Published Apr 22, 2003
I am new to traveling outside my state and recently discovered how big some differences are across the country. My question is this, Is it a practice to use filter needles when drawing up medication out of a glass ampule where you are?
That had always been my practice until recently a hospital I am traveling to siad they don't even have filter needles or know what they are. I was just curious to see what is the standard across the country.
I always use filter needles when drawing from a glass ampule (ex: digoxin)...to avoid injecting small shards of glass.
that was what I thought too, but what do I do if the filter needles are not available to me? Am I putting my patients at risk?
I have lived and worked in Chicago my whole life and am surprised to see how it varies even in my own small niche of the world. I always do this too (use filtered needles), but had a similar response at one hospital where I was working agency. They looked at me like I had 2 heads or something!
I would ask your manager about it...I would be uncomfortable not using filter needles too. Maybe ask someone in the education dept? Try and find information on the net to back you up.
Practice Resources Practice Resources Home
ASK THE EXPERTS
AUGUST 98 - VOLUME 18 - NUMBER 4
FILTER NEEDLES AND GLASS AMPULES
Q. Are special filter needles required when drawing up medication from a glass ampule? Are there hidden risks to patients, ie, sharp glass particles, if a filter needle is not used?
A. Fred L Meister, PharmD, replies:
Bacterial contamination has always been the major concern associated with the intravenous administration of medications and is a well-known cause of morbidity and mortality. Additional risk factors, however, have been identified and must also be considered.
The potential risks associated with administration of medications supplied in glass ampules is much greater than realized by most practitioners. Opening a glass ampule produces a shower of glass particles, many of which enter the ampule and contaminate the contents. Some of the particles have been shown to carry bacteria, though the significance of this has not been determined.
The number of glass particles found in opened ampules varies, but most reports indicate approximately 100 particles, ranging in size from 10 to 1,000 µm, per 10-mL ampule. The particle count increases as the size of the ampule increases (ie, a 20-mL ampule will contain more glass particles than a 10-mL ampule). When the content of a 10-mL ampule is aspirated through an 18-gauge, 1.5-inch needle, the particle count is reduced by approximately one third (ie, approximately 65 particles remain in the aspirate), and the maximum particle size is reduced to less than 400 µm.
The potential risks associated with intravenous administration of glass particles are based on animal studies, though similar risks would apply equally to humans. It has been shown that glass particles cause inflammatory reactions (eg, phlebitis) and granuloma formation in pulmonary, hepatic, splenic, renal, and intestinal tissue. This represents a significant risk of an adverse patient outcome.
The effective removal of glass particles from an opened ampule can be accomplished by aspirating through a 19-gauge, 5-µm filter needle. Using this method decreases the average total number of particles in the aspirate to approximately ±1, and the particle size to less than 200 µm. Using a 0.22-µm in-line filter offers little or no additional benefit, and is more costly and labor intensive--once the ampule content is aspirated into a syringe, the filter needle must be replaced with a standard needle prior to transferring or administering the medication.
Based on the available information, a filter needle is recommended when aspirating a medication from a glass ampule.
Good one furball.
Thank you so much furball, that is exactly the kind of info i was looking for. I am going to take it to the manager tomorrow and see what she says. She is new to the organization too so maybe something might actually get done!
NRSKarenRN, BSN, RN
If filter needles not available, at least change syringe needle before injecting into patient.
i've only been a nurse 5 years but only discovered filter needles when i immigrated to the US 2 years ago. we didn't use them in the hospitals I worked at in New Zealand or Autralia. now if i see them i use them but they aren't always available.:zzzzz
husker-nurse, LPN, LVN
I do believe that if I got caught NOT using a filtered needle with a glass ampule, they'd grab my license lickedy-split! (ever been tempted to give that nasty pt. his insulin in the cheek with a filtered needle?) JUST KIDDING!!:roll
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