re-used IV needle

[LibraNurse27, BSN, RN]

Hi all,

I am wondering about infection/sepsis risk from IV insertions. I always clean the site, avoid palpating after cleaning and if I need to try again I of course get a new catheter. For some reason today when starting an IV on a patient who was a hard stick I inserted, did not get blood return at first and wanted to withdraw the needle a little bit to re-insert at a slightly different angle (with IV still under the skin) but accidentally removed the needle completely and then re-inserted with success. I am now paranoid that by essentially inserting a catheter that had already poked through the skin to cannulate the patient's vein that I could introduce bacteria into the patient's blood stream. I did some research and sepsis from PIVs is pretty rare but still so worried. any expert opinions? I will make sure this never happens again.

[DextersDisciple, BSN, RN]

Not an expert by any means but I think you're totally overthinking it. As long as the area as cleaned I don't see there being a strong likelihood of any kind of issue let alone sepsis. Now stop driving yourself crazy :)

[brownbook]

I guess in an ivory tower this is inappropriate. But in the real world, while not routine, it does happen.

I've worked out patient surgery for 17 years, all we do is start IV's. It's not uncommon for this to happen. Never been any issues with IV site infections or any other issues.

[cleback]

I work for an infectious disease service, and yes, it does happen. So don't do it again.

But also consider that a lot of ivs are placed under less than clean circumstances (emergencies), and not all of those become infected. Chances are you're good but be more careful next time.

[chare]

If you properly prepared the site, and didn't otherwise contaminate your catheter, you should be okay.

Have you ever watched a physician place a central venous catheter? How many of them use a clean needle with each attempt?

[AnnieOaklyRN, BSN, RN, EMT-P]

Unlikely you caused harm, but I would not do that because of both the infection risk and there is a risk you could shear the catheter when you introduce the needle back through it. This could result in an embolus, although I have never heard of it happening.

Once the need is even partially withdrawn from the catheter it should not be pushed forward back through, again this is risking catheter shear and not so much infection.

Learn form it and move on...

Annie

[AnnieOaklyRN, BSN, RN, EMT-P]

If you properly prepared the site, and didn't otherwise contaminate your catheter, you should be okay.

Have you ever watched a physician place a central venous catheter? How many of them use a clean needle with each attempt?

Generally speaking central lines are done fairly sterile unless its a true emergency. Also as I mentioned the bigger risk of reintroducing the needing into a PIV catheter is that you could shear a piece off.

Annie

[chare]

Generally speaking central lines are done fairly sterile unless its a true emergency. Also as I mentioned the bigger risk of reintroducing the needing into a PIV catheter is that you could shear a piece off.

Annie

If you are referring to removing and replacing the stylet from the catheter, while the catheter remains in the vessel I agree that this is problematic, and if this is what the OP did then I agree with you that shouldn't have been done. If the OP removed both, and then reinserted the stylet, this shouldn't be an issue.

As far as site preparation, whether it is central or peripheral access, outside of an emergent situation, and even this is questionable, the site should be properly cleaned with either alcohol or chlorhexidine prior to catheter insertion.

[Night__Owl, BSN, RN]

Sticking twice with a needle on the same (properly cleaned site) is not 100% correct, but it isn't outrageously risky or negligent either.

The biggest infection risk for peripheral IVs IMO is when the dressing becomes compromised.

For example, if you have a somewhat hairy armed man and place an IV without shaving a small area first, you can guarantee that the seal around your tegaderm won't last six hours.

[LibraNurse27, BSN, RN]

Thanks for all the replies! The problem was re-sticking with the same needle after accidentally withdrawing it while trying to adjust placement, but I have seen what Annie is talking about where people try to advance and then readjust the plastic catheter back onto the needle, causing the shearing issue and then inability to re-thread. Thanks for the reassurance and I will make sure it doesn't happen again... even a small infection risk is not cool!

[Guest219794]

I work for an infectious disease service, and yes, it does happen. So don't do it again.

But also consider that a lot of ivs are placed under less than clean circumstances (emergencies), and not all of those become infected. Chances are you're good but be more careful next time.

Why? Not disagreeing, just would like the rationale.

[iluvivt, BSN, RN]

Why? Not disagreeing, just would like the rationale.

It can happen because you can not render skin sterile...you can only reduce the resident bacteria count on the area in which you are performing the venipuncture..They have also discovered that bacteria is not only on the surface layer of skin but in the other layers as well.