Accidental needlestick injuries are both far too frequent and far too risky. However, recent developments in butterfly sets include safety features which should prevent any such injuries.

Greiner Bio-One GmbH

Every day, thousands of healthcare workers worldwide are accidentally stuck with contaminated needles, plunging them into months of despair and anxiety that they may have acquired a deadly disease from the exposure. Because studies have shown that over 20 different diseases can be transmitted by blood exposure, including hepatitis C, hepatitis B and HIV, their fears are well founded.

According to estimates by Medical Data International, accidental needlesticks account for 80% of all occupationally acquired diseases. At increased risk are those healthcare workers who use winged infusion (“butterfly”) sets. Studies show that butterfly sets are responsible for 32 percent of all accidental needlesticks to phlebotomists.

Increased risks

This increased risk can be attributed to two features of butterfly sets that have been, until recently, inherent to the device. The first is devices without a safety feature that activates immediately upon removing the needle from the patient’s vein lengthen the time users are exposed to the risk of an accidental needlestick with a contaminated sharp. Since it has been shown that most accidental needlesticks occur within seconds of when the needle is removed, any device that shortens the time in which this “window of vulnerability” remains open dramatically reduces the potential for injury and exposure. Devices with needle concealment features that can be immediately activated upon needle removal, therefore, can minimize or even eliminate the moments after needle removal during which healthcare workers are most vulnerable.

This process is made cumbersome because of the second feature that makes butterfly sets riskier to use: tubing that retains their coil after being removed from the package, a characteristic that has made disposal of butterfly sets dangerously cumbersome. Since butterfly sets have a needle at both ends, healthcare workers are exposed to twice the potential to suffer an accidental needlestick during their disposal. Dangling two contaminated needles connected by coiled tubing into a sharps container changes quick disposal into a game of skill—a game that unnecessarily extends the time frame in which the user can be exposed to the contaminated needle. Therefore, devices designed with memory-free tubing, i.e., tubing that does not remain coiled after removal from the packaging, bring an additional element of safety to blood collection procedures.

Safety features

One product combines both of these important features into one device. The Vacuette® Safety Blood Collection Set from Greiner Bio-One (Kremsmunster, Austria) is a single use, sterile, needle bonded to a flexible tubing with a female Luer adapter. Its safety shield can be activated to cover the needle immediately following venipuncture to aid in the protection against accidental needlestick injury. The device is available alone or in combination with a Luer adapter or Luer adapter and holder to accommodate all applications.

Upon completion of the sampling, the collector activates the safety feature by holding down the wings with one hand and, with the other hand, pressing in on both sides of a safety mechanism near the wings to release a lock. The operator slides the safety mechanism back until an audible click is heard confirming activation while applying pressure to the puncture site. The device is then discarded directly into a sharps container. The memory-free tubing facilitates a quick disposal by eliminating the cumbersome dangling that coiled tubing requires in order to dispose of the sharp. Although the company recommends activation of the safety device during removal of the device to provide maximum protection, activation can also be accomplished after the device is removed.

Protection research

The product is part of Greiner Bio-One’s “Vacuette Safety Project,” a long-term investment in research that reflects the company’s commitment to the development of blood collection products that protect healthcare workers from injury and exposure.

-Jagger J. Rates of needlestick injury caused by various devices in a university hospital. N Engl J Med.1988;319(5).

-Safer needles limit injuries. Healthcare Purchasing News. Northfield, Illinois. Medical Econonics, Co. March, 1997.

-Jagger J. (1994) Risky procedure, risky devices, risky job. Advanced Exposure Prevention 1(1):4-9.

-Centers for Disease Control and Prevention.(1997) Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures. MMWR Morbidity and Mortality Weekly Report. 46(2):21-25.