Stylets and needle safety

A quick sketch from a number of years ago
A quick sketch from a number of years ago

I strongly suggest that my fellow piercers discontinue the use of any caps applied manually after piercing, especially two handed capping methods, which appear most likely to result in sharps injury.

OSHA considers recapping of needles unacceptable risk unless there are no alternatives. OSHA allows one handed capping, such as spearing the needle tip into a stopper on your work tray, or using a mechanical device such as a tweezer or clamp to apply the cap providing a safe distance from the sharp end. Even using a receiving tube can pose risks if the tube a small diameter or not sufficiently puncture resistant.

When piercing without a clamp, longer needles allow the tube to be held securely far away from the tip once it has passed through the body. I use 3 inch needles for all body piercings so that the sharp end can be cleared far enough from the pierced area and the tube can be secured close to the blunt base without the need to manipulate the sharp end.

The stylet approach is stable, and based on existing self-blunting sharps technology. Provided that the wire is the appropriate size, the sharp is secured and there is not a cutting edge to catch or stick. It will only move back in the needle with a similar level of force that would puncture through a cork or plastic tube.  A telescoping metal tube with a reduction to catch the needle could be more secure, and I’m working on a demonstration of that as well.

This is a prototypical demonstration of the concept and a version of it can be made to fit into needles for our industry with a number of locking and blunting variations of the same strong passivated 304 steel as the needles.

OSHA regulations:

1910.1030(d)(2)(vii)

Contaminated needles and other contaminated sharps shall not be bent, recapped, or removed except as noted in paragraphs (d)(2)(vii)(A) and (d)(2)(vii)(B) below. Shearing or breaking of contaminated needles is prohibited.

1910.1030(d)(2)(vii)(A)

Contaminated needles and other contaminated sharps shall not be bent, recapped or removed unless the employer can demonstrate that no alternative is feasible or that such action is required by a specific medical or dental procedure.

1910.1030(d)(2)(vii)(B)

Such bending, recapping or needle removal must be accomplished through the use of a mechanical device or a one-handed technique.

1910.1030(d)(2)(viii)

Immediately or as soon as possible after use, contaminated reusable sharps shall be placed in appropriate containers until properly reprocessed. These containers shall be:

1910.1030(d)(2)(viii)(A)

Puncture resistant;

1910.1030(d)(2)(viii)(B)

Labeled or color-coded in accordance with this standard;

1910.1030(d)(2)(viii)(C)

Leakproof on the sides and bottom; and

1910.1030(d)(2)(viii)(D)

In accordance with the requirements set forth in paragraph (d)(4)(ii)(E) for reusable sharps.

via Bloodborne pathogens. – 1910.1030.

Engineering Sharps Safety Workshop

Wednesday, October 22, 2003

Work practice controls

Demonstrated knowledge of and aptitude for appropriate aseptic techniques, and practices, and legal issues involved is required prior to handling sharp instruments.

Watch the sharp end

Maintain awareness and control of sharp implements at all times

Don’t point sharp things at your self, especially fingers

Aim away from client and piercer

  • Example: Eyebrow begins by aiming away from eye towards hairline and away from the scalp and forehead.
  • Example: Navel begins by aiming out from the top center of the navel opening, out and away from the stomach.
  • Example: Tongue begins underneath the medial sulcus center and out away from upper lip and nose.
  • Example: Male urethral piercing begins inside urethra and aim outward between the glans penis perineal seam.

Use nonwoven gauze or SMS to support tissue upon exit

  • To decelerate leaving the exit wound and avoid fingers
  • To reduce tissue tearing and aiming sharp accidents

Select sharp device of appropriate length

  • Three inch sharp instruments (currently lancet pointed cannulae) allow for superior control and aim.
  • Use the extra length to keep fingertips away from sharp end.

Use appropriate amount of pressure for gentle penetration and exit

  • To reduce pressure is to reduce risk, error, and equipment failure
  • Slow down to ensure correct angle of exit

Engineered safety controls

No available devices exist specifically engineered to effectively reduce sharp injury risk both safe and effective to satisfy the requirements of the job.

