factors. For example, an induration of 5 mm or more is considered positive in HIV-infected individuals, while a larger induration size is required for those with no known risk factors.

Allergy Testing

Tuberculin syringes are vital in allergy testing because of the need for precise intradermal administration of allergen extracts. Minute quantities of potential allergens are injected into the skin to observe for localized reactions.

This method, known as intradermal allergy testing, is often used when skin prick tests are negative or inconclusive. The accuracy of the allergen concentration is critical to minimize false positives or false negatives, and for patient safety.

Following the injection, the patient must be closely monitored for any signs of an allergic reaction. These reactions can range from mild itching and redness to severe, life-threatening anaphylaxis.

Healthcare professionals administering allergy tests must be prepared to manage these reactions promptly with epinephrine, antihistamines, and other supportive measures.

Medication Administration (Small Volumes)

In many clinical situations, the accurate measurement of small medication doses is crucial. Tuberculin syringes are ideally suited for these scenarios, offering the precision needed to deliver the correct dosage.

This is especially critical in pediatrics, where medication dosages are often weight-based and require fine-tuned adjustments.

Specialized treatments, such as hormone injections or certain ophthalmic medications, also demand precise dosing to achieve the desired therapeutic effect and minimize side effects.

Before administering any medication, it is essential to consider drug compatibility and stability. Some medications may degrade or interact with the syringe material, affecting the accuracy of the dose delivered.

Vaccination (Infants and Young Children)

Vaccinating infants and young children requires administering small, yet accurate vaccine doses to ensure both effectiveness and safety. The correct dosage is critical to elicit a sufficient immune response without causing adverse events.

Tuberculin syringes provide the control needed to administer these vaccines precisely, minimizing the risk of under- or over-dosing. Under-dosing may lead to inadequate protection against the disease, while over-dosing can increase the likelihood of adverse reactions.

Adherence to recommended vaccine schedules and dosage guidelines is paramount to ensure optimal outcomes.

Intradermal Injection Technique

Regardless of the specific application, mastering the intradermal injection technique is essential for anyone using tuberculin syringes. This technique requires precise control and angle of insertion to deliver the substance between the layers of the skin.

The first step involves selecting the appropriate injection site, typically the inner forearm. The skin should be cleansed with an alcohol swab and allowed to dry completely.

Using a tuberculin syringe with a fine-gauge needle (27-30 gauge), the needle is inserted at a shallow angle (5-15 degrees) with the bevel facing upward. The substance is then slowly injected, creating a visible wheal.

If the wheal does not form, the injection may have been administered too deeply, and the procedure may need to be repeated at a different site.

Proper training and technique are essential to ensure accurate and safe intradermal injections, regardless of the specific medication or test being administered. Anatomical considerations, such as avoiding areas with prominent veins or lesions, are crucial to minimize complications.

Technical Specifications: What Makes a Tuberculin Syringe Reliable?

Before a tuberculin syringe can be trusted in clinical practice, it must meet stringent technical requirements. These specifications ensure not only the accurate delivery of medications and test solutions but also the safety of both patients and healthcare providers. This section delves into the critical technical attributes that define a reliable tuberculin syringe, examining the importance of each specification.

Dosage Accuracy: The Cornerstone of Effective Treatment

Perhaps the most crucial aspect of a tuberculin syringe is its dosage accuracy. Without precise volume markings and the ability to obtain an accurate reading, proper medication administration or test results cannot be assured.

The syringe's barrel must display clear, easily readable gradations that allow healthcare professionals to measure the intended volume with confidence. Any ambiguity in the markings can lead to dosing errors, with potentially serious consequences.

Factors that affect accuracy extend beyond the syringe itself. Proper injection technique is essential; parallax error when reading the meniscus, or air bubbles within the syringe, can skew the administered dose. The quality of the syringe is also paramount, with poorly manufactured syringes potentially having inconsistent internal diameters, further affecting accuracy.

Sterility: Preventing Infection

Sterility is non-negotiable. The invasive nature of injections means that any contamination can introduce pathogens directly into the patient's body, leading to infections ranging from mild to life-threatening.

Tuberculin syringes must be manufactured and packaged in a sterile environment, typically undergoing sterilization through methods such as irradiation or autoclaving. Rigorous quality control measures must be in place to monitor and ensure the sterility of each syringe before it reaches the end-user.

Single-Use: Eliminating Cross-Contamination

The universal practice of single-use syringes is a cornerstone of infection control. Reusing a syringe, even on the same patient, poses a significant risk of cross-contamination, potentially transmitting bloodborne pathogens such as HIV, hepatitis B, and hepatitis C.

Single-use syringes are designed to be discarded immediately after use. Protocols for proper disposal, typically involving sharps containers, are essential to prevent accidental needlestick injuries and further minimize the risk of infection.

