question about needles

Long Term Care Columnist / Guide · Nov 15, 2003

Of course we are all concerned about needlesticks, and gloves don't do much to protect us from them. That's why needleless systems are gaining in popularity in a lot of healthcare settings, and while we will probably always have to rely on some invasive procedures such as injections and IV starts, there's a lot we can do to stay safe. I've been in health care for 10 years now and only stuck myself with a used needle one time......it was my sister's Epi-pen, with which I had just injected her and forgotten to put the shield back over the needle. So no worries there! But like most nurses, I'm very careful about not leaving syringes around or sticking them in the mattress after using them, making sure the sharps container isn't too full, and disposing of used IV equipment immediately.

Then, there is testing that is done after an exposure to make sure we haven't gotten infected with things like hepatitis and HIV, and the exposed person is followed regularly for some time and given antibiotics, if appropriate, to forestall the onset of disease. Of course, the best prevention is common sense, and that's what tells a nurse NOT to start an IV or give an injection when the patient is thrashing around, out of control. Forget what you see on TV---no nurse marches up to a combative patient who's flailing his arms & legs, hitting and biting etc. and jams a needle into his neck (or any other part of his body).

Hope this helps answer your question.:)

Hellllllo Nurse, BSN, RN · Nov 15, 2003

I have been stuck with several dirty needles and splashed in the eyes with blood. Been lucky so far, thank God. All pts were HIV and Hep B neg.

chris_at_lucas_RN, RN · Nov 15, 2003

With needles, you always make sure that the pointy part is your first priority. You don't put it down until it is safe. (Can't imagine someone poking it into a mattress, but then.....)

I think the bigger risk is being exposed to and spreading contagion we don't see so easily--handwashing is the biggest and best way to protect ourselves from the worst risks.

You will learn ways of "recapping" needles (we aren't supposed to do that, but if you lay the cap on a flat surface and use the syringe to scoup up the cap, you can recap that way, for example). Needleless systems are good too. And there are new needles that have a shield that slides down over them.

You'll get in good habits, and you will be safe. And so will your patients.

azverte · Nov 15, 2003

Originally posted by Hellllllo Nurse
I have been stuck with several dirty needles and splashed in the eyes with blood. Been lucky so far, thank God. All pts were HIV and Hep B neg.

The AVERAGE time form the exposure to onset of symptoms for Hepatitis C is 20 years. Average! Yet testing for HCV after exposure is recent. Were you tested for HCV? HCV is chronic in almost every case - but takes decades to manifest symptoms. What about all the other blood borne diseases? An asymptomatic West Nile Patient (and MOST WNV is asymptomatic) could be your source patient. I could go on and on. "60 Minutes" did a great show on why hospitals are not consistently using all real safety products. The reasons are between shameful and criminal.

"Real safety products" as opposed to those that are still causing needlesticks but DO have the word "safety" on the packaging.

Testing for reasonable bloodborne diseases after exposure would not only be "expensive" but may just expose the truth!

Imagine construction workers not being issued hardhats, police officers not issued vests, firefighters not issued breathing apparatus.

Thanks for letting me rant! I just care so much about my colleagues - and me too.

Be safe colleagues!

lmd32 · Nov 15, 2003

No offense meant, MJLRN97, but just for the sake of accuracy I have to take exception to the statement "Forget what you see on TV---no nurse marches up to a combative patient who's flailing his arms & legs, hitting and biting etc. and jams a needle into his neck (or any other part of his body). " All right, not the neck (why are we jamming needles into the neck?), but I've worked psych for a number of years and have given IM haldol to flailing psychotic patients and IM valium to seizing patients (glad we went to pr a few years back) and I have seen nurses stuck. But not a lot, thank goodness.

My instructor the other day was telling a story about a surgeon who pitched a fit in an OR and was THROWING used needles and instruments. And, yes, a nurse got stuck with a needle. So, it's not just the patients we have to watch out for.

I think the important point to take home here is that nurses are aware of the risks, that there are precautions in place to lessen the risks, and that you will learn how to be as safe as possible during your training. Even if I think some of the "safety" needles make it more likely I'll stick myself.

---->:-) Lynn

azverte · Nov 15, 2003

Originally posted by lmd32
Even if I think some of the "safety" needles make it more likely I'll stick myself.
---->:-) Lynn

What part of "safety" includes sliding one's finger up a dirty needle? The added manipulation alone, not to mention the added time in one's hand is PROVEN in multiple studies to INCREASE needle stick injuries!

The major manufacturer of needles and syringes was highlighted on the 60 Minutes show. They had made binding, long term and exclusive contracts with a majority of the nation's hospitals as a response to REAL safety products coming on the market.

An example of a REAL safety needle is one that retracts into the barrel of the syringe upon completion of the dose. The needle is retracted right out of the patient's skin (passive retraction). The fast and stright removal is even more comfortable for EVERY patient I have injected with them.

I had a prison nurse report to me that she injected a violent inmate, partially held by 5 deputies and after the injection, the syringe went flying therough the air. No-one was upset - they all heard the "click" of safety. There was the needle, on the floor safely well within its own sharps container (the syringe) unable to hurt anybody. There has NEVER been a needlestick injury with these needles used around the world, in health departments, prisons, etc and not even introduced to almost all hospitals due to these exclusive big-business-as-usual contracts.

I guess I can't mantion these life-saving needles due to TOS but PM me and I will share.

Be safe!

Az