Filter needles...are they necessary?

[fsaav]

I'm about to graduate in 2 months and I know there are things that are different in the real world than "textbook." I see nurses on the floor do so many things differently than what I'm taught and lately I've been struggling with figuring out which things are okay to do a different way and which are just nurses taking unsafe shortcuts. One of my issues lately is the use of filter needles. I always use filter needles when administering meds from ampules. Nurses will kind of snicker and make comments about me using them because I'm a student. Do you use them? I was taught that shards of glass can be injected into the vein if the filter needles aren't used. Is this true or is this just in theory and the filter needles aren't actually necessary?

Also, if you have time...can you mention some things off the top of your head that really are okay to do differently than what is taught textbook.

Thanks.

[nursel56]

I didn't say it wasn't possible, just that I would be interested to see it, and I didn't say using a filter needle was a bunch of hooey, either, as some other posters did.

In the case of someone jumping out of an airplane, we do have actual data in the form of mishaps with the opening of a parachute telling us that 100% of the time if you free fall from an airplane you will die when you hit the ground. The cause and effect relationship is made pretty easily.

To say that when glass particles of several microns being linked to phlebitis in a cow when the particles are injected intravenously is "injecting glass shards into your patient" requires quite a bit more conjecture.

[royhanosn]

unless nursing has become a sloppy or lazy profession when using needles. the syringe is sterile, needle is sterile, the seal of the ampule is sterile. Would the use of a filter, for a solution that is sterile, is overkill and costly.

[Asystole RN]

unless nursing has become a sloppy or lazy profession when using needles. the syringe is sterile, needle is sterile, the seal of the ampule is sterile. Would the use of a filter, for a solution that is sterile, is overkill and costly.

Unless you actually understand the rationale for filter needles.

It is to remove glass shards. I cite my post on page 2.

[Deb123j]

I re-took PALS a week ago, it was mentioned, with a great roll of eyes, that if a needle is used to puncture the rubber/plastic stopper on a pre-filled epinephrine syringe a filter needle should be used!!!!!! Now that is crazy making.

Many times I have given IV Ativan which requires puncturing the rubber stopper. On a few occasions a small piece of the rubber ends up in the syringe. When this happens, I will use a filter needle with another syringe to make sure the rubber piece is not in the syringe I plan on using with the pt.

[Deb123j]

Trust me on this one, YOU WILL NOT HAVE TIME to use a filter,yes ideally it should be used in some situations, however, in the last 5 facilities I have worked at, filters arent even available.Best of luck in the real world,its gonna suck.

This is absolutely rediculous!!!! How much time does it take to use a diffeent needle? If the filter needle is available...use it! The real world doesn't "suck" it's just different/harder/more rewarding! Good grief!!!!!

[penguin2]

While it is true there are no RCT's involving the injection of glass particulates in humans for the final confirmation of a risk, there are also no RCT's that compare jumping out of a plane with a parachute to jumping out of a plane without a parachute. So no, there is no true scientific evidence to confirm any increased safety of using a parachute when jumping out of a plane either.

What we do know is that a significant amount of glass shards are drawn up when using a glass ampule without a filter and that this causes harm to other animals. Should the burden of proof lie with proving it's safe to inject the glass shards or with proving it's unsafe in humans? For me, I'm probably going to continue to wear a parachute, even in the absence of a confirmed risk, until it's safety can be proven given the logical risks of falling out of the sky with no parachute, or having glass shards in your circulatory system.

Gee, are there any survivors of jumping out of planes sans parachutes out there to back this up? LOL

[Jules A, MSN]

This is absolutely rediculous!!!! How much time does it take to use a diffeent needle? If the filter needle is available...use it! The real world doesn't "suck" it's just different/harder/more rewarding! Good grief!!!!!

In psych there are times when it is, IMO, not practical to take the extra time when the patient is violent, being forcefully restrained and my staff is getting the stuffing beat out of them. Do I think it is the best way? no but that is the decision I have faced more than once.

[MrsEd]

Trust me on this one, YOU WILL NOT HAVE TIME to use a filter,yes ideally it should be used in some situations, however, in the last 5 facilities I have worked at, filters arent even available.Best of luck in the real world,its gonna suck.

I have never worked anywhere that did not stock filter needles, nor have I ever worked anywhere where filter needles were stocked in the crash carts.

[Tait, MSN, RN]

I don't quite understand the hostility towards a simple safety measure. I use a filter needle, have never thought twice about not using one. Everyone on my floor uses filter needles. They are stocked on every cart.

Tait

[AirforceRN, RN]

Gee, are there any survivors of jumping out of planes sans parachutes out there to back this up? LOL

For those that have nothing better to do right now...or for the curious...

http://en.wikipedia.org/wiki/Nick_Alkemade

Alan Magee - Wikipedia, the free encyclopedia

Ivan Chisov - Wikipedia, the free encyclopedia

Pretty amazing stuff...

[rn/writer, RN]

unless nursing has become a sloppy or lazy profession when using needles. the syringe is sterile, needle is sterile, the seal of the ampule is sterile. Would the use of a filter, for a solution that is sterile, is overkill and costly.

Sterility from microscopic organisms is not the issue.

The kind of contamination filter needles are designed to prevent is from particulate matter--glass shards invisible to the eye but nevertheless capable of causing tissue damage.

Not using filter needles under most conditions would be the "sloppy or lazy" way to go.

That said, there are exceptions.

In psych there are times when it is, IMO, not practical to take the extra time when the patient is violent, being forcefully restrained and my staff is getting the stuffing beat out of them. Do I think it is the best way? no but that is the decision I have faced more than once.

You have to have to look at the big picture and go with the most sensible option in any emergent situation.

[nursel56]

QUOTE=Tait;4578783]I don't quite understand the hostility towards a simple safety measure. I use a filter needle, have never thought twice about not using one. Everyone on my floor uses filter needles. They are stocked on every cart.

Tait

It's just one of these things that often cause people to immediately form into two groups --- the oh my God group and the chillax group. The glove issue and the aspirate before giving an injection issue often cause that dynamic. Saying "why would you want to injectI glass shards into your patient?!??" I:eek:[ has a tone that indicates the offense is akin to adding ethylene glycol to the IV solution.

In reality the supposedly offending nurse may surmise that if x number of millions of injections given without a filter needle x y number of years have not one single documented case of human injury or death directly attributable to glass particles there's no need to totally freak out and say "oh I would never do that!! I like my patients alive thankyouverymuch". What I find interesting is that the same nurses who are calling the non-filter needle using nurses dangerous because there might be a problem no longer aspirate before injecting IMs and subQs because "it has not been proven it makes the shot safer". The "it might be bad so I won't do it" principle is not applied to the possibility that several molecules of the drug injected might find their way into a blood vessel and cause organ damage.