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Medipin - Neurological Testing Single Use Protected Cutaneous Pinprick Device - Box of 100

TESTING FOR EARLIER DETECTION OF LOSS OF PROTECTIVE SENSATION IN YOUR OWN PRACTICE: The professional examination procedure utilising an advanced pinprick technique and dedicated device for improved safety and diagnosis of loss of protective sensation - Box of 100 for Clinical Use


Medipin is a unique single use cutaneous pinprick testing device. Its patented precision technology uses lateral inhibition to enhance patient pinprick sensation response, which is commonly compromised by diabetic neuropathy. 100 count box is excellent for use in the primary care setting.



  • Safe - Single use devices provide infection control.

  • Consistent - Patented design promotes high level sensitivity and testing reliability

  • Convenient - Clinically clean point exposed by easy breaway tab

  • Easy disposal - Plastic point can be easily compressed and flattened after use


Medipin sets the standard for consistenly precise diagnosis with enhanced accuracy, safety and convenience. 



Availability: In stock

$23.95

Details

Details

TESTING FOR EARLIER DETECTION OF LOSS OF PROTECTIVE SENSATION IN YOUR OWN PRACTICE: The professional examination procedure utilising an advanced pinprick technique and dedicated device for improved diagnosis of loss of protective sensation - Box of 100 for Clinical Use

Medipin is a unique single use cutaneous pinprick testing device. Its patented precision technology has been designed to enhance patient pinprick sensation response. Each Medipin has a short pyramid shaped point with highly defined edges and a flattened top intended to stretch rather than penetrate the skin surface. The point is surrounded by an annular ring to provide a contrasting perimeter of dull stimulation that further augments the sharp sensation created by the point and helps prevent skin puncture. The tab, which protects the point integrity until it is ready to be used, is designed to break away and can be used to conduct a two-point discrimination (6mm) test. The blunt end head of the Medipin is for comparison testing.

Medipin is designed to enhance the acuity of perceived pinprick sensation by combining stimulus from multiple biological sensory receptors rather than utilizing increased physical pressure to elicit a similar level of pain response. It is a medical instrument, designed with safety in mind, that may help reduce the risk of patient skin penetration and seeks to protect clinicians from accidental needle stick injury.

Medipin is ideal for use by any person with increased risk of neuropathy or loss of protective sensation and clinicians who regularly work with patients that may have a potential neurologic deficit. Healthcare practitioners who benefit from the convenience and precision of Medipin® brand esthesiometers include a wide range of clinicians from general practitioners to neurologists and emergency room traumatologists to diabeticians. An FDA listed instrument, Medipin has been in regular use by US Doctors for many years, as well has having been employed successfully in quite a number of international medical studies.

TESTING IN YOUR OWN PRACTICE: 
The professional examination procedure utilising an advanced pinprick technique and dedicated device for earlier detection of loss of protective sensation

Do The Right Test
Use Pinprick Modality Correctly For Greater Sensitivity Than Monofilament

Do The Test Right
Simply Compare Sensation Scores Out Of ‘10’ Between Areas Of ‘Normal’ Control and Potential Deficit For Greater Specificity – Use Multiple Applications

Use The Instrument of Choice
MEDIPIN, THE SINGLE USE PROTECTED NEUROLOGICAL PIN; Designed To Optimize/Intensify Pinprick Perception Without Penetrating/Breaking/Piercing The Skin.

 

DO THE RIGHT TEST - THE MODALITY
Though it might not be the primary or most fashionable choice, pinprick remains a medically useful device by which to assess sensation, especially with an instrument designed to lend itself to an easy testing scenario and utilising the very straight forward technique described by key source material cited by ADA literature. As a testing modality for the prediction of serious diabetic complications, like the development of lower extremity ulceration, pinprick has actually been reputably demonstrated to be rather more sensitive than current fashion would suggest. 1,2,3

DO THE TEST RIGHT  - TECHNIQUE IS PIVOTAL
The current standard, evidence based clinical test procedure recommended by the American Diabetes Association is published as follows:

“A disposable pin should be applied just proximal to (before) the toenail on the dorsal (upper) surface of the hallux, (great toe) with just enough pressure to deform the skin. Inability to perceive pinprick over either hallux would be regarded as an abnormal test result”. (Extract from: Comprehensive Foot Examination and Risk Assessment: A report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists, Diabetes Care August 2008 vol. 31 no. 8 1679- 1685, p1681) http://care.diabetesjournals.org/content/31/8/1679.full.pdf+html

However, a more sophisticated technical adaptation is available that will significantly improve test subtlety.

