Safety Sheath Syringes

[Dixiecup]

We are having quite the controversy at work so I thought I would look here for some answers.

Regarding safety syringes; Do you slide the safety sheath up after you've drawn up your medication and transport it to be given to the patient that way.

Or do you recap the clean needle and pull the sheath up only after the injection is given and lock it.

I say to throw away your cap after you've drawn up the medication and just slide the sheath up to transport. That's what I thought the purpose of it was.

Some of my co-workers state that it's too dangerous and if someone would fall and the sheath would come down that the needle and/or med could go into a person.

They even went as far as to write a tag on a facility that did this when doing a mock state survey. They sayu you're supposed to recap the clean needle and use the sheath after the injection is given.

I disagree. What does everyone else do?

[Elvish, BSN, DNP, RN, NP]

I have used those previously but I don't like them.

I thought you were supposed to recap after drawing up the med and slide the safety sheath up after the injection. The reason I don't like them is that that requires a two-handed technique to engage the safety sheath & you're just as likely to stick yourself doing that. I am glad that we don't have them where I am now.

Maybe someone else can shed more light on the subject...

[MALE*RN*777]

There should be a Nurse Educator at your facility that has the manufact. instructions for the product. You should contact them in order to have the proper training of the product. Don't think of it as a stupid answer because you already see that some agree and some don't agree with you. JMHO

[AnnieOaklyRN, BSN, RN, EMT-P]

recap after drawing it up and use the sheath after you have given the injection.

It is A LOT safer to recap the clean needle in a controlled situation rather than use a sheath that does not lock and then risk falling or tripping and stick yourself or someone else, or lock the sheath and not be able to use the drug.

If the sheath was meant to cover the needle before injection it would have a mechanism for locking and unlocking.

Swtooth

[Danish, MSN, APRN, NP]

Im only a student, but we were told to recap (by laying the cap on the counter, swooping the needle into the cap, and pressing against the wall untill tight) then transport to the pt, inject, and then use the sheath...this could be wrong though. Im interested in hearing what everyone says on this, because I dont like recapping EVER. Too risky

[HuggyPuglet]

First of all, let me say I don't like these new syringes at ALL. The safety sheaths are semi-opaque making it hard to discern exact measurements. I've had the sheath move during the injection process as well, particularly when withdrawing to be sure you aren't in a blood vessel.

With that said, the manufacturer sent a rep to our facility to inservice all of us and they instructed as follows: After drawing up the medication (and trying to figure out if it is correct through the semi-opaque sheath - MY comment not the reps), you raise the sheath above the needle until it clicks. This does not lock it but holds it in place. You then lower the sheath to give the med to the patient. When done you push up the sheath harder until it does lock. Then discard.

Personally, I'd like to discard them permanently and go back to those syringes that are readable with the safety cap that snaps over the needle when you are done. And all of us know not to ever recap after an injection is given, don't we?

[OneChattyNurse]

i always re-cap the needle because if you pull the sheath up to hard it will lock into place and you won't be able to use the medication.

[jimthorp]

If the sheath was meant to cover the needle before injection it would have a mechanism for locking and unlocking.

The syringes we use do. To lock the safety sheath simply twist after extension. The syringes we use are designed so that the safety sheath is used instead of recaping.

[mom2michael, MSN, RN, NP]

i always re-cap the needle because if you pull the sheath up to hard it will lock into place and you won't be able to use the medication.

that's happened to me 2x now, both with insulin and it's hacked me off, not to mention i look like an idiot fighting with the insulin syring and i'm more likely to poke myself that way, fighting with the stupid thing than just re-capping the needle....

but according to our powers that be where i work - you are supposed to use the sheath for transport and not re-cap

[RNsRWe, ASN, RN]

Looks like different types of safety sheaths are being discussed here, so of course you're going to get different answers.

Our newer insulin syringes have a sliding, translucent "tube" cover that, once the med is drawn up, you are to slide up to shield the needle for transport. Yes, I suppose you could do some weird trip-fall-untwist the shield-stick yourself, but it's hard to picture that, you know? Upon arriving at the patient's side, it's quite simple to slide down the sheath and inject, sliding it back UP to dispose.

On the other hand, we also have needles that have a safety sheath that is designed to be "locked on" after an injection is given, prior to disposal in the sharps box. That said, the ONLY time that actually occurs is when someone gives an IM, which is pretty rare on our floor, or rarer yet, a sub-q that is not manufactured in advance (like Lovenox or Arixtra, that have self-locking syringes).

The great majority of the time, if using one of these needles to draw up into the syringe, we slide up the safety lock/sheath and transport to the patient, where we use our needless IV system to deliver the med. Meaning, twist off the whole needle, locked as it is, give the med, and toss both parts in sharps. No issues or controversy.

[AfloydRN, BSN, RN]

I would rather poke myself after drawing up a med versus after injecting a patient. I have never liked those safety shields. I think they stick sometimes and are difficult to get the shield down.