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Puncture Injuries Due to Needles Removed From Intravenous Lines: Should the Source Patient Routinely be Tested for Bloodborne Infections?

Published online by Cambridge University Press:  21 June 2016

Farrin A. Manian ,
Lynn Meyer  and
Joan Jenne
Farrin A. Manian*
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Lynn Meyer
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Joan Jenne
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
*
Suite 3002, Tower B, 621S. New Ballas, St. Louis, MO 63141
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Abstract

Objective:

To better assess the risk of exposure to bloodborne pathogens following puncture injuries due to needles removed from intravenous(IV) lines.

Setting:

Tertiary care community medical center.

Patients:

A convenience sample of hospitalized patients requiring IV piggy-back medications.

Methods:

Examination of 501 IV ports of peripheral lines, heparin-locks, and central venous lines for visible blood and testing the residual fluid in the needles removed from these ports for the presence of occult blood by using guaiac-impregnated paper.

Results:

The proximal ports of central venous lines and heparin-locks were statistically more likely to contain visible blood than proximal and distal ports of peripheral lines (17% and 20% versus 1% and 3% respectively, P<0.05). Similarly, needles removed from proximal ports of central venous lines and heparin-locks were statistically more likely to contain occult blood than those from peripheral lines ( 11% and 14% versus 2%, respectively, P<0.05). Only two needles removed from IV lines without visible blood contained occult blood: one from the proximal port of a central line and another from a heparin-lock. None of the needles from peripheral lines without visible blood contained occult blood.

Estimation of the risk of transmission of hepatitis B and C and human immunodeficiency virus (HIV) following injury by needles from various IV lines revealed that injury due to needles removed from peripheral IV lines and distal ports of central lines without visible blood was associated with “near zero” risk of transmission of these bloodborne infections at our medical center.

Conclusions:

Routine serological testing of source patients involving injury due to needles removed from peripheral IV lines and distal ports of central lines without visible blood is not necessary at our medical center. Conversely, due to the relatively high rate of occult blood in the needles removed from proximal ports of central venous lines and heparin-locks, puncture injuries due to these needles are considered significant and managed accordingly.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 6 , June 1993 , pp. 325 - 330
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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