Table of Contents

Handle and Care of Syringes, Needles& IV Tubing

handle and care of syringes

The importance of appropriate handling and care

The Occupational Safety and Health Act (OSHA) defines “sharps” as “any object that can puncture or penetrate the skin.” “Sharps” is the collective term for syringes, hypodermic needles, IV tubing, and other medical devices that can potentially prick the skin. Accidental skin puncturing is more complex than it appears to be. The puncture is not as dangerous as when a medical worker introduces an infection or a hazardous substance into the victim’s circulatory system. The injection of infectious agents and hazardous chemicals or substances when the accidental prick takes place makes the event more dangerous and more complicated in terms of management. Thus, medical workers need to pay attention to the handle and care of syringes and needles “sharps” with utmost care and safely dispose of them when the time comes to end their use.

Causes of needle stick injuries

Needle stick injuries are wounds caused by hypodermic needles that accidentally puncture the skin. Based on the literature, the two most common causes of needle sticks are recapping hypodermic needles and improper disposal of hypodermic needles.

Prevention of needle sticks and other injuries

Medical personnel must pay attention to the handle and care of syringes, hypodermic needles, and IV tubing with the hypodermic needle, which should be put inside an approved puncture-resistant “Biohazard Sharps Container (BSC).” Safety engineers must specifically design the container for sharp medical devices and label it as bio-hazardous waste with the bio-hazardous symbol and phrase. OSHA requires that medical workers place used “sharps” inside the BSC immediately after use. Thus, the BSC must be in the treatment room where medical staff can immediately place the used needles, blades, wires, and other disposable “sharps” in it. Medical workers should immediately cap the BSC when the contents reach the fill line and discard it according to local regulations.

Medical personnel need to observe the following precautions to prevent the occurrences of needle sticks, which could cause, in turn, the spread of infections and spillage of hazardous substances:

  • Place the BSC within arm’s length where the medical workers use the “sharps.” With this set-up, the medical doctors, nurses, and caregivers can immediately place in the BSC the used medical devices. Position the BSC low enough in the work area so that medical staff can readily visualize the opening and prevent spillage of used materials.
  • Work with only one uncapped hypodermic needle at a time. Keep uncapped needles and other sharps in view.
  • Do not use your mouth to uncap a needle or hold the cap.
  • Make sure not to leave sharps unattended.
  • Used needles must not be cut, bent, broken, or recapped by hand before disposing of them because of the increased chance of injury. Recapping, purposeful bending, breaking, removing disposable syringes, or other manual manipulation of needles are strictly discouraged.
  • Dispose of used hypodermic syringes and needles with dispatch without further manipulations.
  • Avoid handling broken, contaminated glassware directly by hand, even if wearing gloves. BSC should be in all areas where medical workers use hypodermic needles and sharps. 
  • Do not force sharps items into a congested container or retrieve discarded items. Medical staff must always keep the BSC upright.

Proper working attire and procedure when using syringes and hypodermic needles

  • Whenever medical workers use syringes and hypodermic needles, put on hand gloves and other necessary protective equipment and clothing. The appropriate attire protects medical workers from the harmful consequences arising from mistakes in handling syringes and hypodermic needles. Performing various forms of surgery wherein medical staff use a lot of syringes and hypodermic needles necessitates having the proper protective attire.
  • Nurses and other staff need to place the used syringes and hypodermic needles back in the cassette slots. This action prevents exposure to the sharp and contaminated ends of the instruments, thus avoiding injuries.    
  • Medical staff must immediately place used syringes and hypodermic needles in a properly and clearly labeled puncture-resistant hazardous waste container different from the BSC. Nurses need to place this particular container inside the work area.
  • Sanitary workers must store the puncture-resistant hazardous waste container in the clinic for a limited time. Sanitary workers must transport the container to the licensed waste facility for treatment as soon as possible.

Care of IV tubing

Medical practitioners and workers must change all IV tubing using a sterile technique. The said technique means that in the process of replacing an old IV set with a new one, medical staff needs to exercise caution in handling the removal of the old one and the installation of the new IV set. Patient care manuals explain in detail the steps to do the sterile technique. Still, the endpoint is that doctors and nurses prevent infection and unnecessary injuries to the patient.

A medical worker needs to change and replace the IV tubing at a certain point in the IV therapy. There are three occasions when the IV tubing needs to be changed:

  • The IV tubing reached its allowable time duration of use. 
  • Medical workers need to infuse a different type of solution. 
  • The current IV tubing is inappropriate for the following solution that medical workers need to infuse.

The ensuing table summarizes the necessary changes in IV tubing:

FREQUENCY OF IV TUBING CHANGETYPE OF IV TUBING AND SOLUTION
Every 72 to 96 hoursPrimary tubing is used for infusing hypotonic, isotonic, or hypertonic continuous solution, when the needle insertion is transferred to another site, or when the type of solution or medication being administered is changed and requires a change in IV tubing.
Every 24 hoursSecondary or intermittent IV solution or medication. Rationale: If the infusion is not continuous and disconnected and connected now and then, the frequency of contamination of the catheter hub, needleless connector, and the male Luer end of the administration set increases, potentially increasing the risk for infections. 
Every 24 hoursInfusion containing fat emulsions (IV solutions combined with glucose and amino acids infused separately or in a 3-1 admixture). Example: Total parenteral nutrition (TPN). 
Every 4 hours or 4 units, whichever comes first or between productsBlood and blood products.
Table 1. Frequency of IV tubing change for every type of solution  

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