I attempted to open an ampule with no succes, so I rotated it and tried again. I had my alcohol wipe in package around it to "protect" me from the glass. I know that ampules are scored in a certain spot so they will break, and break clean at that. Well, it broke on the second attempt. However, instead of breaking clean and flat it had a big old jagged sharp that sliced my thumb right open.
After bleeding for 55 minutes the house supervisor sent me to the ER. I ended up recieving 5 stiches on the side of my thumb, about 3/4 inch long. It spanned my thumb joint, so it ended up needing to be splinted. I missed 2 days of work because of the injury (I work 4 12's and then I am off for 10). The physician said I needed to keep my thumb dry and not use my hand since moving the other fingers in effect pulls some of the tendons/ligaments in the thumb and would cause the cut to dehisce (sp?) more.
First off, I filed all of the paperwork required by my facility and was not held financially liable for the medical bills which totalled $653.45 (in the ER they x-rayed my thumb to check for glass fragments that could be present). However, workman's comp in my state will not reimburse me for the days of work I missed because I wasn't out of work for 3 or more days. That's 24 hours of pay I missed out on! Since I'm part time that's half of my paycheck!
I'm mad. In nursing school I learned how to open ampules, we used alcohol wipes in their package and ampule breakers so we'd know how to do both. I figure I've opened around 30 ampules since I've been a nurse (3 years). When I got home I got out my old nursing book and reviewed the procedure of breaking an ampule to see if I had missed some step. Upon review I know my technique was textbook perfect.
At my first job, a large regional hospital of 350 beds we had plastic disposable ampule breakers. This is my second job with the same company but at a small community hospital of theirs. Often nurses here complain that since they are the small community hospital they don't have the same supplies, pharmacy staffing at night, diagnostic staffing on the weekends etc. At this hospital we do not have ampule breakers, we are to use the alcoholl wipe method.
I checked out the price of plastic ampule breakers online, I found them for less than 7 cents each. For 7 cents, this whole mess could have been avoided! 2 days of missed work, the pain in the butt that it was to keep my thumb dry and not use my hand, with a 18 month old to take care of at home could have been avoided. The $653.45 cents the company spent to treat my thumb should have been spent prior to my cut on preventing things like this from happening.
If I can buy a pack of 1000 ampule breakers on my own for 7 cents each Couldn't a large company with 13 hospitals have some bargening power on the price when buying in large quantities? Not very many drugs even come in ampules the only one's I've dealt with have been vit k and nubain.
Have you ever been sliced by an ampule? Do you know someone who has? How often does this happen?
Does your facility provide plastic ampule breakers?
I guess it must happen often enough that someone invented the plastic ampule breaker and was able to sell it to hospitals.
P.S. I checked CINAHL and MEDLINE databases for more info to try and get some hard core data to present to my manager. I wanted to help her see the need to make this small investment. All I found was info on spikes on ampules. In manufacturing the ampules sometimes the glass gets pulled while still hot and forms a glass spike that cools. A bunch of anesthesiologist journals had complaints and info on how often they've been cut by a spike and how often the spikes occur.
I use an alcohol wipe in one hand to hold the bottom of the bottle, and an alcohol wipe in the other hand to hold the top. I have yet to be cut. I'd like to extend thanks to the anonymous nurse in the med-room during nursing school who taught me that (whoever you were).
Specializes in LTC, assisted living, med-surg, psych.
I attempted to open an ampule with no succes, so I rotated it and tried again. I had my alcohol wipe in package around it to "protect" me from the glass. I know that ampules are scored in a certain spot so they will break, and break clean at that. Well, it broke on the second attempt. However, instead of breaking clean and flat it had a big old jagged sharp that sliced my thumb right open.
After bleeding for 55 minutes the house supervisor sent me to the ER. I ended up recieving 5 stiches on the side of my thumb, about 3/4 inch long. It spanned my thumb joint, so it ended up needing to be splinted. I missed 2 days of work because of the injury (I work 4 12's and then I am off for 10). The physician said I needed to keep my thumb dry and not use my hand since moving the other fingers in effect pulls some of the tendons/ligaments in the thumb and would cause the cut to dehisce (sp?) more.
First off, I filed all of the paperwork required by my facility and was not held financially liable for the medical bills which totalled $653.45 (in the ER they x-rayed my thumb to check for glass fragments that could be present). However, workman's comp in my state will not reimburse me for the days of work I missed because I wasn't out of work for 3 or more days. That's 24 hours of pay I missed out on! Since I'm part time that's half of my paycheck!
I'm mad. In nursing school I learned how to open ampules, we used alcohol wipes in their package and ampule breakers so we'd know how to do both. I figure I've opened around 30 ampules since I've been a nurse (3 years). When I got home I got out my old nursing book and reviewed the procedure of breaking an ampule to see if I had missed some step. Upon review I know my technique was textbook perfect.
