0 Stylets and needle safety - brnskll.com

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.

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 gauze 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

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.

 

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