Everyone’s perception is idiosyncratic and state dependent. Attempting to impose a standardized neuropathy threshold of stimulation across the population, even with a device that imparts a predictable level of force, simply won't work 4. Therefore we detect subtle degrees of deficit rather than just a threshold driven “yes or no” picture by using the second rule of clinical examination - comparison. Use a Medipin to establish “Normal” sensation in an area you know to be unaffected by pathology - for example the palmar aspect of a wrist is particularly good or tip of a shoulder - by using multiple light applications in a continuously repetitive, percussive action to establish an “average” for the patient 5 – this represents the “control”. Whilst doing so you can tell your patient that this is “normal” for them. You can grade their responses by setting the “normal” control area at an arbitrary score of “five” out of 10 allowing them to offer a specific comparative value in another area. Immediately move to the region under suspicion – for example the dorsal halux - and ask them how the score compares to the control. This makes the test quantitative rather than the binary interpretation provided by the “yes or no” response and you can easily move back and forth between the test areas to help refine their response 6,7. Patients are very good with verbal and visual analogue pain scales for expressing subtle differences in either direction– either hypo or hyperaesthetic 8-12. Remember; each application is imperfect and it is the continuous application that reduces the standard deviation and produces a more reliable picture by negates missing out randomly distributed receptors and averaging out application pressure.

Use The Instrument of Choice – MEDIPIN; THE SINGLE USE PROTECTED NEUROLOGICAL PIN; Designed To Optimize Pinprick Perception Without Piercing Delicate Skin

Medipin is an FDA listed, dedicated device which has been in regular use by US Doctors for many years, as well has having been employed successfully in quite a number of international medical studies. 

It is an all-plastic precision instrument designed to avoid skin puncture whilst, simultaneously intensifying stimulation at lower application pressures.  This is achieved by situating a short and flat topped, faceted, pyramidal point within a surrounding annular component something like a golf tee. 

The result is to harmlessly micro-displace the skin sufficient to hyper-sensitize it whilst creating a perimeter of dissimilar dull sensation to generate the phenomenon known as a center surround field.  This contrasting effect promotes cortical lateral inhibition, which concentrates and intensely distinguishes, the point and its boundaries to create a neural, ‘illusion’ (mechanically akin to the better known optical variety) of enhanced perception.  This means that usefully acute stimulation can be achieved using a much lighter contact pressure. 

The point is, frankly, not so much a point as a very small pyramid that concludes in a plateau.  Medipin is designed specifically to be consistently precise without penetrating the skin.  Ideal for the fragile conditions often associated with diabetes.

Medipin is also excellent for infection control.  The point is largely shielded by the annulus surrounding it which helps protect against inadvertent self-contact and scratching.  It is also very easily destroyed.  If not in a sharps box, simply compress the point against a hard surface such as a sink or metallic trolley and it will flatten without snapping off.  It can also be broken in two to avoid re-use.

See “Instructions” below:

Instructions For Use

1. BREAK TAB TO EXPOSE POINT - AVOID CONTACT WITH FINGERS.

2. GRASP DEVICE BETWEEN THUMB and INDEX FINGER LIGHTLY ENOUGH TO PERMIT SLIGHT AXIAL SLIPPAGE IF REQUIRED - UTILISE TEXTURED SURFACE TO FACILITATE CONTROL.

3. APPLY TO SKIN AT A PERPENDICULAR TO standardiSe point pressure FOR improved test consistency and OPTIMISE ANNULAR CONTACT TO GENERATE A ‘CENTRE SURROUND’ FIELD OF ENHANCED ACUITY.