At my first job, a large regional hospital of 350 beds we had plastic disposable ampule breakers. This is my second job with the same company but at a small community hospital of theirs. Often nurses here complain that since they are the small community hospital they don't have the same supplies, pharmacy staffing at night, diagnostic staffing on the weekends etc. At this hospital we do not have ampule breakers, we are to use the alcoholl wipe method.
I checked out the price of plastic ampule breakers online, I found them for less than 7 cents each. For 7 cents, this whole mess could have been avoided! 2 days of missed work, the pain in the butt that it was to keep my thumb dry and not use my hand, with a 18 month old to take care of at home could have been avoided. The $653.45 cents the company spent to treat my thumb should have been spent prior to my cut on preventing things like this from happening.
If I can buy a pack of 1000 ampule breakers on my own for 7 cents each Couldn't a large company with 13 hospitals have some bargening power on the price when buying in large quantities? Not very many drugs even come in ampules the only one's I've dealt with have been vit k and nubain.
Have you ever been sliced by an ampule? Do you know someone who has? How often does this happen?
Does your facility provide plastic ampule breakers?
I guess it must happen often enough that someone invented the plastic ampule breaker and was able to sell it to hospitals.
P.S. I checked CINAHL and MEDLINE databases for more info to try and get some hard core data to present to my manager. I wanted to help her see the need to make this small investment. All I found was info on spikes on ampules. In manufacturing the ampules sometimes the glass gets pulled while still hot and forms a glass spike that cools. A bunch of anesthesiologist journals had complaints and info on how often they've been cut by a spike and how often the spikes occur.
I think ampules are dangerous. A few years ago I did exactly the same thing to my thumb that the OP did, only I was too stubborn to go down to the ER and get it checked.....all I did was sit there at the nurse's station for about 20 minutes trying to stop the profuse bleeding and cursing myself for the accident. The wound/ostomy nurse saw it and threatened to tell my supervisor if I didn't at least write an incident report, which I did, but nothing ever came of it since I didn't have the injury evaluated by a doctor. That was dumb, because I have some nerve damage in the area now that might have been fixable had I taken the time to have it assessed. No big deal........but I think ampules should have been replaced by something safer a LONG time ago.
I had a similar experience, except that I luckily wasn't cut by it. I ended up having a defective ampule that wasn't scored. I wonder if that may have been your problem......
With the smaller ampules, I have a harder time putting forth the force needed to break them open. It may be I'm rightfully afraid of cutting myself, I dunno. But it is funny 'cause I have to actually jump up and down to get them open.
So then I go and do this with metoprolol or other large ampules and that's too much force, either I cut myself or the top's all jagged, or worse, I completely smash the little bottle and spill the contents. Why on earth does anything come in a 5 ml ampule anyhow? Good grief. You get vials of stuff in as little as 1 ml and I've never seen an ampule have a volume smaller than 1 ml.
I was just cut opening an ampule of phenergan!! I was having trouble opening it and when I finally did I sliced the top of my index finger knuckle wide open. Had to get 3 stitches. After doing this all the nurses have said that they have had difficulty opening them also! When I first started working the phenergan came in a regular vial, not sure why they switched? So I am not glad that you got cut also but glad to see that I am not the only one having trouble, thought it was just me at first and felt stupid!
Specializes in NICU, PICU, PCVICU and peds oncology.
Two weeks ago I had a 10 mL amp of Ventolin shatter from the neck up when I attempted to crack it. (Thank God for filter needles...) My glove was still completely intact so no injury there, but rather than risk it with the other 4, I sent my neighbour to the dietary area of our unit for a nipple. Works like a charm. But I wonder why some amps just WON'T snap where they're supposed to!
I've never opened an ampule except in nursing school as practice. They taught us both ways. Either way opening them was scary! I've only been a nurse for 2 months though so I may come across them later. I do know we have filter needles, so they must be used or prepared to use them. But now thanks to this thread I have lots of good advice!
I've noticed the glass ampoules are getting harder to snap off now. I think some companies are not making them correctly to be honest. When I was a student, I think there was only one ampoule I didn't break correctly.
I don't know about ampoule openers but sometimes you have to develop a 'wrist' technique 2 snapping them. I try to do it quickly and sort of rotate my wrist as I snap, that seems to work.
But sometimes the glass does break, then I have to start again (sigh)
november17, ASN, RN
1 Article; 980 Posts
I use an alcohol wipe in one hand to hold the bottom of the bottle, and an alcohol wipe in the other hand to hold the top. I have yet to be cut. I'd like to extend thanks to the anonymous nurse in the med-room during nursing school who taught me that (whoever you were).
I do know others that have been cut by them.