Tuesday, February 27, 2007
Stuck in the Middle
Seem to be in a pattern here: post about something bad in the OR, then something cool. Here's another bad thing, based on a bad thing. Then maybe I'll get off it for a while.
Getting stuck with a needle has never been fun, even before it could be fatal. I've had my share. Converted my hepatitis titer while I was in San Francisco, though I never got sick. If nothing else, sometimes it hurts like hell, right in the middle of a case. Methods to prevent getting nailed are in the category of the desirable. Great minds attend to it. Less than great minds appear to be the ones, so far, to have come up with solutions:
And I couldn't even find a picture of the worst offender: probably got sold just before the sales force slunk out of town. The "safety" part looks like the back leg of a grasshopper, as it slides up and down the needle. Where I work, the hospital bought it by the pantload.
Anyhow, the point is this: laudable as the concept might be, the "safety needles" I've seen and used to date are anything but. Cumbersome, clumsy, and complicated to use, they interfere with the underlying purpose; namely, to inject stuff. Trying to fill up the muscle with local anesthetic through a small incision is all but impossible. So, at least in the operations I'm involved in now, we cut the damn sleeves off, defeating the entire purpose. The good news is that in doing so, we are actually making the procedure safer. The hospital recently completed a study: since the advent of the particular needle used in these parts, needle sticks in operating room personnel have gone UP!!!! Is anyone surprised?
Work-flow. Ergonomics. Energy expenditure: not my bag except in figuring out how to do what I do. But my two-cents worth says: the more complicated the system aimed at simplifying things, the more opposite from effective it is. The more people have to manipulate things in order to make their manipulations safer, the unsafer they get. Paying attention is really all it takes. However: I already admitted to my share of pokes. So, whaddya gonna do? Screwed. Either way.