Dead Space: Minimizing Waste and Ensuring Correct Dosage

Dead space refers to the volume of fluid that remains within the syringe and needle after the plunger has been fully depressed. This volume, if significant, can lead to underdosing, particularly when administering very small volumes of medication.

Tuberculin syringes are designed to minimize dead space. Low dead space (LDS) syringes can make a significant difference.

Techniques to further minimize the impact of dead space include drawing up a small amount of air after the medication, or "chasing" the medication with a small amount of sterile saline or air, although these are not always appropriate and depend on clinical context.

Needle Gauge: Balancing Flow Rate and Patient Comfort

The needle gauge refers to the diameter of the needle bore. The gauge is expressed as a number; the larger the number, the smaller the diameter. Needle gauge significantly impacts flow rate and injection force.

A smaller gauge needle (higher number) reduces patient discomfort, but may increase the injection time and force needed, particularly with viscous solutions. A larger gauge needle (smaller number) allows for faster flow, but may cause more pain and increase the risk of bleeding or tissue damage.

Selecting the appropriate needle gauge depends on several factors, including the viscosity of the injected fluid, the injection site, and the patient's age and size. Smaller gauge needles are generally preferred for intradermal injections and for pediatric patients, while larger gauge needles may be necessary for intramuscular injections of thicker medications.

Essential Equipment and Materials: Assembling Your Injection Kit

Technical Specifications: What Makes a Tuberculin Syringe Reliable? Before a tuberculin syringe can be trusted in clinical practice, it must meet stringent technical requirements. These specifications ensure not only the accurate delivery of medications and test solutions but also the safety of both patients and healthcare providers. This section describes all the necessary equipment and materials required to prepare and administer injections using tuberculin syringes. With a focus on safety and infection control, this segment guides healthcare professionals through the proper assembly of an injection kit.

Tuberculin Syringe: The Heart of the Kit

The tuberculin syringe is the core component, meticulously designed for delivering minute volumes with exceptional precision. Typically, these syringes have a capacity of 1 mL (or cc), and are graduated in increments as fine as 0.01 mL, enabling clinicians to administer dosages with confidence.

Each part of the syringe plays a critical role in ensuring accurate and safe administration. The barrel, with its clearly marked graduations, allows for precise volume measurement.

The plunger ensures smooth and controlled delivery of the medication or solution.

Types of Tuberculin Syringes

Tuberculin syringes are available in two primary configurations: fixed needle and Luer Lock. The fixed-needle syringe integrates the needle directly into the syringe body. This design minimizes dead space, ensuring maximal delivery of the intended dose.

Luer Lock syringes, on the other hand, feature a threaded fitting that securely locks the needle onto the syringe. This prevents accidental needle dislodgement during injection. The choice between these types often depends on the specific clinical application and the healthcare provider's preference.

Needles: Precision Delivery

The needle, an integral part of the injection kit, facilitates the precise delivery of medications or test solutions into the body. Selecting the appropriate needle gauge and length is crucial to ensure patient comfort and accurate deposition of the injected substance. Needle selection must be informed by a thorough understanding of the patient's physiology and the specific type of injection.

Factors Influencing Needle Selection

Gauge refers to the diameter of the needle bore: higher gauge numbers indicate thinner needles. For intradermal injections, such as the Mantoux test, fine-gauge needles (e.g., 26-30 gauge) are preferred to minimize trauma and ensure accurate placement within the dermis.

Length should be appropriate for the target tissue depth; too short, and the medication may not reach the intended tissue; too long, and there's a risk of injecting too deep. Safe handling and disposal are paramount to prevent needlestick injuries and cross-contamination.

After use, needles must be immediately discarded into an approved sharps container to minimize the risk of accidental injury and infection.

Alcohol Swabs: Aseptic Preparation

Alcohol swabs are indispensable for preparing the injection site. They are essential in minimizing the risk of bacterial contamination.

Proper skin preparation involves cleansing the intended injection site with an alcohol swab in a circular motion, moving outward from the center. This process helps to eliminate surface bacteria, reducing the likelihood of infection.

It is crucial to allow the alcohol to air dry completely before administering the injection. This allows the alcohol to exert its full antimicrobial effect.

Sharps Container: Safe Disposal

A sharps container is a puncture-resistant receptacle designed for the safe disposal of used needles, syringes, and other sharp medical instruments. These containers play a vital role in preventing needlestick injuries and the transmission of bloodborne pathogens.

Compliance with local, state, and federal regulations regarding sharps disposal is mandatory to protect healthcare workers, patients, and the community. Proper placement and accessibility are key to ensuring that sharps containers are readily available at the point of use.

These containers should be easily accessible and never allowed to overfill.

Gloves: Barrier Protection

Gloves provide a critical barrier between healthcare providers and potentially infectious materials. Wearing gloves during injection procedures protects both the healthcare worker and the patient from cross-contamination.

