Changing needles for injections...

[Otessa]

I have a question about changing needles for injections.

Drawing up with one needle and then changing the needle prior to injection (IM).

There are new needle-syringe combos (Vanishpoint for example) where youdraw up and give with the same needle.

Is there any reason that you would change the needle-----and no "that's the way we've always done it"

I would like a solid reason one way or the either.

Thanks for your input.

otessa

[rich8ames]

When in doubt ALWAYS change the needle - your patient will be thankful for it!

[SaraO'Hara]

I always change the needle - a fresh, sharp needle is less painful for the patient. For most IM injections, I'll draw up with an 18g (we don't have blunt needles), then switch to a 22g (smallest we have in a length suitable for IMs).

[McBx3]

The only time we were required to change the needle is if the medication to be given was in a glass vial... we had to draw it up with a filter needle, then change it to a regular needle for the injection, to make sure that no glass fragments were drawn up with the medication.

I never liked the VanishPoint (or similar) syringes, because they always seemed to malfunction on me for some reason *shrugs* Almost definitely user-error, but I swear they just didn't like me

[Higgs]

...so if the consensus appears to be that a needle is made less sharp by drawing up meds - whether via a rubber stopper or not, (though, personally I dont see that pushing a needle through a rubber stopper will dull the needle point to the extent that a pt can feel the difference) then why do we continue to use insulin syringes that don't have removable needles...?

[Lacie, BSN, RN]

I only change the needle if a medication that will be caustic to tissue. Ie: IM Iron preparations is a very good example. If a thick med then yes I will draw up with 18g then change needle to smaller needle. One push through a stopper isnt going to significantly dull a needle. If that was the case well all the folks getting flu immunizations, insulin, heparin, etc would be yelling ouch alot lol.

[interleukin]

Dear Lacie,

Unless you want to divide your med into two syringes and do a little "experiment" you can't make the "stopper" statement.

Stoppers dull the incredibly fine point of needles. If it didn't matter so much needles would not be manufactured with such precision.

Hurt a little or hurt a little more, ask your patients which they'd prefer?

[RaechelK]

All the hospitals I've been at have used some sort of combo set. You use a blunt 18 (I think?) to draw meds and then grab whatever size needle you actually need to inject into pt. Unless it insulin, then I just draw and give.

I guess if your employer is using something different where you draw & inject w/ the same needle, you kinda have to use what you got.......If it has bad outcomes w/ pt's, keep your DON informed and do your best to get others on board to try to get it changed. Good luck!

[spooky64]

I have always changed my needles after drawing up a med. On the couple of occasions I have used the same needle, I found the needle harder to advance when giving an injection. I noticed that I caused more pain when using a duller needle. I worked at an urgent care and one of the doctors there disapproved of changing the needle, saying that he was concerned about the patient not getting the full amount of med due to some med remaining in the throwaway needle. I still changed them though. I don't like to cause undue pain!

Chris

[SolaireSolstice, BSN, RN]

Easy enough to make sure you get all of the med out of the discarded needle, just pull the plunger back until air is visable at top of the syringe, then switch the needle, and push out the excess air. We have to do this anyway to expell bubbles. Doctors can be so illogical. (and I say this with all fondness because both my parents are doctors.)

I did a vaccine clinic this summer for the zostavax, shingles vaccine. These have to be reconsituted, so I was pushing the original needle through the rubber stoppers 3 times, once into the sterile water, then into the vaccine vial, then mix, then back into the vaccine vial to draw out the vaccine. I know the needle would be dull, because on that 3rd stick into that vial, it would actually be harder to get into the rubber. We knew we would have to switch the needles, and we got 3 cc syringes with 18 gauge needles to draw up the vaccine, then just switched out the needle to a 25 gauge. But we order our own supplies, so these things are easier to acquire.

[All4Seasons]

If you're drawing up a med from a glass ampule (the ones you snap the top off) you must draw up with a filter needle then change it so there's no chance of injecting glass.

[Guest219794]

I have always changed my needles after drawing up a med. On the couple of occasions I have used the same needle, I found the needle harder to advance when giving an injection. I noticed that I caused more pain when using a duller needle. I worked at an urgent care and one of the doctors there disapproved of changing the needle, saying that he was concerned about the patient not getting the full amount of med due to some med remaining in the throwaway needle. I still changed them though. I don't like to cause undue pain!

Chris

That's funny.

[Otessa, BSN, RN]

I think the point the OP is making is that with the new Vanish Point syringes, you CANNOT change the needle.

I have never changed my needle after drawing up a med. I have never even seen this practise.

Exactly-with the VanishPoint it is attached and there is NO option to change needles....