Recapping needles

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The text on this page is taken from an informal compilation of opinions of contributors to the online VOLE List. As such, they are not peer reviewed and may contain differences of opinion. Those wishing to contact the list may contact Adrian Smith.

Do you now re-cap a needle? Does anyone have any protocols for safe handling of needles and preventing re-capping?

I’d be particularly interested if you’re using needle blocks or Luer lock syringes.

I try to follow this myself, but sometimes it's tricky. For example when you are handling a venous catheter and you have to secure it in place. I try to have the best set-up with a bin next to me and an assistant, but with still not 100% success. Is there evidence for the number of needle stick injuries caused by recapping? I guess there must be, for it to be such a heinous crime. I’ve been a vet for 32 years and recapped every needle before disposing of it in a needle bin for fear of someone giving themselves an injury, and never had a problem. Have others found this an issue?

The University I attended decided it was to become a bad idea to recap needles, due to health and safety perceiving a risk of needlestick injuries, and doing so would mean you failed your exam! Therefore, I think that removing the needle from the syringe using the part on the lid of the sharps box designed for such a feat, is the safe way to do it.  I always recapped needles in practice though, as you aren't really next to a sharps bin when dealing with large animals, and I've been stabbed more often when the cap falls off in my pocket due to not securely recapping!

In my opinion it really depends on the situation, the person and the substance. We teach scientists in laboratory animal science courses. Vets or MD have a long experience with the use of needles. But some scientists have less experience with this. We teach to not recap if they plan to inject in the next 1-2 minutes. To avoid to touch the tip of the needle with anything, making it less sharp. If they plan to inject later, we recommend to re-cap the needle to avoid contamination. After injection we recommend to use a medibox to dispose of needles. No need to re-cap with medibox.

Last point: if the substance to be injected is considered as hazardous (for example, carcinogens), never re-cap.

No fixed rules, safety first and common sense.

I always prefer using a sharp box. Recapping sometimes ended in stabbing my finger when in a hurry.

Fine if you have a needle disposal box close by, if not there is far more chance of a sharps injury. Perhaps I need to change the protocol and have a box close by at all times, but habits of 33 years say the boxes are in one place and the animals in another. Recap always.

I can't recall stabbing myself in the 30+ years I used syringes, but if I had to recap I always did one of two things:

1. put the cap down and then "fished it up" with the needle (making sure afterwards that it was locked on), or

2. (in the very few cases where there was nowhere to put the cap down) making sure that my fists made contact with each other first, and then rotating my wrists to ease the cap onto the needle in a totally controlled fashion. That had the advantage that if you were kicked by something, your hands moved together - no risk of stabbing yourself.

I've seen some horrifying footage on TV of the way in which medical personnel stick needles into vaccine bottles. Lucky their patients don't put up a fight...

I agree. In my 35 years as a practising vet as well as a lab vet and scientist, I may have stabbed myself couple of times. One has to be careful but I believe there is no harm in re-capping, especially if you are working in an unfamiliar place. Footage of recent Covid-19 vaccination procedure in human is questionable, when in general practice (at least at my practice), the needle that is used to pierce the vaccine vial is not used for injecting. These days with covid restrictions, clients are not allowed to come inside the consulting rooms. Hence most vaccinations or injections are done in the reception area. Therefore, recapping needle after filling the syringe is essential.

What a bunch of dinosaurs! Stop grumbling and get over it! It shouldn't be beyond peoples' wits to work out safe working practices.

Please don’t re-cap needles. Ever.

3 reasons:

  1. There’s the basic danger of needle stick injury, so safety first and straight into sharps bin after use.
  2. Besides the sharps injury, what was in that needle anyway- your reagent? tumour cells? biologicals? blood or contaminants? Again, safe working processes, particularly in the research environment, would say always dispose directly to sharps bin.
  3. And of course, a needle is only used once, so if you’re injecting the next animal in a minute, you’ll be using a new, sterile needle anyway (the previous one is disposed of without any need to re-cap it.

When preparing an injection, if not carrying out the procedure immediately, then needle (cap) blocks are useful, as this prevents your fingers being anywhere close to the dangerous end. Sometimes it just needs a bit of a look at the workflow and how to organise the workspace too, to ensure that needles, animal, reagent and disposal are all handy to use.

I too subscribe to the do-not-recap school!

From our Occupational Health and Safety organisation records, it is evident that accidents associated with the use of needles covers a large percentage, and that before re-capping was 'prohibited' this procedure accounted for too many of these.

As a colleague writes: “what was in that needle anyway”. Some years ago a technician ‘poked’ (not injected) herself with a needle which had contained Freunds Incomplete Adjuvant, resulting in a granuloma that caused her chronic pain in the thumb. Also, when working with biological/human samples, you don’t always know the status in terms of e.g. HIV, hepatitis etc.

Naturally, you can take precautions working with hazardous material.

But I also think that we have to take into account the ‘we’ (the ones with +/- 30 years of experience) act as (negative) role models for our younger colleagues. They see what we do, - and think “I can do that too”.