OSHA Safety Regulations on Medical Needles

Safety Features on Medical Equipment

• OSHA regulations require safety features on needles to minimize the risk of accidental needlesticks.

Evacuated Tube System (ETS)

• The evacuated tube system is a closed system used for collecting blood samples.
• It consists of a needle, a safety device holder, and an evacuated tube with a vacuum.
• The system is preferred for collecting blood samples due to its efficiency and safety.

CLSI Order of Draw

• The CLSI standard GP41 recommends the following order of draw for ETS collection and filling tubes from a syringe:
  • Blood culture tube or bottles
  • Sodium citrate tube (e.g., light blue-top coagulation tube)
  • Serum tube with or without clot activator, with or without gel (e.g., red, red/gray mottled, or gold stopper)

Tubes and Additives

• Tubes have different colored stoppers to indicate the additive present.
• Examples of additives and their uses:
  • EDTA (lavender top tube): prevents clotting, used for complete blood counts
  • Sodium fluoride (gray top tube): prevents glycolysis
  • Sodium citrate (light blue top tube): prevents clotting, used for coagulation studies
  • Potassium oxalate (gray top tube): prevents glycolysis
  • Heparin (green top tube): prevents clotting, used for plasma samples

Trace Element Free Tubes

• Royal blue top tubes are trace element/metal-free, used for tests such as arsenic, cadmium, chromium, copper, iron, lead, magnesium, manganese, mercury, selenium, and zinc.

Evacuated Tubes and Tube Vacuum

• Evacuated tubes are used with both open and closed systems.
• Different sizes accommodate different volumes of blood.
• Tubes are available in plastic and glass (most are made from polyethylene terephthalate PET).
• Each tube has a color-coded top to indicate the additive present.

Safe Use of Tourniquets and Isopropyl Alcohol

• Tourniquets:
  • Use tight enough to restrict venous flow and not arterial blood flow.
  • Avoid pinching patients' skin in the buckle.
  • Place over thin clothing of elderly patients.
  • Place finger under buckle when tightening.
  • Loosen tourniquet before removing.
  • Ensure tourniquets are disinfected regularly.
  • Do not use to arrest bleeding.
• Isopropyl Alcohol:
  • Keep away from heat and open flame.
  • Keep away from children or confused patients.
  • Containers should be correctly labeled and stored in a labeled poisons cupboard.

Discarding Needles

• Multisample Needle:
  • After removing from the vein, activate the safety feature (using one hand).
  • Hold over the sharps container at a 110-degree angle.
  • Unscrew the needle and allow it to fall into the sharps container.