Tilted Forum Project Discussion Community - View Single Post - Endoscopy Center of Southern Nevada: 4 years of reused syringes, 40000 at risk of HIV

JustJess · 03-02-2008, 12:51 PM

I read the rest of the article - you're right in that there is small risk of actual exposure, but allow me to explain some techniques of IV catheterization.

You put in the catheter (basically a plastic tube) with a needle, and connect it to the IV tubing to the bags of solution you're infusing the patient with. There is always a flashback of blood (if you do it right, that is) when you first stick the pt, and to make sure your IV hasn't fallen out of place, you drop the IV bag to see if the blood comes back down the tube. It goes back down into the patient when you replace the IV bag above the level of their arm. So there's a little bit of possible blood/plasma in the tubing. Certainly you'd never reuse that, and the article doesn't claim that they are.

The next thing that often happens is that the anesthesiologist will inject medication from a vial - some kind of anesthetic, either the paralytic or the sedative - into a port on the IV tubing. So that's using a syringe, and there's possible contamination from products in the tubing, so no one ever re-uses that syringe - even on the same patient, just in case it was contaminated at some other point. Plus, that syringe also has whatever else was in the tubing on it, which could contaminate whatever you use it next on. (Medications, etc., not just blood.)

Now, you CAN reuse that vial. You just wipe off the top of it with an alcohol wipe. BUT it must be with a brand new syringe, not with something "re-sterilized" as mentioned in the article. You re-use the syringe, you've now contaminated the vial, and anyone else you use that vial for afterwards. It would be okay to re-use the vial with that patient, and maybe even for other patients, but you'd still wipe it off every time with an alcohol pad, and it's always poor practice to use the same syringe even on the same patient. I can see budget poor hospitals doing it... this place doesn't seem to have any budgetary concerns.

So the risks are certainly lower than if they were using one syringe on one patient directly in their arm, and then "sterilizing" it and using it on another patient directly in their arm; however, it's still not safe, and not good practice at all.

As for the poor cleaning of colonoscopy equipment: your GI tract is full of nasty stuff and will never be considered a clean surgery. But again, you can give one patient someone else's GI infection by not properly cleaning the equipment each time. Or cause an infection/inflammatory reaction just because their system doesn't have the same organisms etc as another person's.

The whole thing stinks of laziness and money-grubbing.

03-02-2008, 12:51 PM	#12 (permalink)
JustJess Unencapsulated Location: Kittyville	I read the rest of the article - you're right in that there is small risk of actual exposure, but allow me to explain some techniques of IV catheterization. You put in the catheter (basically a plastic tube) with a needle, and connect it to the IV tubing to the bags of solution you're infusing the patient with. There is always a flashback of blood (if you do it right, that is) when you first stick the pt, and to make sure your IV hasn't fallen out of place, you drop the IV bag to see if the blood comes back down the tube. It goes back down into the patient when you replace the IV bag above the level of their arm. So there's a little bit of possible blood/plasma in the tubing. Certainly you'd never reuse that, and the article doesn't claim that they are. The next thing that often happens is that the anesthesiologist will inject medication from a vial - some kind of anesthetic, either the paralytic or the sedative - into a port on the IV tubing. So that's using a syringe, and there's possible contamination from products in the tubing, so no one ever re-uses that syringe - even on the same patient, just in case it was contaminated at some other point. Plus, that syringe also has whatever else was in the tubing on it, which could contaminate whatever you use it next on. (Medications, etc., not just blood.) Now, you CAN reuse that vial. You just wipe off the top of it with an alcohol wipe. BUT it must be with a brand new syringe, not with something "re-sterilized" as mentioned in the article. You re-use the syringe, you've now contaminated the vial, and anyone else you use that vial for afterwards. It would be okay to re-use the vial with that patient, and maybe even for other patients, but you'd still wipe it off every time with an alcohol pad, and it's always poor practice to use the same syringe even on the same patient. I can see budget poor hospitals doing it... this place doesn't seem to have any budgetary concerns. So the risks are certainly lower than if they were using one syringe on one patient directly in their arm, and then "sterilizing" it and using it on another patient directly in their arm; however, it's still not safe, and not good practice at all. As for the poor cleaning of colonoscopy equipment: your GI tract is full of nasty stuff and will never be considered a clean surgery. But again, you can give one patient someone else's GI infection by not properly cleaning the equipment each time. Or cause an infection/inflammatory reaction just because their system doesn't have the same organisms etc as another person's. The whole thing stinks of laziness and money-grubbing. __________________ My heart knows me better than I know myself, so I'm gonna let it do all the talkin'.