N

What Is The Proper Way To Cap A Syringe?

7 Answers
You better hope yo can answer this all medical employees! (Assume there's an OSHA rep. visiting your workplace and following your every move!) What is the proper and safest way to cap a used syringe that requires being recapped!?
T

Here we go (I still stand behind my original answer, but I will elaborate on the ONE exception below)

Although I hate succumbing to links, I chose to do so, as opposed to writing a dissertation on OSHA guidelines.

Direct link to the OSHA website, in which the guidelines for the handling of contaminated needles are officially addressed. http://1.usa.gov/GCI0oX

Please refer to the following citations:
1910.1030(d)(2)(vii)
1910.1030(d)(2)(vii)(A)
1910.1030(d)(2)(vii)(B)
1910.1030(d)(2)(viii)

Now, I will share with you my training and experience. As a surgical technologist , first assistant to the surgeon in the operating room, and a member of the sterile team, there were a couple of methods taught as to how to handle the re-capping of needles.

Needles on a sterile field are counted (so as to not go missing at the end of the procedure and end up inside the patient), and thus cannot be handed off the sterile field for disposal in a red sharps container until after the case is completed.

There are indeed times when needles in a sterile field are used to perform multiple injections, especially during cardiovascular and cosmetic surgery procedures, but for the safety of everyone, these needles MUST be re-capped.

One way to properly re-cap a needle in the sterile field is to use the one-scoop method, by scooping the plastic cap of the needle up with the needle itself (with the needle still attached to the syringe) and then securely twisting the capped needle back onto the syringe, preferably with a surgical needle holder.

There are "safety" needles that can sometimes be used in the sterile field, but the surgeons hate using them, as they do not allow the precision they prefer for injection. These syringes have a plastic guard on them. After injection, the needle is forced back into the plastic sheath by placing it against a hard surface and letting the needle retract back within the sheath. After this is done, the syringe and needle can no longer be used.

Finally, the other alternative to re-capping a needle in a sterile field would be to use a surgical needle holder to grasp the plastic needle sheath and place it carefully over the needle. Once this is done, the entire assembly should be placed face down on a hard surface so that the entire syringe-needle assembly can be safely locked into place. However, the surgical needle holder could also be utilized to twist the needle assembly securely back onto the syringe

Other than this, I refer back to OSHA guidelines for the proper way to handle contaminated syringes and needles, which effectively states they cannot be re-capped or removed unless there is no alternative means, which I personally find preposterous. Obtain a new syringe and needle and avoid needle sticks at all costs!

...
N

Wow,..I do agree Teslar57 Logically anyway! But unless something has changed in the past several years leading to a some bizarre need for such a protocol, I assure you I was TAUGHT so by an OSHA representative (of seemingly sound-mind other than this!), and the clinic I worked in was written up for not adhering to the protocol since after the correction of my own "routine incorrect act" (which my boss had taught me originally, passively - and I had no formal training but what I learned at work) The entire staff failed to produce the 'correct-answer' under later "interrogation."

It was a veterinary clinic, although we were told this was a universal rule (and that normally, exactly as you said, a syringe with a needle should not be recapped before disposal) But that should technically not matter, even though the number of blood born pathogens/diseases are rather small, most being rather "species specific", there are plenty of possible infectious agents, and even one is enough to warrant your response (IMO) - If no one can produce an answer after some period of time (I don't know, maybe a week, if I remember - I will post the answer that I was taught - The best answer if you can post a proper citation disproving what I was lead to believe for many years. I don't remember exactly where I was "seen" committing such an act, though a record does exist, and I am friendly with the owner/management of the facility, to the point that I could get them to look it up for me if necessary. It may have been done during a series of multiple injections during surgery on the same patient, although I couldn't imagine a need to recap in a sterile field. ...

S

Well, I am not a medical professional at all, but I do give myself shots every day due to this wonderful thing called diabetes.

I was taught to use pliers to firmly grip the needle and pull it directly out of the syringe. The needles are then dropped directly in a special sharps container. I don't actually touch the needle part by hand at all. I then hold the cap at a right angle and turn it up and over the end as I feed the syringe into the cap. I also put the cap back over the plunger end before dropping it into a second collection bag.

When I travel, I leave the needle intact and put the cap on the same way. The needle is never pointed directly at any part of my hand even when the entire syringe and needle are still intact. I store them separately and disassemble them following the same procedure for final disposal after I get back home to the collection containers.

When the collection containers are full, I take them back to the medical facility for safe disposal, rather than tossing them in with the rest of the trash.

So how far off am I, Doc?

...
T

You have now sparked my curiosity; however, I will definitely have something to contribute in the near future, based on your clarification, and hopefully we will end up on the same page. Why did I get the feeling this wasn't going to be as easy as I initially surmised it to be? Oh, yes...OSHA!

...
T

There is no "proper" way to re-cap a syringe with a needle attached, as this is forbidden protocol.

After using a syringe, it should immediately be disposed of in a red sharps container.

There should be no other correct answer than this!

...
N

Lol... and you mine! I guess we are all victims of what we are taught... I'll be checking when I get a chance too.

...
T

Sounds like a deal. I'll be checking with you soon...lol.

...