Possible Ideas to assess

Stylet wire

  • At least one half inch longer than the needle tube
  • Use as pin coupling to aid insertion of internally threaded jewelry
  • Friction fit/notch/tab for wire/tube to lock in place

Test

  1. Make 18g wire 3.5” for 14 gauge cannulae
  2. Get IS Needles to make prototypes for other sizes 18 gauge to 4 gauge
  3. Video and photograph to document
  4. Assess at 10 procedures

Using smaller tubing or wire stock cut to size for the stylets.

  • The rod is slightly curved in the middle, to provide enough friction to prevent it from sliding back once advanced.
  • For a REALLY tight fit you can bend the wire twice in opposite directions and it will basically LOCK the wire into the needle and not allow it to twist or pull out at all.
  • The ends are rounded with a cup burr and polished to avoid injury.
  • The tail end can even be tapered or threaded to ensure a transfer with internally threaded jewelry.

What fits?

  • 26/28g fits NeoMetal 18g threadless and most other 18g internally threaded posts
  • 20g fits NeoMetal 16g threadless and some other 16g and larger internally threaded posts
  • 18g fits 14 and 12g internally threaded posts
  • Telescoping tubing better suited for larger bore needles

Transfer pin (TP) connector size and jewelry ga:

  • 26ga TP ? 19ga/18ga jewelry
  • 22ga TP ? 16ga jewelry
  • 20ga TP ? 14ga/12ga jewelry
  • 19ga NB ? 14ga/12ga jewelry

Demonstration:

  1. Stylet wire in place, prepared for a piercing.
  2. Once pierced through, the wire is inserted into the jewelry then advanced flush with the butt of needle, blunting the sharp and maintaining a connection for the jewelry transfer.
  3. Now blunted, the jewelry insertion is safer, and the connection is sturdy without need for a taper.
  4. Blunted needle can be disposed of safely in a sharps container immediately, without need to return it to the work surface.

 

APP Conference soon!

  CONFERENCE IS ALMOST UPON US! THE CONFERENCE ADVANCED (ONLINE) REGISTRATION WILL SHUT DOWN AT MIDNIGHT ON MAY 17TH, PST ANY CHANGES TO YOUR REGISTRATION SHOULD BE MADE BEFORE THEN (OR WILL HAVE TO WAIT UNTIL WE ARE ONSITE IN LAS VEGAS) BANQUET DINNER SPONSORED BY INDUSTRIAL STRENGTH BODY JEWELRY; ANATOMETAL, INC.; LEROI, INC.; AND KAOS SOFTWEAR THURSDAY JUNE … Read more APP Conference soon!

Pronouncing an open tone towards other forms of modification

I've been a member now since 1996
I’ve been a member now since 1996

Here is some progress to be proud of:

The Association of Professional Piercers is an international non-profit organization dedicated to the dissemination of vital health and safety information about body piercing to piercers, health care professionals, legislators, and the general public. Socially and legislatively, body piercing is situated within the greater body modification community. As a result, we recognize that our role extends beyond the discipline of body piercing. Our position on body art practices such as tattooing, cosmetic tattooing, branding, scarification, suspension, and other forms of body modification is as follows:

Read morePronouncing an open tone towards other forms of modification

Processing Devices

Standards are useful, and guidance based on evidence is often even more so.

Scope

This guidance provides recommendations regarding reuse instructions in labeling for reusable medical devices and the validation of the recommended reprocessing process in the instructions. The recommendations are applicable to the three device reprocessing situations below.

Read moreProcessing Devices

Effects of Non-Condensable Gases (NCGs) on Steam Sterilisation Processes

Read the full text: Effects of Non Condensable Gases on Sterilization

Summary:

A gravity displacement (class N) steam sterilization process can not reliably remove gases from hollow or porous items, resulting in areas that do not get sterilized, and the failure of the load. They should not be used for body jewelry, needles, tattoo tubes or textiles.

REVIEW

395 CENTRAL SERVICE Volume 13 2005

ZENTRAL STERILISATION

Effects of Non-Condensable Gases (NCGs) on Steam Sterilisation Processes

U. Kaiser

Keywords

  • steam sterilisation process
  • non-condensable gases (NCGs)
  • process challenge device (PCD)

Introduction

The dangers posed by non-condensable gases (NCGs) in steam sterilisation processes have long been underestimated. Biological indicators, or the best chemical indicators on the market, do not signal the presence of a NCG content of up to 10% in a sterilisation process so long as there is mixing of steam and NCGs in the sterilisation chamber.

