To the point: Safety Huber Needles

TO THE POINT: Safety Huber Needles

By Ron Stoker

December 2003 Issue

Managing Infection Control

Implanted ports were developed in 1983 as an alternative to long-term tunneled catheters. Ports are used to provide vascular access for patients requiring long-term drug or fluid therapies. Implanted port systems consist of an injection port with a large self-sealing septum and a radiopaque catheter that extends just above the superior vena cava for quick hemodilution of the injected materials.

Ports are used for patient therapies requiring repeated vascular access. Port systems are used for the withdrawal of blood samples and the infusion of medications, total parenteral nutritional solutions, blood products and imaging solutions.

Access to the port is performed with the percutaneous insertion of a non-coring needle through the septum of the product. The needle is inserted percutaneously through the port septum and into the port reservoir. The injection fluid then flows from the reservoir through the catheter and into the patient’s vascular system. The tip of the catheter is typically placed to the superior vena cava for maximum dilution of the infusate.

Huber needles, however, present a problem with accidental needlesticks. The removal of standard huber needles require the stabilization of the port. The port is stabilized with at least two fingers of the non-dominant hand of the clinician while the needle is withdrawn from the septum. Because of the proximity of the hand to the needle, this procedure puts the healthcare worker at high risk of accidental needlestick injury. Rebound injuries are common with Huber needles due to the great deal of force required to overcome the resistance of the silicone septum. This is particularly troublesome because ports are used often to provide venous access for AIDS/HIV patients. That would mean that an injury to a healthcare worker sustained from the removal of a standard Huber needle would carry an extremely high risk of contamination from bloodborne disease. It has been estimated that 47% of accidental needlestick injuries from Huber needles are due to this "rebound effect," which occurs during needle withdrawal from the implanted port.

Safety Products to use on Implanted Ports

There are a number of safety Huber needle products that are available on the market. This article discusses all known safety products that are currently used to access implanted ports or to remove standard Huber needles and render them safe.

This article is not intended to compare the features and benefits of one product over another - simply to present the known safety products that are commercially available so the reader is aware of each of these products. The article describes how each product is used in removing the needle from the port septum.

Huber Plus from Now Medical

The Huber Plus Safety Huber Needle was the first self-contained, p Huber Plus from Now Medical assive, safety non-coring huber needle to receive FDA pre-market notification as a safety device. It requires minimal change in user technique and can be activated using a one-handed operation. The safety feature does not interfere with the normal use of the product. The HUBER PLUS safety wings are color-coded to identify needle gauge size and is offered in several needle lengths ranging from 1/2" to 1 1/2". Straight sets are available as well as sets containing a needle free y-site featuring a positive pressure valve.

The Huber Plus is activated by simply grasping the wings with thumb and forefinger and squeezing. The needle is encapsulated within the locked wings as the needle is removed from the port. The safety mechanism provides both visual and audible (the safety "snap") confirmation that the exposed needle is now covered and the clinician is protected from accidental needlestick injuries. Additional information can be obtained from Now Medical by clicking here or call 610-455-0258.

Gripper Plus from Deltec

The design of the GRIPPER PLUS® Safety Needle allows the user to de-access the needle in one safe, easy, natural motion. Its unique feature is a safety arm that is lifted to lock the needle into a protected position when removing it from an implanted port. The fingers are placed on each side of the needle base. With the other hand, place a finger on the tip of the safety arm. The safety arm is lifted straight back until it CLICKS into its locked position. The product can then be dropped into a sharps container.

Gripper Plus from Deltec

The Gripper Plus has a cushioned needle platform for greater patient comfort, needle stabilization and protection of the access site. It has a removable contoured grip for controlled needle placement. The clamps are color-coded for needle gauge size identification. For more information on the Gripper Plus click here or call 800 426 2448.

LifeGuard™ Safety Huber needle from Horizon Medical Products (HMP)

LifeGuard's needle trap fully encapsulates the needle upon removal. Compared to traditional Huber needles, Lifeguard is designed for maximum control and safety with minor changes to technique. It provides both visual and audible confirmation of safety. It has colored safety handle for needle gauge confirmation. To remove the needle from the port septum simply raise the needle trap upward to 90°. Lifeguard Safety Huber Needle from HMP

Using non-dominant hand, grasp the safety hinge with thumb and middle finger. Gently push the safety hinge down against the patient's skin and port.

Flip the safety needle towards the needle trap into the safe position. For more information contact Horizon Medical Products at 800-472-5221 or visit their website here.

SURECAN® Safety Huber Needle by B. Braun

Whether you're delivering chemotherapy, antibiotic t Surecan Safety Huber by B. Braun herapy, or parenteral nutrition, the Surecan® Safety Huber Needle's patented safety clip will automatically engage as you withdraw the needle from the base plate.

It is color–coded by size with 19, 20, and 22 gauge needles available. The Surecan® is latex-free to avoid the risk of allergic reaction and DEHP-free for compatibility with chemo drugs and lipids. Enables you to inject medication or withdraw blood from the Y–site with a simple luer connection. The base of the port is stabilized by firmly holding down with the non-dominate hand. The needle is withdrawn by pulling straight out by the hub grip. The safety clip automatically activates covering the needle. For more information click here or call 800-523-9676.

