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Standards Update: Securing Butterflies

by Dennis Ernst • July 06, 2017

The newly revised venipuncture standard released by the Clinical and Laboratory Standards Institute in April, 2017 is the most comprehensive revision in the document's history. With over 140 new mandates, facilities have a lot of changes to implement. This series discusses one or more substantive changes each month.

GP41_cover_200wDo you let go of a winged blood collection set (butterfly) after you insert it into the vein? If so, you'll have to change your ways. One of the many new provisions of the new CLSI venipuncture standard is to keep butterfly needles secure throughout the procedure. 

A beveled needle is like a scalpel. It slices whatever it comes in contact with. Because winged blood collection sets tend to flop around when released, the needle can damage the vein when the user lets go of it after insertion. The standard, however, doesn't insist users hold it in place, though. Maintaining its position can be accomplished by taping it to the patient's skin during the procedure. 

"The decision to secure butterfly devices during the draw was not made in a vacuum, no pun intended" says Dennis J. Ernst MT(ASCP), NCPT(NCCT), who chaired the revision. "The committee included representatives from three of the largest manufacturers of winged blood collection sets who were all in agreement."

To comply with the provision, users who hold the device in place with one hand can operate an attached syringe with their free hand. If a tube holder is attached, users can exchange tubes single-handedly with little practice. Alternatively, taping it in place meets the requirement.

Readers are urged to obtain their own copy of the standard as soon as possible and begin implementing all new provisions as soon as possible. The document Collection of Diagnostic Venous Blood Specimens (GP41-A7), is the standard to which all facilities will be held if a patient is injured during the procedure or suffers from the consequences of an improperly performed venipuncture.

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