hospitals still use non-needless systems?

[HappyNurse2005, RN]

Follow that?

Had a pt who came from an outlying facility yesterday for a cath. I had her today, day after her cath. had 2 iv sites. one was from our facility (we use the nexiva brand) and one i could tell was from another facility. i went to take down her fluids, and it was a needle system!

I was surprised that anywhere use the systems with needles-i thought needleless was the standard now.

of course, why didn't someone at my facility hook up fluids to her iv that was the leur lock? why did they keep using the needle system? oy.

Anyhoo, are needle systems still common? Maybe i'm just ignorant and too used to the big city hospital, lol.

[TazziRN, RN]

Until this past January our ambulance company did not use needleless systems, which created havoc when we had to give meds, but other than that I haven't seen needle systems for years.

[MIA-RN1, RN]

curious--what is a needle system? Does the needle remain in the vein??

[caroladybelle, BSN, RN]

A needleless system is an IV system that uses leurlocks on the tubing. The IV is started with an needle under a plastic cannula, and the needle is removed. A cap, and or tubing is attached and flushed with saline, so that it need not be attached to continuous IV infusion but may be used intermittently. In some facilities, the cap is a rubber stopper, that is accessed w/ a needle and others, it is a leur lock that the syringe attaches to, without a needle.

The needleless (luerlock) system is considered safer. But the other is still used in some places.

There are a few places that use metal butterfly IVs but they are usually just for a one time, short infusion and then DCd.

To the OP: some facilities cap the IVs/PICCs/Hickmans on an outpatient with a rubber cap, but would replace it with a luerlock, or remove the rubber cap and straight line infuse it, when actually in use. I work with severely immunocompromised patients, and while they may be capped with a variety of tops, when not in use, we use sterile technique when opening the line for use and remove all old caps of either type - due to risk of infection that may be present in them.

[caroladybelle, BSN, RN]

Also, there are some rubber caps that actually accomodate an unusual type of needleless system - one that uses a "blunt" tip access, rather than a standard luerlock. While you can access it with a needle, you shouldn't use one and it can actually damage the cap.

[MIA-RN1, RN]

A needleless system is an IV system that uses leurlocks on the tubing. The IV is started with an needle under a plastic cannula, and the needle is removed. A cap, and or tubing is attached and flushed with saline, so that it need not be attached to continuous IV infusion but may be used intermittently. In some facilities, the cap is a rubber stopper, that is accessed w/ a needle and others, it is a leur lock that the syringe attaches to, without a needle.

The needleless (luerlock) system is considered safer. But the other is still used in some places.

There are a few places that use metal butterfly IVs but they are usually just for a one time, short infusion and then DCd.

Ah ok, I get it. I think that all I have ever seen is the needle-less system, which is why I was confused. Thank you!

[MissJoRN, RN]

Also, there are some rubber caps that actually accomodate an unusual type of needleless system - one that uses a "blunt" tip access, rather than a standard luerlock. While you can access it with a needle, you shouldn't use one and it can actually damage the cap.

Yes, we use these, and I'm thinking it's what you saw. The tubing looks exactly the same as it did 10 years ago. First we got connectors where the needle was surrounded by a plastic cap that locked onto the tubing and were much safer but now we use the blunt plastic tip that snaps around the port like a clothespin. For push meds ot flushes we have plastic tips without the clip... like a child's toy version of a "real syringe" LOL (disclaimer- NO! I never let my peds patients play with them) Surprisingly, they do penetrate the vial stoppers.

[mitchsmom]

EMS still used needle systems during my clinicals (that was recently; I just graduated). One of the hospitals used the blunt tip system described above too.

[Gompers, BSN, RN]

Also, there are some rubber caps that actually accomodate an unusual type of needleless system - one that uses a "blunt" tip access, rather than a standard luerlock. While you can access it with a needle, you shouldn't use one and it can actually damage the cap.

We have these. Each port that is needle-less has a rubber hub with a white circle around it to show that it's accessable by the blunt "needle-less" needles. So many of my coworkers use regular needles in these, though, to give meds, and it drives me crazy! I've told them that it can damage the rubber hub because it's made of a special material but they tell me that they've never heard that and don't believe it. The company TOLD us this when they inserviced us on the system years ago! It's just laziness, too! They'll draw up a med with a needle, and then instead of switching to a blunt one (which takes about 3 seconds) they just use the same needle.

In our PICU I've seen the other type with the luer lock connections, and I don't like them as much as the blunt-needle type systems. I just don't see how you can disinfect the port well enough before attaching a syringe - there seem to be too many crevices. I like the blunt-needle rubber ports better because you can really swab them down.

When we get transports from other hospitals and they have needle-system IVs, we just place a needle-less system T-connector as close to the insertion site as possible and use that for medications.