Micro needles

[Rae83]

I was wondering if anyone can tell me whether or not micro needles (8-0, 7-0) can be seen on fluoroscopy or hard plate x-ray. I work in open heart surgery and often use SEVERAL micro needle. We currently count all needles, but I have been told that the micro needles can't be seen on x-ray so there is no point in counting them. I have no problem either way, but was just curious if anyone else has any in put on this. I guess what I want to know is whether there are places that don't count micro needles, and if there is literature that says they are or are not visible on x-ray.

[shodobe]

You could probably see them if you knew the exact location and had eagle eyes. Hard to locate and have been told by surgeons even if you find them the tissue damage done to extract them would be too much. On the other hand, yes you should count and keep track of the smallest needles.

[Jarnaes]

This question was just covered in the latest AORN Journal. (See Clinical Issues pg. 1231-1235).

"AORN clearly states that needles of all sizes should be counted to promote a safe patient care and work environment, and regulatory guidelines require safe handling of sharps. Manual counting provides an advantage over reliance on radiographic imaging, especially when smaller sized needles may not be detected." AORN Journal June 2008. Vol. 87. No. 6

http://www.aornjournal.org/home

[Rae83]

Thanks for the info. I will definitely check out the website. Our situation is that our surgeon uses A LOT of micro needles and has a tendency to throw them on the field or off the field if the tech isn't "fast enough" in getting them from him. So at the end of the case we occasionally are missing a 7-0 or 8-0. Our policy is that if a count is incorrect than we have to do an x-ray before the patient leaves the room. So we follow procedure and do an x ray and the surgeon gets mad (putting it lightly) and says that it is ridiculous to even count them because you can't see them on x ray and even if you could he would not go back into the chest over a micro needle!! And because there is an incorrect count we have to do an incident report. My DOSN says well " if you can find supporting literature that these needle are not visible under x-ray then we will consider a revision until then count and report, and he (the surgeon) can just deal with it"

[Rose_Queen, BSN, MSN, RN]

Our policy is to count all needles, but if we know that a missing one is 6-0 or smaller, we don't have to x-ray. Still have to fill out the incident report though.