Correct donning and doffing procedures are essential to prevent contamination. Gloves should be put on immediately before the procedure and removed carefully afterward, avoiding contact with the outer surface.

Hand hygiene, including thorough hand washing or the use of hand sanitizers, should be performed before and after glove use.

Rulers/Calipers: Measuring Induration

In certain diagnostic procedures, particularly the Mantoux tuberculin skin test, rulers or calipers are necessary for accurately measuring the induration (raised, hardened area) at the injection site. Precise measurement is crucial for interpreting test results.

Accuracy and consistency in measurement techniques are paramount. Healthcare providers should use a calibrated ruler or calipers and follow established protocols for measuring induration.

Measurements should be recorded meticulously in the patient's medical record to facilitate accurate diagnosis and treatment.

Personal Protective Equipment (PPE): Enhancing Safety

In high-risk environments or when handling potentially hazardous materials, personal protective equipment (PPE) may be required to further protect healthcare providers. This may include face shields, masks, and gowns. PPE should be selected based on a thorough risk assessment and in accordance with established safety protocols.

The use of PPE is especially important in situations where there is a risk of exposure to blood or other bodily fluids. Proper training in the use of PPE is essential to ensure that it is used effectively and safely.

Clinical Environments: Where Tuberculin Syringes Are Routinely Used

Essential Equipment and Materials: Assembling Your Injection Kit Technical Specifications: What Makes a Tuberculin Syringe Reliable? Before a tuberculin syringe can be trusted in clinical practice, it must meet stringent technical requirements. These specifications ensure not only the accurate delivery of medications and test solutions but also the safety of both healthcare providers and patients. Meeting these high standards is key to the effectiveness in clinical settings. Let's consider these environments.

Tuberculin syringes, due to their precision and reliability, are indispensable tools across a spectrum of healthcare settings. From bustling hospitals to community-focused public health departments, these syringes play a critical role in various diagnostic and therapeutic procedures.

Hospitals: Diverse Applications in a Complex Ecosystem

Hospitals, with their multifaceted departments, represent a significant area for tuberculin syringe utilization. Both inpatient and outpatient settings within a hospital rely on these syringes for precise medication administration and diagnostic testing.

In inpatient units, where patients require continuous monitoring and treatment, tuberculin syringes are essential for delivering small, accurate doses of medications, particularly in pediatric and geriatric care.

Outpatient clinics within hospitals utilize these syringes for allergy testing, TB screening, and specialized injection therapies. Strict adherence to medication administration protocols and infection control practices is paramount in these high-traffic environments.

Clinics: Efficiency and Accuracy in Outpatient Care

Clinics, focusing on ambulatory care, frequently employ tuberculin syringes for a range of preventive and diagnostic services.

Vaccinations, allergy testing, and tuberculosis (TB) screening are common procedures performed in clinics, all requiring the precision offered by tuberculin syringes.

The emphasis in clinic settings is on efficient workflow without compromising patient safety and accuracy. Healthcare providers must adhere to standardized protocols for injection techniques, documentation, and adverse event management. Efficient and safe practices are vital for a smooth patient experience.

Doctor's Offices: Personalized Care and Precision Dosing

Doctor's offices, representing a more personalized healthcare approach, also rely on tuberculin syringes for specific procedures. Similar to clinics, vaccinations and allergy testing are common applications.

However, the smaller scale of doctor's offices allows for a greater focus on individual patient needs. The emphasis is on building a strong rapport with patients. This trust can improve adherence to treatment plans.

Ensuring proper storage and handling of syringes and medications is crucial in maintaining the integrity of the practice. Safe medical practices are essential for patient safety.

Public Health Departments: Addressing Community Health Needs

Public health departments play a vital role in disease prevention and control at the community level. Tuberculin syringes are indispensable tools in their efforts.

TB screening and treatment programs rely heavily on tuberculin syringes for administering the Mantoux test and delivering medications. Vaccination campaigns, targeting various infectious diseases, also utilize these syringes for accurate dose delivery.

Public health departments must adhere to strict guidelines and regulations. These procedures are to maintain data integrity and ensure equitable access to care. The adherence to public health guidelines is vital in these unique community-focused environments.

Quality Assurance and Regulatory Compliance: Maintaining Standards

Before a tuberculin syringe can be trusted in clinical practice, it must meet stringent technical requirements. These specifications ensure not only accurate dosing but also patient safety and the reliability of diagnostic and therapeutic procedures. Therefore, rigorous quality assurance and strict adherence to regulatory guidelines are paramount.

Adherence to Manufacturer’s Instructions: A Cornerstone of Safe Practice

The foundation of quality assurance rests on meticulously following the manufacturer's instructions for each specific syringe model. These instructions detail proper usage, handling, and storage requirements.

