The History of Butterfly Needles

When I was a young student learning how to draw blood, I struggled with butterflies quite a bit more than I did with straight needles. I asked my instructor if we had to use them and she told me no—that they were less common than straight needles, and at her workplaces in the past it was rare to have an abundance of butterflies available (a problem which still persists in some places today). She said that they were a newer invention, and that she had always drawn blood using straight needles, or hypodermic needles and syringes, and it wasn’t until the 90s that she started seeing butterflies more commonly. She herself didn’t like them very much.

Her lack of skill and knowledge about butterflies contributed to my own struggles with learning how to utilize them properly for a while. The practice that I did in class was largely unsuccessful and often left my classmates with hematomas. It took longer than I liked for me to get the hang of them, and even longer for me to like them. Now I have mastered my techniques, and I know when to reach for a butterfly, but looking back on my first introductions to them, I was not set up for success the way I should have been.

For several years I believed that butterflies were relatively new equipment, and while I worked on improving my skills with them, I also learned more about their use and their history. I have always been one who wanted to know the history and reasons behind why we do things a certain way. It’s so helpful to understand things. What I learned was that my instructor was incorrect. Butterflies had been around since the 1950s and started to become popular not long after that.

Once I started digging, I realized that the butterfly needle—that tool we reach for dozens of times a week for difficult draws—has a pretty fascinating origin story. More importantly, understanding why it was invented helps us make better decisions about when to use it.

The Problem That Needed Solving

Picture yourself as a phlebotomist in the 1940s. You’re working with hypodermic needles attached to glass syringes – the only option available. An elderly patient comes in with thin, fragile veins. You need to draw from her hand.

You need one hand to hold the syringe steady, one hand to pull back the plunger to create suction, and one hand to stabilize the needle in that delicate vein. But you only have two hands.

So you try to do it all at once. You hold the syringe with one hand, use your thumb to pull the plunger, and hope the needle stays put in the vein. The weight of the glass syringe pulls on the needle. The vein rolls. The patient moves. You’ve lost the vein, and now you have to stick her again.

This wasn’t an occasional problem – it was a daily frustration for anyone working with pediatric patients, geriatric patients, hand veins, or anyone with small or fragile vessels. The straight needle design that worked beautifully on the antecubital veins of healthy adults was failing for a significant portion of patients.

The Butterfly Solution: 1950s

The winged infusion set – what we call a butterfly needle – was developed in the 1950s to solve exactly this problem. And the design is brilliant in its simplicity.

Those wings give you something you never had before: an anchor point. You can stabilize the needle in the vein using just your thumb and forefinger on the wings, leaving your other hand completely free to manage the tube or syringe. Even better, you can tape the wings down for longer procedures, securing the needle so it’s not going anywhere.

The flexible tubing between the needle and the collection device is the other key innovation. Several inches of tubing means the weight and movement of your vacutainer tube or syringe doesn’t transmit directly to the needle sitting in the vein. Less torque on the vein means less trauma, less rolling, and way better success rates on difficult draws.

The name “butterfly” comes from those wings, of course – when you flatten them out, they look like butterfly wings. It’s a much friendlier name than “winged infusion set,” which is what you’ll see on official packaging.

Rapid Adoption in Healthcare

Here’s what surprised me when I researched this: the butterfly didn’t take decades to catch on. The butterfly needle was invented by Dr. John Court in Melbourne, specifically to facilitate intravenous access in pediatric patients, including scalp veins on newborns. An Australian company called Plastalon began commercial production in the late 1950s, and it gained rapid adoption in hospitals worldwide – especially for infant blood collection and short-term IV therapy. It was originally dubbed the “Court needle”, and was a game-changer for pediatric care, minimizing procedural discomfort and dramatically improving success rates on difficult venipuncture.

Major medical device companies like Becton Dickinson quickly incorporated similar winged designs into their product lines, which helped standardize the tool for broader clinical use. By the 1960s and 1970s, butterflies were becoming common equipment in hospitals that could afford them.

So when my instructor told me butterflies were a “newer” invention that she didn’t see much until the 1990s, she wasn’t entirely wrong – she likely just worked in facilities that were slow to adopt them, likely because of cost concerns. The technology had been around for 40 years by the time she started seeing them regularly. It’s a good reminder that adoption of medical technology isn’t uniform – some facilities embrace new tools quickly, while others stick with what’s familiar and economical for much longer.

Why Both Designs Still Exist

So if the butterfly is so great, why do we still use straight needles? Because for many draws, the straight needle is actually the better choice.

Straight needles are faster. Blood flows more quickly through a straight needle because there’s less tubing to fill. When you’re drawing from a good antecubital vein on a cooperative patient and you need five tubes, that time difference adds up.

Straight needles are more economical. They’re cheaper to manufacture, and in high-volume settings where you’re doing hundreds of draws a day, that cost difference matters.

Straight needles work perfectly well for routine draws. If you’ve got a nice, visible median cubital vein on a healthy adult, a straight needle will do the job quickly and efficiently. There’s no need to overcomplicate it.

The butterfly shines when you need control and stability. Hand veins, small or rolling veins, fragile veins, pediatric patients, anxious patients who might move – these are all situations where the butterfly’s design advantages are worth the extra cost and slightly slower flow rate.