ESTABLISH A CONTROL AREA IN AN UNAFFECTED REGION WITH AN ‘AVERAGE’ STIMULATION LEVEL BY MAKING SEVERAL QUICK APPLICATIONS AROUND THE SAME LOCALITY.  PRESS FIRMLY BUT CAREFULLY USING A REPETITIVE, PERCUSSIVE CONTACT.  AVOID HIGH AMPLITUDE or ‘STABBING’ ACTIONS - PENETRATION IS CHECKED BY THE ANNULUS BUT NEVER ASSUMED ‘IMPOSSIBLE’.  INSTRUCT YOUR PATIENT THIS “NORMAL” AREA REPRESENTS A SCORE OF “5” OUT OF TEN

4. COMPARE SYMMETRICAL or ADJACENT REGIONS OF SENSORY DISTRIBUTION CONTINUOUSLY ASKING YOUR PATIENT WHERE POSSIBLE TO IDENTIFY and GRADE THE QUANTITY OF DEFICIT BETWEEN THEM AND YOUR ‘AVERAGE’ OR ‘CONTROL’ AREA

5. TO PREVENT RE-USE DESTROY POINT BY COMPRESSION AGAINST A HARD SURFACE and/or DISPOSE OF IN A BIOHAZARD CONTAINER.

ALWAYS OBSERVE SHARPS POLICY

Instructions for HOME Use - Please see pictures below

1. Grasp a Medipin between thumb and finger and snap the tab to expose the point.

Expose Medipin Point

2. As in the picture gently press the point onto your big toe between the knuckle and nail with just enough pressure to dimple it. DO NOT TRY TO PIERCE THE SKIN. You should be able to feel a sharp pinprick sensation. 


 Pinprick Test on Big Toe

3. Use the same Medipin to test the other big toe in exactly the same way. 

INABILITY TO FEEL PINPRICK ON EITHER BIG TOE WOULD BE REGARDED AS AN ABNORMAL TEST RESULT AND YOU SHOULD CONSULT YOUR DOCTOR.

4. Though not truly sharp, dispose of the Medipin safely, either in a sharps container or by compressing the point against a robust metal surface to flatten it, before you throw everything, including the tab, away. You may also break the Medipin in two. 


Compress PointDiscard Sharps Safely

5. Repeat the test monthly and check the Result OK for each foot to record it on the calendar provided on the back of the box. 


Record Result

HOME TESTING WITH MEDIPIN® IS NOT DIAGNOSTIC OR A SUBSTITUTE FOR EXAMINATION BY A QUALIFIED MEDICAL PROFESSIONAL.
IF IN DOUBT ALWAYS CONSULT YOUR DOCTOR.

References:

1. Standards of Medical Care in Diabetes, ADA Position Statement, January 2015, Diabetes Care, Volume 38, Supplement 1, PS62-4.

2. Boulton et al, Comprehensive Foot Examination and Risk Assessment: A report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists, Diabetes Care August 2008 vol. 31 no. 8 1679- 1685, p1681)

3. Abbott CA, Carrington AL, Ashe H, for the North-West Diabetes Foot Care Study. The North-West diabetes foot care study: incidence of, and risk factors for, new diabetic foot ulceration in a community- based patient cohort. Diabet Med. 2002;19:377-384.

4. A.T. Shirgaonkar, M. Purva, I.F. Russell; A double blind comparison of the variability of block levels assessed using a hand help Neurotip™ or a Neuropen® at elective caesarean section under spinal anaesthesia. International Journal of Obstetric Anesthesia (2010) 19, 61–66

5. Herrero JF, Laird 2000, JMA, Lopez-Garcia JA. Wind-up of spinal cord neurones and pain sensation: much ado about something? Prog Neurobiol ;61:169–203

6. Jeng C, Michelson J, Mizel M. Sensory thresholds of normal human feet. Foot Ankle Int. 2000;21:501-504.

7. Rolke R, et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol
and reference values. Pain 123 (2006) 231–243

8. Wallerstein SL (1984.) Scaling clinical pain and pain relief. In: Bromm B, ed. Pain measurement in man: neurophysiological correlates of pain. New York: Elsevier

9. Kelly AM (1998). Does the clinically significant difference in VAS pain score differ with age, gender or cause of pain? Acad Emerg Med;5:1086–90.

10. Collins SL, Moore RA, McQuay HJ (1997). The visual analogue pain intensity scale: What is moderate pain in millimetres? Pain;72:95–7.

11. Scott J, Huskisson EC (1976). Graphic representation of pain. Pain ;2:175–84. 12. Menegazzi J. (1996 ) Measuring pain at baseline and over time. Ann Emerg Med;27:433–5.

12. Menegazzi J. (1996 ) Measuring pain at baseline and over time. Ann Emerg Med;27:433–5.

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