Deviation from these guidelines can compromise the syringe's integrity and potentially lead to inaccurate dosing or contamination. Healthcare professionals must be thoroughly trained and demonstrate competency in utilizing tuberculin syringes according to these specifications.

The Significance of Training and Competency Assessments

Regular training sessions should cover best practices for:

• Syringe handling
• Aseptic techniques
• Proper disposal methods

Competency assessments should be conducted to verify that healthcare providers can consistently and safely administer injections.

Compliance with Healthcare Regulations: Navigating the Regulatory Landscape

Beyond manufacturer guidelines, healthcare providers must navigate a complex web of regulatory requirements. These regulations, established by governing bodies, aim to ensure patient safety and prevent the spread of infections.

Industry Standards: Setting the Bar for Quality

Compliance with industry standards, such as those set by organizations like the International Organization for Standardization (ISO) and the American National Standards Institute (ANSI), further validates the quality and reliability of tuberculin syringes.

These standards outline specific requirements for:

• Syringe construction
• Sterilization processes
• Packaging

Manufacturers must adhere to these standards to demonstrate their commitment to producing safe and effective devices.

The Consequences of Non-Compliance: Protecting Patient Well-being

Failure to comply with quality assurance measures and regulatory guidelines can have severe consequences.

These can include:

• Inaccurate dosing
• Increased risk of infection
• Compromised patient outcomes

In some cases, non-compliance can also lead to legal ramifications for healthcare providers and institutions.

Continuous Improvement: The Path to Excellence

Quality assurance is not a static process; it requires continuous improvement. Healthcare facilities should implement systems for:

• Monitoring injection practices
• Tracking adverse events
• Identifying areas for improvement

By actively engaging in quality improvement initiatives, healthcare providers can enhance patient safety and ensure the ongoing reliability of tuberculin syringes.

Future Trends: Innovations in Tuberculin Syringe Technology

Before a tuberculin syringe can be trusted in clinical practice, it must meet stringent technical requirements. These specifications ensure not only accurate dosing but also patient safety and the reliability of diagnostic and therapeutic procedures. Therefore, rigorous quality assurance and regulatory compliance are indispensable. Looking ahead, the field anticipates advancements that promise to elevate these standards even further.

What innovations are on the horizon for the tuberculin syringe? Several key areas of development hold considerable potential for enhancing accuracy, safety, and user-friendliness.

Enhanced Accuracy Through Microfluidics and Digital Integration

One of the most promising trends is the integration of microfluidic technology into syringe design. Microfluidic systems allow for extremely precise control over fluid volumes, potentially enabling more accurate drug delivery than traditional methods.

This is particularly relevant for medications requiring very small doses. Imagine a future where tuberculin syringes incorporate digital displays that show the exact volume being dispensed in real-time. Such a feature would minimize human error and increase confidence in dosing accuracy.

Smart Syringes and Dose Confirmation

Another area of innovation involves the development of "smart" syringes. These syringes could incorporate sensors to confirm the correct dose has been administered.

They could also include features that prevent accidental needle sticks. For example, retractable needles or safety shields that automatically engage after use. This would not only protect healthcare workers but also reduce patient anxiety related to injections.

Novel Materials and Coating Technologies

The materials used in tuberculin syringe construction are also evolving.

New polymers with improved chemical resistance and biocompatibility are being explored. Additionally, advanced coating technologies could reduce friction within the syringe barrel. This would lead to smoother plunger movement and more consistent dose delivery.

Expanding Applications in Emerging Therapies

Tuberculin syringes are finding new roles in emerging therapies. One example is intradermal delivery of vaccines. As new vaccines are developed and refined, the precise control offered by tuberculin syringes will be essential.

This precision is crucial for maximizing immune response while minimizing side effects.

Gene therapy is another field where tuberculin syringes could play a critical role. Localized delivery of gene therapies often requires precise targeting and accurate dosing. The tuberculin syringe's capabilities make it well-suited for such applications.

Diagnostic Innovations: Micro-Sampling

Beyond therapeutics, tuberculin syringes are being adapted for diagnostic purposes. Researchers are developing microneedle technologies that can be integrated with tuberculin syringes. This allows for minimally invasive collection of skin interstitial fluid for diagnostic testing.

Such applications could revolutionize point-of-care diagnostics, enabling rapid and convenient detection of various diseases.

In conclusion, the future of tuberculin syringe technology is bright. Ongoing innovations promise to improve accuracy, safety, and expand the range of applications for this essential medical device. As healthcare continues to evolve, tuberculin syringes will adapt and remain a critical tool for delivering precise and targeted therapies.

So, there you have it! Hopefully, this guide has shed some light on what a tuberculin syringe is and how it's used. Remember, if you're ever dealing with one, always prioritize safety and follow proper procedures. If you have any further questions, don't hesitate to consult a healthcare professional.