What Do You Think?: What's Your Protocol On This?

[All4NursingRN]

i was looking up on mannitol when i came across this comment which i thought was interesting.

may 30, '07

i have done a literature search on when a needle filter is needed. everyone should consider looking it up for evidence based nursing practice. we are the ones that administer the meds and need to be aware of quality and safe practices. evidently, every medication that comes in a glass ampule should be filtered. the glass shards can cause all types of inflammatory issues from organ failure to vascular damage. i contacted the schools of pharmacy in my state and found out that pharmacist have been taught to filter anything that is in a glass ampule that they draw up. nurses need to consider ebp for medication administration. i was surprised that hospital pharmacist have not prompted the use of needle filters. ask your pharmacist. when tpn is put together, they not only are wiping down the glass with alcohol but they are using a 5 micron needle filter when drawing up the medications to put in the tpn, if they come in glass ampules

now i know that when i'm giving a medication from an ampule most especially i try to use the smallest needle to extract the fluid, but i still worry i am getting glass particles in the syringe. any remedy for this?

and do you agree with the statement? i wouldn't mind using a filter for administration of medications from a glass bottle/ampule but are there syringes with filters built in? does your facility use them? or can i get crafty and take a regular micron filter and somehow stick it on the end of the needle?

[CCL RN, RN]

I was surprised that hospital pharmacist have not prompted the use of needle filters.

I'm suprised. Basically, this is common sense, and I'm suprised that using a filter needle is even a question.

Yes, you're breaking glass, you need up to use a filter needle. This was taught to me in nursing school (even though it's implied that we already knew it). I assume that pharmacists don't "prompt us" to use them because they assume we are already doing it!

You should have a stock of filter needles right next to the other ones. They are usually light brown.

[All4NursingRN]

I will check, but I'm sure my facility doesn't have them, or atleast they don't stock them on my unit.

[sapphire18]

Then you can't give meds from glass ampules. Simple as that. Do you want to inject glass into their veins? Our filter needles are packaged in green- every manufacturer is different.

[Silverlight2010]

We use filter needles to draw up medications from glass ampules. It became policy shortly after I started and is habit now.

[Vespertinas]

We were taught to use filter needles, which exist, but the first hospital I worked at out of school never had them stocked and everyone used sharps to draw up (also blunt-tips weren't stocked). I asked a few times about it and eventually figured what I learned was just old hat. Turns out (duh) you DO need filter needles and everyone else uses them!

[Starfish, RN]

That was medication administration 101 in nursing school for me. I cannot believe your facility doesn't use filter needles with glass ampules. I hate to agree with the common sense comment, but the previous poster is correct.

[Altra, BSN, RN]

I think what you are saying is that your department may not have filter needles ... and you pulled up an old post in which another poster was also surprised to learn of the existence of filter needles.

Call your hospital pharmacy. They will be able to tell you whether or not the hospital stocks filter needles, and what you need to do to get them.

[canned_bread]

WOW! I HAVE BEEN ASKING THIS QUESTION FOR SO LONG BY MY NURSE EDUCATORS AND NO ONE ANSWERS OR WORRIES!! I have been convinced that a shard of glass, tiny little bits that we can't see MUST harm the patient and MUST enter in there, but have been told that if I crack a grass ampoule properly, well, it shouldn't be a problem! On my ward we frequently give heparin via insulin needles which is not filtered... and I worry that tiny shards of glass are being injected into my patient. We don't actually have any filtered needles available!

[lumbarpain, ADN, RN]

Strange how nothing was ever done about those glass ampules and the glass remnants when I was in school I never liked them and thought the same thing how dangerous they were to both nurse and patient. Especially patient!!!