Blood volume and pain perception during finger prick capillary blood sampling: are all safety lancets equal?

OBJECTIVES: This study aimed to assess various types of safety lancets in terms of blood volume and pain perception during capillary blood sampling, a routine finger-puncture procedure for obtaining a small amount of human blood for running various screening and diagnostic tests. METHODS: Data were collected from 100 adult healthy volunteers following finger-puncture procedure. Four different types of safety lancets were tested (Acti-Lance, Prolance, Medlance Plus, and MediSafe Solo). Each type has its own versions, giving 16 different safety lancets in total. RESULTS: A significant difference in the mean capillary blood volume was found between blade and needle equipped safety lancets. MediSafe Solo type lancet had no blade version, and hence its use was associated with the lowest mean collected capillary blood volume (42.4 µL). Acti-Lance and Medlance Plus type lancets had one blade version and the mean collected capillary blood volume was 82.2 and 99.0 µL, respectively. Prolance type lancet had two blade versions, and its use was associated with the highest mean capillary blood volume (118.3 µL). The level of pain intensity was evaluated as low by the majority of patients for all lancets. Medlance Plus was the least painful and Acti-Lance was the most painful type of safety lancet. On a 0-to-10 scale of pain, 75% of punctures were assessed by the participants at a level not exceeding 3 points. CONCLUSIONS: This study suggests that although all investigated safety lancets achieve adequate performance regarding the necessary capillary blood volume to run a diagnostic of test, lancets equipped with blades differ significantly from those equipped with needles in terms of the mean obtained capillary blood volume. Further, although all devices produced relatively low levels of pain, the amount of pain caused by blade versions of safety lancets has been found to be higher than that of needle versions. CLINICALTRIALS.GOV ID: NCT04001348. (https://clinicaltrials.gov/ct2/show/NCT04001348?term=NCT04001348&draw=2&rank=1).

A feature study of innovative high-speed lancing device and safety lancet.

The study developed two models of an innovative high-speed lancing device and safety lancet, where the specially designed structure causes high-speed motion of the lancet, resulting in only one puncture of the skin. The two experimental models and other lancing devices sold on market were compared in order to: (1) measure the forces of lancets piercing animal skin by a load cell; (2) observe the wound areas caused by lancing devices under a microscope. The experimental results showed that, after using this innovative high-speed lancing device, the maximum force of a lancet piercing skin is only 1/3 of the force of conventional lancing devices, and the duration of the former under the skin is 1/6 of the latter. In addition, the wound area caused by the innovative lancing device is 20 % smaller than those of the conventional lancing devices. Usage of this innovative high-speed safety lancet shows that its maximum skin-piercing force is only 2/3 of conventional safety lancets, its duration under the skin is 1/4 of conventional safety lancets, and the wound area is 12 % smaller. In conclusion, both the innovative high-speed lancing device and safety lancet are proved effective in alleviating pain for diabetics and shortening the recovering time for wounds, thus, providing a more comfortable process for the self-monitoring of blood glucose.

Impact of a single safety-engineered device on the occurrence of percutaneous injuries in a general hospital in Brazil.

BACKGROUND: Health care workers are exposed to bloodborne pathogens through occupational injuries, and the replacement of sharps by safety-engineered devices has been recommended as a key preventive measure. This recommendation has been difficult to implement in Brazil. METHODS: We conducted a retrospective study of selected data from a database of blood and body fluid exposures reported from January 2007 through December 2011 in a public general hospital in Rio de Janeiro where, from the end of 2009, a safety lancet for blood glucose testing (BGT) was introduced. A log-binomial model was used to evaluate the effect of the introduction of the safety lancet on the proportion of percutaneous injuries (PIs) during BGT in the nursing staff. RESULTS: Nursing staff had a significant reduction in rate of PIs per 100 full-time equivalents from 2007 to 2011 (P < .001), and medical residents had the highest rate throughout the same period. A reduction of PIs by small-gauge needles was observed since 2009, and injuries during BGT fell abruptly in 2010 and 2011 paralleling the number of purchased safety lancets (P < .001). CONCLUSION: The adoption of a single safety device, which required no training, significantly reduced PIs among the nursing team.

Acidentes perfurocortantes e avaliação do impacto de um dispositivo de segurança para a sua prevenção em um hospital geral terciário do Rio de Janeiro (2001-2011) / Impact of a safety-engineered device on the prevention of percutaneous accidental exposures in a tertiary general hospital in Rio de Janeiro (2001-2011)

Introdução Os trabalhadores da saúde estão expostos a riscos biológicos no exercício da profissão, particularmente os agentes transmitidos por sangue e secreções, através de acidentes perfurocortantes. A maioria dos países implantou normatizações ou leis visando proteger estes profissionais, entre outros através da introdução de dispositivos de segurança. Desde a publicação da NR.32 em novembro 2005, as novas diretrizes vêm sendo implementadas nas unidades de saúde brasileiras, com dificuldades. Objetivos: (1) Principal: Verificar as alterações na incidência e no perfil dos acidentes perfurocortantes após a introdução de dispositivos de segurança (lanceta retrátil e catéteres para punção venosa periférica) no Hospital Federal dos Servidores do Estado a partir de 2009 em relação ao período anterior (2001-2008). (2) Secundários: – Determinar os tipos de acidentes que sofreram redução. - Determinar a(s) categoria(s) profissional (is) beneficiadas pela introdução do(s) dispositivo(s) – Estimar a relação entre os acréscimos de custos devidos à aquisição do(s) dispositivo(s) e a redução teórica das despesas obtida com diminuição dos acidentes. Métodos. Análise retrospectiva de um arquivo contendo os dados dos acidentes biológicos registrados entre janeiro de 2001 e dezembro de 2011 quanto a natureza do acidente, categoria profissional, tempo de profissão, tipo de instrumento, causa e/ou circunstância. Foram comparados os índices ao longo do tempo, particularmente até 2008 e de 2009 a 2011. Estimou-se também, com a ajuda de um modelo teórico, o impacto eventual de uma lanceta retrátil para coleta da glicemia capilar no orçamento da instituição. Resultados. A proporção dos acidentes perfurocortantes diminuiu a partir de 2009 em comparação com o período anterior (P<0,001). Evidenciou-se uma relação inversa entre a média do tempo de experiência dos profissionais e o número absoluto dos acidentes perfurocortantes...

Background Healthcare workers are exposed to bloodborne pathogens through occupationalinjuries and the replacement of sharps by safety-engineered devices has been recommended asa key preventive measure. This recommendation has been difficult to implement in Brazil.Objectives: (1) Primary. To evaluate the impact of safety-engineered devices (SEDs)introduced since 2008, on the profile of percutaneous exposures reported in a tertiary generalhospital in Rio de Janeiro. (2) Secondary. To determine the nature of avoided exposures, theoccupational group(s) benefited by the SEDs and the hypothetical impact of purchasing thedevice(s) on costs for the institution. Methods. Retrospective study of a database of blood andbody fluid exposures reported from January 2001 through December 2011 in a public generalhospital in Rio de Janeiro where, from the end of 2009, along with SEDs for IV usage, asafety lancet for blood glucose testing (BGT) was introduced. A log-Poisson regression modelwas used to determine the effect of selected co-variates on total percutaneous injuries (PIs)and PIs during BGT. The hypothetical impact of purchasing the safety lancet on costs wasalso analyzed. Results. An inverse relation was apparent between average length ofprofessional experience and absolute number of PIs. Nursing staff had a significant reductionin rate of PIs per 100 full-time equivalents from 2007 to 2011 (P<0.001), while medicalresidents had the highest rate throughout the same period...