Modern Innovations: The Silicone Coating

Here’s something most phlebotomists don’t know: butterfly, hypodermic, and straight needles today are coated with a thin layer of medical-grade silicone lubricant. If you have ever repeatedly used the same needle over and over on a fake arm (because we would never do that to a real person), you can quickly tell the difference after just 2 or 3 pokes. The needle becomes much harder to push in – that’s because the silicone has rubbed off, and the needle has dulled a bit.

This coating reduces friction as the needle passes through the skin and vessel wall. Less friction means less force required for venipuncture, which translates to less trauma for the patient. And here’s where it matters to us: less tissue trauma during insertion should mean less hemolysis.

I haven’t found studies that quantify exactly how much the silicone coating reduces hemolysis rates, but the principle makes sense. Smoother insertion with less tissue damage means less mechanical stress on red blood cells as they flow through the needle.

The coating also helps with patient comfort – a silicone-coated needle glides in more smoothly than an uncoated one, which means less pain at insertion. It’s one of those manufacturing details that makes a real difference but nobody ever thinks about.

Other Modern Refinements

Today’s needles – both straight and butterfly – have thinner walls than their predecessors, which means better internal diameter for the same gauge. A modern 21-gauge needle has more blood flow than a 21-gauge from 50 years ago because the walls are thinner and the internal bore is larger.

Bevel design has also improved with modern manufacturing. Consistent, sharper, more precise bevel angles mean more predictable insertion and less trauma.

And of course, safety engineering. Retractable needles, safety butterflies with shields, needles that automatically retract after use – all designed to dramatically reduce needlestick injuries. These features exist because of the very real risks of bloodborne pathogens, and they’ve made our jobs measurably safer.

The Butterfly’s Real Drawbacks

Before you start reaching for butterflies for every draw, we need to talk about their downsides – and they’re significant.

Cost is a major factor. A butterfly needle costs several times more than a straight needle. I’ve seen pricing where a straight needle runs around 10-15 cents while a butterfly costs 60 cents on the low end, realistically it’s closer to at least $2 or more (sometimes a lot more). In a high-volume lab doing thousands of draws per week, that adds up fast. Using a butterfly when a straight needle would work just fine isn’t being cautious or thorough – it’s being wasteful. Plus, a butterfly that costs a medical facility $2 - $5 will cost the patient 500% or more, which means the patient is paying $25 for that butterfly, rather than 50 cents.

But here’s the one that really concerns me: safety risk. You are more than five times more likely to get an accidental needlestick exposure from a butterfly needle than from a straight needle. Let that sink in for a second. Five times more likely.

Why? That tubing. The same tubing that makes the butterfly so useful for difficult draws also creates more opportunities for exposure. There’s more to handle, more chances for the needle to swing around as you’re disconnecting tubes, more surface area where blood can collect, and more steps in the disposal process. The needle isn’t immediately sheathed after withdrawal the way it can be with some straight needle systems.

Even with safety butterflies that have shields or retraction mechanisms, the risk is higher than with straight needles. You’re handling that exposed needle for longer, and there are more hand movements involved in the process. There are two needles to look out for rather than just one.

This is why I get genuinely frustrated when I see phlebotomists reaching for butterflies out of habit rather than clinical need. Every unnecessary butterfly use is expensive, and an unnecessary exposure risk. If you’ve got a good antecubital vein and no complicating factors, using a butterfly isn’t being “extra careful” – you’re actually putting yourself at higher risk for no clinical benefit.

Making the Right Choice

Understanding the design helps you make better decisions in the moment:

Reach for a straight needle when you’ve got a good vein, a cooperative patient, and no complicating factors. It’ll be faster, more economical, and safer for you.

Reach for a butterfly when the clinical situation demands it – small veins, difficult anatomy, fragile vessels, anxious patients, or situations where you absolutely cannot afford to lose the vein and have to restick. In these cases, the butterfly’s advantages outweigh its higher cost and increased exposure risk.

The butterfly isn’t “better” than the straight needle, and the straight needle isn’t “better” than the butterfly. They’re different tools designed for different situations, and knowing when to use each one is part of being a skilled phlebotomist. But if you’re using butterflies for routine draws on good veins, you’re making your job more expensive and more dangerous without any benefit to your patient.

Why This History Matters

Every tool in your toolkit was designed to solve a specific problem. The butterfly wasn’t created because someone thought wings were cute – it was invented because phlebotomists literally needed a third hand for difficult draws, and the wings provided that stability.

When you understand what problem a tool was designed to solve, you make smarter choices about when to use it. And when you appreciate that the silicone coating you can’t even see was added specifically to reduce patient trauma and improve specimen quality, you realize that even small design details matter.

I think back to my struggles as a student and realize that if my instructor had understood the history and purpose of the butterfly – that it was specifically designed for difficult draws, not routine ones – she might have approached teaching it differently. Maybe we would have practiced proper angles and insertion techniques. Maybe she would have emphasized when NOT to use it as much as when to use it.

Next time you grab a butterfly for a challenging draw, take a second to appreciate that those little wings represent someone’s elegant solution to a real clinical problem. And that extra smooth insertion you just performed? That’s thanks to a microscopic layer of silicone someone engineered to make both your job and your patient’s experience just a little bit better.

But also remember: every time you reach for a butterfly when a straight needle would work, you’re increasing your exposure risk and your facility’s costs without any benefit to anyone. Use the right tool for the right situation.

What’s your experience with butterflies? Were you taught when to use them versus when to stick with straight needles? I’d love to hear how your training compared to mine.

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