Letters to the Editor: Letters & Announcements
To the Editor:
Although the introduction of safety needles and angiocatheters have improved safety and lessened needle stick injuries, they have not all been met with success.1 The Introcan Safety angiocatheter, manufactured by Braun (Melsungen AG, Germany), has a passive safety device comprised of a metal clip in the hub of the catheter that automatically covers the tip when the needle is withdrawn. There were no needle stick injuries reported in an entire year of use in one report,2 and none in 87,000 uses in another report.3 In a recent report comparing safety catheters, there were no needle stick injuries, but there were exposures to blood via splashes.4 To the best our knowledge, there have been no prior reports of a needle stick injury with this catheter.
The Introcan Safety catheter has been in use in our institution since 2003, and has been well received by the staff. However, there was one case in which a medical student was stuck with a used Introcan Safety angiocatheter needle. This student had just finished inserting an IV catheter into a patient’s vein, and placed the used needle on top of gauze. The student then grabbed the gauze pile and needle en masse, gripping the needle lengthwise sustaining a needle stick injury at this time. Gripping the needle in this fashion apparently pushed the needle through the metal clip, exposing the needle, and leading to the injury (Fig. 1).
The Introcan Safety Device is effective, but is not a replacement for an anesthesiologist’s vigilance. The needle should still be handled carefully and following its use, should be immediately placed in a disposal container for sharps. It should never be picked up with the tip pointing into the hand. While this device covers the sharp tip upon removing it from the catheter, it does not completely eliminate the possibility of a sharp injury.
Michael Pham, MD
Steven M. Neustein, MD
Department of Anesthesiology
The Mount Sinai Medical Center
New York, New York
1. Neustein SM. The use of safety needles in anesthesia. Anesthesiology 2006;104:1112–13
2. Iinuma Y, Igawa J, Takeshita M, Hashimoto Y, Fujihara N, Saito T, Takakura S, Ichiyama S. Passive safety devices are more effective at reducing needlestick injuries. J Hosp Infect 2005;61:360–1
4. Prunet B, Meaudre E, Montcriol A, Asencio Y, Bordes J, Lacroix G, Kaiser E. A prospective randomized trial of two safety peripheral intravenous catheters. Anesth Analg 2008;107:155–8