Glass micro-particulate contamination of intravenous drugs – should we be using filter needles?

Journal article

The universal use of filter needles in the aspiration of all medications from glass ampoules for intravenous administration has been recommended due to safety concerns surrounding possible inadvertent injection of glass micro-particulate created from snapping open ampoules. Implementing this would involve significant costs. This article aims to review the relevant literature to evaluate whether sufficient evidence for patient harm due to glass micro-particulate contamination exists to justify the universal introduction of filter needles for the aspiration of medications from glass ampoules for intravenous administration.
Methods: A search of OVID Medline, TRIP, Embase and Google Scholar databases was conducted with a wide variety of terms with no limitation on publication date. Papers addressing the research question were included in the review.
Results: Contamination of drugs by glass micro-particulates does occur with aspiration from glass ampoules. Pathological changes such as granuloma formation, embolic or thrombotic events may occur if these are injected intravenously. There is, however, a lack of evidence of consequent clinical harm in humans.
Conclusion: A recommendation for the universal introduction of filter needles for aspiration of drugs from glass ampoules for intravenous administration cannot be justified on the basis of the paucity of available evidence showing harm and in light of the significant cost of this recommendation. Concerns regarding the lack of studies demonstrating that particle contamination poses no threat remain valid from a perspective of total patient safety.

Authors: Fry, L

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: AMSJ
• Journal: Australian Medical Student Journal
• Volume: 6
• Issue: 1
• Pages: 20-22
• Publication date: 2015-09-01
• Acceptance date: 2014-09-21
• EISSN: 1837-1728
• ISSN: 1837-171X
• Keywords: SBTMR