To the Editor
Recently our department switched to a needleless system of blunt tipped needle-like devices for use in the operating rooms. Unfortunately, sharp steel needles are still commonly used in the operating rooms, largely for aspiration from various containers. All of the systems which we considered required the additional expense and inconvenience of at least one type of device for this purpose. This in turn led to additional storage problems on the anesthesia cart. I am sure this hassle and expense is shared by many anesthesiology departments throughout the country. Worse still is the continued risk assumed by those departments that do not utilize such systems. Widespread acceptance of needleless systems could become a reality only if there are no significant obstacles to their use. An immediate concern is the absence of pre-pierced rubber stoppers on medication and fluid containers. If vial makers switched to this more practical alteration of an old stand-by, this reduction in use of sharps could be more readily accomplished.
The Anesthesia Patient Safety Foundation is an ideal forum to address this concern. I suggest that the APSF sponsor a forum for health care providers, manufacturers of needleless systems, and vial and medication manufacturers to work toward a consensus of the problem. The goal would be the practical elimination of the use of sharps for anything other than patient contact. If anesthesia machines can be “standardized’ and ‘modernized’ why not our IV tubing and injection/aspiration devices? Although this is largely an issue of health care provider safety, patient safety is an important consideration, and needs to be addressed here as well.
George Gabrielson, M.D. Assistant Professor of Anesthesiology
Director, Liver Transplantation Section The Mount Sinai Medical Center
New York, NY