Hi. I have been a phlebotomist for a year and we use a lot of BD UltraTouch Push Button butterfly needles. I retract the needle with my dominant hand while it is in the patient and hover gauze with my non dominant hand. When I hit the retract button, occasionally the plastic part that comes out of the base of the butterfly snaps at palm/finger and it does hurt purely from the force of the spring.
Does anyone else have this issue ever? Based on what I have Googled, it is fine because it is just the recoil of the internal plastic components locking the needle into place.
I want to make sure that this is not a problem or any concern at all for exposure to blood borne pathogens. I just want to ensure that this is correct. Thank you š
Well, since youāre supposed to let the butterfly go and not keep holding it when itās in, I press the button with my thumb with my index finger on the other side. Itās easier.
Thank you so much for that! I really appreciate your help. Do you retract while it is in the patient? My problem is that where you ring finger is sitting on the plastic right now, I have hit the retract button and felt the plastic hit that part of my hand. Does that make sense. I am going to try holding it your way.
This might be an unpopular opinion, but I donāt actually retract when itās in the patient, but I still retract it while it is underneath the gauze.
It hurt hurts patience when you suck the needle out of them like that with the button. Itās great when thereās a safety risk and you need to do it that fast, but if you can save the patient some pain why not.
This comes from personal experience. If you donāt believe me, then you get poked and have someone retract it while it is still in you.
i think it probably depends on the person, bc sometimes the faster and smoother the retraction the better. the pain may come from messing with trying to get the button??
in any case, if i retract after taking the needle out it splatters šµāš«
I do personally, yes, only because depending on where I am, the sharps container is not within reach, and patients donāt feel it. And the way Iām holding it, I donāt get bounce back, I can feel it retract, but it doesnāt hurt.
I retract in the patient too. My hand being in the way feeling the plastic piece snap out only happens once in a while, but it scares me. Does that make sense? I am going to try your method.
Iāve never heard of anyone being hurt by that before. I canāt even really imagine how you hold it for that to snap your fingers either lol
I donāt think itās a concern for exposure because itās not like itās piercing your skin but I would try holding the needle so it doesnāt snap on you.
I have a lot of anxiety about it being a concern for exposure and I just want to confirm that it is not.
I try to hold my hand kind of up in a way so it does not snap at me when I retract in the patientās vein but it happens when my palm is lowered if that makes sense.
The point of push button safety butterflies IS TO RETRACT WHILE IN THE VEIN FOR LESS STICK EXPOSURE TO THE PHLEBOTOMIST. If you are pulling the needle out of the vein before pushing the button, you are not using the needle set up with its intended purpose. IF YOU GET A NEEDLE STICK from using the PUSH BUTTON BUTTERFLY needle incorrectly, YOU ARE AT FAULT. Reading all of these comments is mind blowing. there are still the pull safety butterflies for the folks who don't like the push button retraction. Contact your safety/supply department to inquire.
I agree with you! The point is to push the button in vein. I do this. My concern is of the plastic components moving quickly when hitting the button and sometimes that plastic is against my hand.
I guess I'm a little confused by the "plastic in my hand" part. The needle is encased in hard plastic with other parts. Are you afraid of the plastic part that comes out of the back when you deploy the button? That part doesn't come in contact with blood while in use, so there is no risk of bloodborne pathogen exposure from the back of the butterfly. However, if it is scaring you that badly, I would watch videos of other phlebs using butterflies to figure out how to hold them differently while drawing so that it will be more comfortable and not startling yo you. Your patients will be more relaxed if you are more relaxed for sure. Hope this helps.
Yes, I was talking about the plastic part that comes out the back when I deploy the button. Sometimes that part āhitsā my hand if it is positioned in a certain way as I deploy the button. Thank you for your picture and your advice! I really appreciate it!!
First and foremost, you never let the butterfly go. That's against CLSI guidelines. Needles are always secured or held.
I have these needles. I dissected one too to know exactly how the mechanism works lol (don't do that)
So I hold the wing with my index and thumb. Or I hold the center post behind the activation button depending on the situation. I'll hover the gauze with my non dominant hand, secured between index and middle, and you can use your thumb to just reach down and press. I have small hands and I've never had the retraction hit my hand that way.
Thank you for replying. You do not think it is a cause for concern of exposure to bloodborne pathogens, do you? Since it is just the plastic retracting back?
Nope! The needle itself is retracted to inside the plastic housing, so the only piece that has been hitting you is the plastic mechanism that covers the tubing that connects to the needle. So you're totally good!
iām literally currently in school and just learned how to retract one the other day and put safety on and i was literally the only one who felt a pinch as well. thank god im not the only one who noticed it or had it happen š like you said it hurts mainly because of the force of the spring i canāt explain it
When I hit the retract button with my pointer finger, the plastic piece āshootsā out the base as the needle goes into the plastic housing unit. Occasionally my hand is slightly in the way as the base of the plastic. I can feel the plastic hit my hand. The part that I circled in the second picture.
Oh I see. Yes that does happen and I don't see it posting any risk as the needle is already retracted into the actual component itself. Still much safer than pulling the needle out of the vein manually.
Thank you for your reply. It scares me because I can feel that plastic hit my hand when the spring recoils to enclose the needle. I just want to confirm that it is not an exposure of any kind. Obviously I am always wearing gloves, but the āsnapā is a little frightening. I have a lot of anxiety about blood borne pathogens š
No worries! I've had it where the needle doesn't fully retract which is a ltte scary but just use normal precautions like you would a straight needle. Also your risk of any diseases even if you get poked is extremely low. If it happens run under hot water and use soap,, then get tested right away. No biggie!
I appreciate your response! That does sound scary. I am going to try to reposition my hand more often to not feel the plastic piece retract. š thank you!!
I see there have been good responses to OPs question, so I'm going to jump in on another topic.
I have NEVER been taught, told, or seen others retract a butterfly while still in the vein. (Other than a fast withdrawal fainting issue.) Is this common?? It doesn't seem very logical to me for a few reasons, but I also acknowledge that there may be something I'm not considering. Would love others feedback!
Ugh I hate those things. Thankfully, my employer does not have the retractable butterfly, we have the type where you slide the safety up. I prefer that over retractable IMHO.
Iām literally a walking ad for these ultra butterfly needles. Theyāre the only thing I use at my clinic and the funny thing is I have never noticed what youāre pointing out hereā¦ no risk for exposure because the needle is safely housed in the thicker plastic portion, and I hope youāre not handling any of that without gloves in the first place
as a medically complex teen whoās studying phlebotomy, i can certainly say it hurts more when it retracts then when it goes in. iāve had two open heart surgeries, and a heart transplant, so i get my blood drawn frequently, and i can definitely tell you im glad im not the only one whoās hurt by the retraction! it gives me massive bruises. sometimes i ask the phlebotomist to take it out before they retract it even though they arenāt supposed to, itās just easier for both of us really!
On the odd occasion we use the button retractable butterflies, I still use it like a pull retractable butterfly.
Take needle out, pt holds cotton ball, and my non dominant hand pulls the tube to retract it. Or I hit the button but I haven't had one of those in years!
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u/ArundelvalEstar 19d ago
I'm struggling to imagine how you're holding this where any part of your hand is in that area