Read moreEffects of Non-Condensable Gases (NCGs) on Steam Sterilisation Processes

Water quality; staining of sterile packaging; soil detection devices

March 2013 – CS Solutions.

Water quality; staining of sterile packaging; soil detection devices

by Ray Taurasi

Q I work in a small rural hospital in New Hampshire. We only have one OR and one sterilizer and no automated washers. All of our instruments and other reprocessable items are manually cleaned. I have noticed at times, especially during the winter months, our tap water has a cloudy color. Since we use tap water to clean our instruments and to mix with our chemical disinfectants, I was wondering if the water is safe to use or if it can damage our instruments.

A In the winter time in cold regions such as New Hampshire, the water coming into the hospital is extremely colder than the inside temperature and your water may have a milky or cloudy appearance. The reason for this is that cold water holds more oxygen than warmer water does.

Read moreWater quality; staining of sterile packaging; soil detection devices

Titanium body jewelry

Titanium!

What Titanium materials are best for body jewelry? My articles at https://jewelry.piercing.org/ and https://brnskll.com/shares/titanium-standards-why-not-g23/ explain that the two most effective Titanium standards are alloyed ASTM F136 and pure ASTM F67, the most common being the former as it is stronger, harder and easier to polish. Both are used for permanent surgical implants.

Bravo

Welcome to Bravo! A fractionated vacuum autoclave from SciCan Buy a Bravo now     BRAVO chamber autoclave   Features Fractionated vacuum system 17L or 21L chamber capacity Intelligent closed door drying Integrated datalogger Industry leading cycle times Single use Pull’n Push water system 2 Year warranty The BRAVO fractionated vacuum chamber autoclave continues the … Read more Bravo

Disposable wrap

Can unused wrapped items be re-sterilized reusing the original wraps?

When unused sterile instrument sets are returned from the OR or patient floors our policy is to re-sterilize the sets. Since these were unopened we inspect the wrap to be sure there are no holes, replace the tapes and labeling and re-sterilize the item.

Read moreDisposable wrap

Returning jewelry(explants) to clients

Do not buy or sell used body jewelry brnskll dot com

An interesting observation on safety issues raised in returning contaminated items such as jewelry to clients, as voiced by this medical professional’s concerns for their patients. It is evident that infection control measures should be carefully considered when previously worn jewelry or other contaminated personal items are to be returned to a customer.

Please regard the discussion in the comments below


Question

I am an OR nurse and recently started a new job in a prestigious orthopedic hospital. At the request of a surgeon or patient when implants are removed we have been cleaning and flashing them  and returning them to the patient in a plastic bag.

[NOTEFlashing is an outdated term for sterilizing items unwrapped for immediate use]

https://brnskll.com/shares/flash-faq/

Read moreReturning jewelry(explants) to clients

Sharpies for labeling

Can we label sterilization packages with a Sharpie brand marker?

Question

Our staff used to label all of our cardiovascular sets and supplies with a red Sharpie brand permanent marker and we would use a black Sharpie for all other items. This provided a quick and easy method to visually identify these special critical items. The labeling was restricted to the autoclave tape on the outside of wrapped packages and the film side of peel pouches.

Read moreSharpies for labeling

OPTIM 33TB protocol

OPTIM 33 TB is a One-Step Cleaner Disinfectant with no hazardous ingredients.

For the modern body artist, OPTIM offers a number of advantages for cleaning and thorough and safe disinfection in one minute for:

  • Temperature sensitive Body jewelry materials for healed piercings
    Such as wood, horn, stone, bone, certain polymers
    Break the chain of infection for MRSA, VRE, HCV, HBV, HIV, Mycobacteria and other pathogens for non-critical items that can not withstand the heat of an autoclave.
  • Tattoo machine frames, coils, springs, clip cords
  • Mayo trays and other work surfaces
  • Exam tables, massage tables, tattoo chairs
  • Display cases
  • Furniture in your waiting area including fabric covered items.
  • Suspension rigs and equipment

Read moreOPTIM 33TB protocol

Learn about piercing bumps

Have you noticed some sort of raised bump at the exit point of your piercing?

This could be due to a number of sources of irritation or infection that can result in overgrowth of scar tissue when the healing process is disrupted. There may be a single, simple solution though it commonly may take a combination of protective measures to help this turn out well.

Read moreLearn about piercing bumps