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tjack
Changing Access Needle

Interested in what others are doing in cases when the first attempt to access the vessel is unsuccessful and a second stick is required. Are you using a new access needle, it seems most manufacturers only provide one needle to access the vessel in their procedure trays. Thanks in advance for your responses!

lynncrni
There is ***never*** an

There is ***never*** an acceptable situation where a needle/catheter used for venipuncture can or should ever be used for more than one puncture through the skin. I am assuming you are talking about short peripheral IV catheters, but maybe not. All manufacturers, all infection prevention practices, all national standards and guidelines firmly state that the needle/catheter should never be used more than once. You can never render skin sterile regardless of the agent or technique for skin prep. As the needle/catheter passes through the layers of the skin, organisms will attach to it. So you are setting up for a serious infection if used for multiple skin punctures. This would make a plaintiff's lawyer extremely happy to find this practice in a case of any type of catheter associated infection!! Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

tjack
Referring to PICC's

Thanks Lynn for the reply.

I was referring to placement of PICC's and other forms of central lines. When I was trained by a manufacturer and interventionalists, the practice was to use the same needle for a second attempt on the occasion that it was needed. Of course everything remains in the sterile field and the second stick is within the area of the fenestrated drape. Physicians that I have witnessed placing subclavians use this practice, using the same needle, as well and in the full procedure tray there is only a single access needle. If the practice should be to use a new needle should there not be another needle in the tray. Thanks and I appreciate the feedback!

lynncrni
Thanks for the clarification.

Thanks for the clarification. I would suggest that you locate the instructions for use that comes in each of these procedure kits. I am pretty sure that all manufacturers make a statement about single use only. I think this is an FDA requirement. Skin can never be made sterile so that is the reason for this statement. The finder needle will not be the device left in the vein though, so that could be the argument for using it for a second attempt. I don't think there are any reports or studies connecting the repeated use of a finder needle to an infection risk. Each pass through the skin would have an impact on the sharpness of the needle though, so the second time may cause more pain. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

tjack
Checked IFU

I checked the IFU's for several of the major manufacturers. No mention of single use.....................

lynncrni
That is odd. I just

That is odd. I just downloaded the IFU for Groshong catheters and found an extensive statement in the section on Contraindications, Warnings, Cautions, and Precautions. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

kathykokotis
new scalpel

In surgery do they use a scalpel for more than one pucture of the skin?  So how does this thought work as I am confused when one can use again and when one cannot.  Is that addressed in a guideline for AORN?

Kathy

Constance
Needle

I was tought that the needle should only be used once, for the same reasons that Lynn stated infection and sharpness. The MedComp tray has two needles without an extra cost.

Dianne Sim RN VA-BC
Changing Access Needle

We have been following the one stick rule. We utilize a Galt needle if required. Our concern was both for the sterility and sharpness of the needle.

Dianne Sim RN, CEO

IV Assist, Inc.

Dianne Sim RN, VA-BC, CEO; IV Assist, Inc.

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