LiftLoc™ Safety Infusion Set manufactured by Specialized Health Products(R) International, Inc and marketed by Bard Access Systems

LiftLoc Safety Infusion Set features a robust shield that is deployed as the needle is withdrawn from the port, effectively reducing the risk of accidental needlesticks, including rebound injuries. A Patient Comfort Pad™ is included with each LiftLoc set, and is designed for patient comfort. The use of the Patient Comfort Pad is optional. LiftLoc’s safety mechanism is easy-to-use and conforms to common user technique. To access simply grasp the wings and lift them. As the wings are lifted up the clinician pulls the LiftLoc from the port while covering the needle.

The LiftLoc Safety Infusion Set is distributed under the SHPI label by Cardinal Health, Medline Industries, Inc., and Physician Sales and Service, Inc. (“PSS”), leading distributors with a strong presence in the oncology, chronic hematology and long-term intravenous nutritional markets. The product line is distributed in the hospital market on a private label basis by Bard Access Systems, Inc., a subsidiary of C.R. Bard, Inc. For more information about the product contact Bard Access Systems, Inc. at 800/545-0890 or go to their website.

LUTHER SAFETY HUBER NEEDLE Protector by Luther Research Partners

The Luther Safety Huber Needle Set is a device intended to administer medications to a patient through a subcutaneously implanted port. This safety device is for use on all Huber needles manufactured from ½ to 1 ½ inch. Luther Safety Huber Needle by Luther Research Partners

The Huber Safety Needle cover is manually activated. It uses a permanent locking tip that renders the sharp portion of the needle inaccessible upon removal of the needle from the implanted port. It has a foam pad for patient comfort. The sure-grip handle is available for easy insertion and removal from even the m Luther Safety Huber Needle by Luther Research Partners ost difficult ports. Simply grab the sure-grip handle and lift the needle from the implanted port septum.

The safety system cannot be defeated or reset. For more information call (714) 434-1564 ext 4 or visit their website here.

Kawasumi Laboratories America, Inc. – K-Shield

Kawasumi America is marketing a new needle safety devi K-shield by Kawasumi America ce designed to protect oncology clinicians from Huber needle stick injuries incurred while removing needles from subcutaneous ports. The device also provides a convenient means for disposing the Huber needle after removal from patients, but does not discomfort the patient at any time, nor does it present any needle movement during the time of infusion. The K-shield ensures safety for the clinician while maintaining maximum patient comfort. When deaccessing the Kawasumi Huber needle from the implanted port, simply lift up and fold the wings down on top of the needle. [kshield.jpg] For more information on this product call 800-KAWASUMI (529-2786) or visit their website here.

TriState - Centurion® HuberGuard™ Safety Device ( Manufactured by Harmac and distributed by TriState Hospital Supply Corporation)

Centurion® HuberGuard(tm) Safety Device provides needlestick prevention when used in conjunction with the Centurion® huber infusion sets for removal and disposal. The low-profile needle is comfortable for the patient and reduces bumping and dislodgement from the port. To deaccess from the port septum the HuberGuard is aligned over top of the Centurion huber needle. The needle is pulled up by the right wing so that the needle is held within the HuberGuard. The needle clicks securely into place providing both tactile and audible safety lock position indicators. The needle is then disposed of in a sharps container. The Centurion HuberGuard is available in sterile or non-sterile configurations. For more information contact Tri-State Hospital Supply Corporation at 517.546.5400 or visit their website here.

Huberloc (Manufactured by MedCare Medical Group, Inc. and Distributed and Marketed through Baxter Healthcare.)

The Huberloc is a safety product that removes the needle from the port and contains it thus eliminating rebound needlestick. It allows the clinician to use the huber needle of their choice. The Huberloc Device also offers a positive pressure flush and lock technique. Because the Huberloc Device enables you to remove a huber needle with one Huberloc marketed by Baxter hand, you can perform a positive pressure flush during decannulation with the other hand.

This simultaneous flush and lock technique helps maintain catheter patency. The Huberloc is designed for compatibility with 19 GA x 1 ½” long and smaller 90° winged huber needles. Simply align the HuberLoc with the needle hub that is opposite of the tubing. The forks of the HuberLoc are slid forward until the needle shaft is all the way to the back of the forks. While pressing down on the top of the HuberLoc with your thumb, pull up on the finger grips with your first two fingers (like syringe motion). This extracts the Huber needle. Continue this motion until the slide "snaps" into its locked position. For more information please phone 888-229-0001 or visit their website here.

Are you aware of additional safety products used with implanted ports? Contact the author at ron@isips.org or 801-280-8797.

Author bio:

Ron Stoker, a frequent contributor to Managing Infection Control magazine, is the Executive Director of ISIPS, the International Sharps Injury Prevention Society. He is a frequent speaker on sharps safety and occupational blood exposure at national and international events. For more information about ISIPS and sharps safety products, visit www.isips.org, or email Mr. Stoker at ron@isips.org.