As a patient, when I go in to get my blood drawn, I have the anxieties and fears that most normally feel. Even as someone who understands the collection process and subsequent testing, it’s human nature to be nervous when having any type of medical procedure performed. Something most do not consider, however, is the fear and anxiety that the phlebotomist, nurse or laboratory technician who is drawing the blood may be feeling. Healthcare workers are at risk of biohazardous exposure daily and, in the wake of infectious diseases that can result in global pandemics, protection from this exposure is even more important. In the worst case, unanticipated patient movement or a combative patient may cause a needlestick injury to the person collecting. But what about the much less obvious risk of blood splatter? It’s important to understand all risks in order to put the appropriate protection in place. So, what exactly are the risks of blood splatter and how is the healthcare system working to minimize it?
Over the years, legislation such as the Needlestick Safety & Prevention Act and the Bloodborne Pathogen Standard has been put into place to decrease exposure risk, resulting in safety-engineered collection devices becoming mainstream. Prior to these changes, it was not uncommon for needles to carry no additional safety measures to protect healthcare workers and ensure the used needle was shielded when collection was completed. The rates of infection reflected this and, thankfully, have been significantly reduced with the introduction of safety devices.
While there have been several studies focused on needlestick injuries and the efficacy of safety engineered devices, there have been few on the potential for exposure through splatter when using these devices, though equally important. Splatter presents a real danger since it is known that infection can occur if mucous membranes are exposed to even minute amounts of blood. Most users may not even be aware that splatter or aerosolization has occurred and would not seek prophylaxis to prevent potential infection as a result. This would mean that they may not even be aware of a deadly infection taking hold in their body.
Though methods for assessing splatter may differ slightly, there have been studies that demonstrate visible and/or measurable splatter from use and activation of safety devices. One such study looked at retractable phlebotomy and intravascular devices and showed both measurable and visible splatter with a winged collection device.1 Studies since have taken this type of evaluation further looking at specific devices and the mechanism of activation.2
So, what does this tell us about the risks that phlebotomists and lab techs face every day from this potential for exposure that is often unrecognized? Because healthcare personnel must be aware of all avenues of exposure in order to take the necessary precautions, it is extremely important that use of safety devices meant to protect them does not create an additional risk of infection. Picking the safest device for use should not only include consideration of reduction in needlestick injuries but also assessment of splatter and review of studies such as those cited here to properly evaluate performance. Additionally, especially with devices associated with greater incidence of splatter, the appropriate protective equipment, e.g. face shields or googles, gowns, etc., should be utilized to prevent exposure and potential infection from bloodborne pathogens.
In summary, it is crucial that healthcare employees are equipped with the appropriate safety equipment when dealing with the potential for biohazardous exposure, that they understand the impact of the products being used and how these products can either help or hinder protection from bloodborne pathogens.
- Haiduven DJ, Applegarth SP, Shroff MP. (2009). An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices. Am J Infect Control 37(2); 127-130.
- Haiduven DJ, McGuire-Wolfe C, Applegarth SP. (2012). Contribution of a winged phlebotomy device design to blood splatter. Infect Control Hosp Epidemiol 33(11); 1069-1076.
-Michelle McLean, MS, MT(ASCP), BS is currently the Scientific Affairs Manager for Greiner Bio-One Preanalytics in North America. In this role, she is responsible for new product development and associated clinical studies, defining appropriate device application and developing technical and educational materials to support the preanalytic product portfolio. She is a Medical Technologist with an additional Bachelor of Science Degree in Biology and a Master of Science Degree in Pharmacology & Physiology.
-Mackenzie Farone is a Senior Manager of Corporate Communications, Greiner Bio-One North America