Prunet Bertrand, Meaudre Eric, Montcriol Ambroise, Asencio Yves, Bordes Julien, Lacroix Guillaume, Kaiser Eric
Department of Anesthesiology, Military Teaching Hospital Sainte Anne, 83800 Toulon Armées, France.
Anesth Analg. 2008 Jul;107(1):155-8. doi: 10.1213/ane.0b013e318174df5f.
To reduce the risk of accidental needlestick injuries, first active then passive safety devices were developed on IV catheters. However, whether these catheters are easy to implement and really protect personnel from accidental needlestick is untested.
In this prospective randomized survey, we compared a passive safety catheter with an active safety catheter and a nonsafety classic catheter. The main objective was to evaluate the difficulty of inserting the catheters in terms of the number of insertion failures, difficulties introducing the catheter and withdrawing the needle, and the normality of the blood reflux in the delivery system. The second objective was to determine the degree of exposure to patients' blood evaluated as the number of exposures of the staff and blood splashes of the environment, and the staff's sense of protection.
Seven hundred fifty-nine assessment cards were collected. The number of failures for the three catheter groups was similar and not statistically different. Introduction of the catheter was more difficult with the active safety catheter. Needle withdrawal was more difficult with the passive safety catheter. The blood reflux was abnormal more often with the safety catheters. The staff's exposure was more frequent with the active safety catheter. The number of blood splashes was more common with the safety catheters.
Safety catheters are not superior with regard to failure rate in the catheter's placement. Users feel better protected, but find the use of safety catheters more difficult, and their handling generates more splashing of blood into the environment. The passive safety catheter is more efficient than the active safety catheter with regard to ease of introduction of the catheter into the vein and the staff's exposure to the patient's blood.
为降低意外针刺伤的风险，静脉留置针先后研发出了主动安全装置和被动安全装置。然而，这些留置针是否易于操作以及能否真正保护工作人员免受意外针刺尚未经测试。
在这项前瞻性随机调查中，我们将一种被动安全留置针与一种主动安全留置针以及一种非安全经典留置针进行了比较。主要目的是根据穿刺失败次数、导管置入和拔针的难度以及输液系统中回血的正常情况来评估导管插入的难度。第二个目的是确定工作人员接触患者血液的程度，以工作人员的接触次数和环境中的血液飞溅情况来评估，以及工作人员的防护感受。
共收集了759份评估卡。三组导管的失败次数相似，无统计学差异。主动安全留置针的导管置入更困难。被动安全留置针的拔针更困难。安全留置针的回血异常情况更常见。主动安全留置针导致工作人员接触更频繁。安全留置针导致血液飞溅的情况更常见。
在导管置入的失败率方面，安全留置针并不具有优势。使用者感觉受到了更好的保护，但发现使用安全留置针更困难，而且其操作会导致更多的血液飞溅到环境中。在将导管插入静脉的难易程度以及工作人员接触患者血液方面，被动安全留置针比主动安全留置针更有效。
