Using Ampules w/o filter needles

[ilovenursing2009]

I work for a company that does not supply filter needles to be used with the epi ampule in the emergency kit.

Is this ok?

In nursing school I was told to never use ampules unless I had a filter needle. What do you think?

[Key_]

I have always used a filter needle with amps, I can't imagine doing it any other way. Thank goodness the hospital I work for feels the same way

[talaxandra]

I remember contributing to a thread in this topic a couple if years ago. We only use filters when drawing up iron for infusion, so I know filters aren't a built in part of the system. The , and this one I found,were interesting and made me think.

As the use of filter needles is clearly not universal, one would expect to see a lower incidence of these kinds of complications in wards and hosptials that routinely use filter needles - "pulmonary thrombi and microemboli, infusion phlebitis, end-organ granuloma, and inflammation" as well as systemic infection from the bacteria-laden glass fragments unwittingly injected. I only had a bried search but couldn't find any in vivo research, only projecions and possibilities. I'm not saying the risk's not real, but figures on actual incidence would be useful.

In the meantime, as the ampoules I use are vastly predominantly 1 to 2 ml (frusemide, morphine, fentanyl), and the needles I use to draw up are 19g (thereby reducing the particles by at least 30%), and I also use a needless system to administer IV meds, I'm happy with the status quo, at least for now. Of, and wouldn't there also be a marked difference in injection site complication rates between filter and non-filter sites?

[Reno1978, BSN, RN]

I, too, was taught to use filter needles when drawing up the contents of an ampule for IV administration. Even though the only ampules I use lately are fentanyl, the hospital provides mostly filter needles to draw up any meds.

[JomoNurse]

I haven't seen a filter needle since using them in lab in Nursing School. I don't mean to sound like an butt here, but, do you guys really think a piece of glass that's actually small enough to be sucked up through a needle lumen would do any harm to a patient in the first place? I work with a few anesthesiologists and they don't use filter needles either. They say it's not necessary.

[wanderlust99]

I wasn't taught to use a filter needle for drawing up meds through an ampule in nursing school. My 1st job @ a large well known teaching university hospital did NOT supply filter needles. I worked there for 3 years & had no idea about filter needles. Never heard of them until I started a new job & everyone used these to draw up meds through ampules.

I didn't know. Now I do. Follow your hospitals policy on drawing up medications. Obviously it isn't universal. Anyone have any information that it really isn't safe to not use a filter? ALSO, when you draw up the medication maybe it's possible to get some glass in the syringe...but what about when you push it through the PORT?? Does that not act as a sort of filter as well?

[wooh, BSN, RN]

What I want to know is WHY are we still using ampules at all??? They're dangerous to staff and there's obviously other ways to package meds. Are they really cheaper once you factor in filter needles (which apparently some hospitals are not) and whatever you guard your fingers with? (I personally like bottle nipples.)

[rn/writer, RN]

I was concerned about this and asked the charge nurse when I had to use an ampule, and I found out the normal needles we use to draw up most things were filtered needles. They don't come in a package in the supply room so I didn't realize it. So you might want to ask, you might already be using them.

The purpose of a filter needle is to keep any small glass fragments from being drawn up into the syringe. They stay in the needle instead. With that in mind, injecting the med with that same needle would, in theory, send those fragments into the blood stream. After the med is drawn up, the filter needle is supposed to be removed and a new, debris-free needle put on in its place.

It would be interesting to find some evidence-based research to demonstrate whether or not the use of filter needles and subsequent replacement with a "clean" needle accomplishes anything worthwhile.

I'm with the folks who wonder why we're still breaking glass ampules--a risky practice at best.

[morte, LPN, LVN]

my understanding on why we are still using ampules is that some meds can not come into contact with any presently used stopper material.....

[snowy31]

I think this was misunderstood, I am not quitting my job over this. I am moving into an RN position from LPN. I was simply saying that I guess it didn't matter anymore since I am leaving.

[snowy31]

Fyi, that is NOT why i am leaving my job. I was simply stating that I was working a 2wk notice for career advancement, so it didn't matter anymore about the whole filter needle thing.

[nursepotter05, RN]

I work in a facility that provides filter needles, and i use them when pulling from glass ampules. Before working @ this hospital, I worked for a major children's hospital emergency department and they did not provide filter needles, so i never used them. I guess this is along the same lines as i was always taught to always aspirate when giving all im injections , even vaccines to the deltoid, and now the consensus is you do not have to do it. As one of the above posters said, things change, i guess.

[castornpollox]

In regards to the Emergency Nurse comments: You sound like a horribly rude nurse. It's too bad that after 15 years of service to the nursing field, you have become complacent and refuse to educate yourself on the literature regarding filter needles. The nursing students are being taught the latest in evidenced based nursing and to ridicule them is shortsighted. You would be surprised at what the nursing students can teach you, if you aren't too afraid to learn. Good luck to you!