are filter needles necessary?

[brownbook]

I always use filter needles for drugs drawn from ampules. I notice many intelligent respected co-workers, including anesthesiologists, do not? The drug (I'm talking fentanyl here) is given via the IV access port, the needle is removed and the syringe screwed onto the access port. Does that somehow make filter needles not necessary? Do the screw on type access ports act as a filter?

[kfmc]

The concept of using filter needle is for patient's safety.. we don't want to risk this. Is there any documented event, where this ampule fragment caused harm to the patient?... I haven't heard anything yet,. but I would still continue doing what is right for the patient..

[GilaRRT]

I always use filter needles when drawing from an ampule. I'm doubting that anyone was ever actually harmed from being injected with tiny glass shards. It's probably more a theoretical risk than anything else. However, since filter needles are readily available, it's an easily preventable risk. So I use them. We used to have labels on ampules reminding us to use filter needles, but those have recently disappeared.

The risk is real; however, the problem is more about the inflammatory response and end organ (tissue effects). It's not really about tiny pieces of glass cutting stuff up as many think, it is more about the bodies inflammatory response to foreign material. I am unsure of any human studies, but the problems have been fairly well documented in animal studies.

Kfmc, links to the names of animal based studies:

Ask the Experts: 18(4) FILTER NEEDLES AND GLASS AMPULES

[jlcole45]

Filter needles are not a new idea or practice in the US - I've been nursing more then 20 years and they've been around the whole time.

[HamsterRN, ADN, RN]

There is evidence to support the use of filter needles. A 2004 study found that 22% of medications from glass ampules contain glass shards if a filter needle is not used.

Journal of Advanced Nursing, 2004. 48(3); 266-70)

[donsterRN, ASN, BSN]

It wouldn't occur to me NOT to use the filter needle when drawing up meds from a glass ampule.

[head3rd]

Using filter needles with ampules is simply best practices, keep in mind often our higher educated team members (Dr's) don't seem to feel the need to wear gloves with MRSA patients, masks with neutropenic patients etc.

Do what is best for your patient and mention to the person that you heard of a study about it

[PetiteOpRN]

YES. Yes, filter needles are absolutely necessary any time you are drawing a drug from an ampule. The shards of glass are microscopic, so it really doesn't matter whether or not you can see anything in the ampule. No matter what you're doing with it (IV, infiltrate, irrigation...if it comes in contact with the patient, use a filter needle).

The only reasons not to use a filter needle are laziness and apathy. Anesthesiologists DO know better. Some just don't care. Some put in art lines without even attempting to maintain sterile technique. That doesn't mean it's the right thing to do.

[Pepper The Cat, BSN, RN]

I've worked in Canada for nearly 25 years and have never used a filtered needle.

Never heard of them until Allnurses.

[Corlee]

I think they are absolutely necessary as well. I am just starting nursing school this Fall but have been a Pharmacy IV Technician for over 5 years and we always filter anything that comes out of a glass ampule prior to being injected into the IV bag. We also filter anything that is going to be used intrathecally, I.E. a Methotrexate IT, ARC IT, etc. I guess its just a better safe than sorry thing in my book.

I did work with a man who was a pharmacist in India (technician in America) and he had another technique he thought worked just as well as a filter needle. He always got in trouble for using it though.

[blondy2061h, MSN, RN]

Thanks for the info on filter needles and the studies showing the evidence. Now I'm curious- why do we still use ampules? What is the benefit over a vial or carpujet?

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Most definitely.

[regularRN]

Yeah - always use a filter when drawing up anything from a glass ampule. Also, always snap the ampule with an alcohol wipe to avoid cutting yourself. I'm guessing the risks of injury in both cases are negligible. Filter needles have been around for years... I qualified in the UK in the 1980s, we always used them.