phlebotomy

When is recapping a needle is considered an appropriate procedure?

[gymdandee]

when being disposed of!

[caregiver222]

It depends.

In the case of small diameter needles used for sub-cu injections by diabetics, there is a "needle clipper" that snaps off the needle and stores it in a non-accessible compartment.

The only truly appropriate use of a cap is by a diabetic who injects him or self and does not have immediate access to a needle clipper.

In general, circa 2010, capping  is not appropriate in a hospital environment.

In some hospitals the use of capping  is prohibited. There is too much danger of an accidental needle stick, with the resultant possibility of transmission of disease. The uncapped needle is brought to the specially constructed sharps box, the needle tip is clipped off with a special device attached to the unit and dropped in the box, and then the barrel and plunger are dropped in the box.

[caregiver222]

Generally, in every medical facility an "infection control" officer is designated, generally, but not always an R.N.

A written needle disposal protocol is established which must be read and signed by all new personnel.

There are certain exceptions to the "needle clipping" rule.

Morphine sulfate, for example, commonly comes in 10 mg syrettes which are used to dilate the blood vessels of cardiac patients. The entire 10 mg may not be used. Initially, only 4 mg may be used. These syrettes are not injected intramuscularly, but into an IV line. In such a case the needle is recapped and reserved for use within the next hour or so. If not used the disposition must be witnessed by a second person, at which time the needle is clipped. If, however the practicioner accidentally sticks himself while re-capping the entire unit is to be disposed of without further use.

Certainly all needles used for intramuscular, subcu or invasive procedures should be clipped, rather than capped, immediately.

Bristojets, used for large "bolus" injections of epinephrine, atropine, bicarbonate and calcium, are large-guage long needles which are only used in IV sets. Because they are difficult to clip, they are often capped and the unit disposed of in it's entirely.

In the case of a blood draw, there are two methods. One involves a hypodermic syringe directly into the blood vessel. This is the case during an arterial blood gas draw in the wrist. In such a case, once the sample is taken, the needle should be immediately inserted in a sharps disposal device.

When drawing blood for general lab tests, my preference is to use the same line for the draw and the IV line. The stainless steel trochar is immediately withdrawn, and ideally a sharps container has been brought along and is within arm's reach. Only a plastic catheter remains in the blood vessel.

If a butterfly is used, again a sharps container should be nearby and the needle immediately clipped.

The cap is used primarily to prevent contamination of a sterilized needle.