Safe Injection Practices: Establishing the Habit in Residency

Categories: Healthcare-associated infections, Injection Safety

December 8th, 2014 10:00 am ET - DHQP

Aaron Rich Ducoffe, MD

Guest Author: Aaron R. Ducoffe, MD
US Department of Health and Human Services

In my first few weeks as a Health Policy and Quality Fellow, I immediately became intrigued with the CDC’s One & Only Campaign

and its applicability to my former and upcoming planned specialties.

I have learned in residency that a physician’s best and worst habits develop during training. Therefore, even in the midst of a chaotic hospital day, it is crucial that I maintain a mental checklist for every procedure, especially injections.

A frequent encounter concerns the lidocaine vial. Last year, I performed countless lidocaine injections in the ER for suturing wounds and hematoma blocks for fracture reduction. If the vial was multi-use, I always ensured it was stored appropriately – out of the ER bays in a safe, clean area, avoiding the ever-present improperly stored “leftover” vial. Continuing down the checklist, I always utilized sterile needles and syringes as well as proper aseptic technique for both drawing and injecting the lidocaine. These practices are not only important for subcutaneous injections, but even more so for intra-articular aspirations and injections, vascular access, and at the depths of other interventional procedures often requiring a sterile IR suite, such as spinal injections

[PDF – 1.35 MB]

The importance of safe injections and proper sterile technique in general has been repeatedly underscored by the ongoing danger of emerging and re-emerging infectious pathogens. With the worldwide rise of resistant organisms, as well as the recent and worst Ebola outbreak to date (which on a historical note had documented syringe and needle re-use as a risk factor in the1976 outbreak in Zaire

), safe injection practices have never been more important from a preventive standpoint.

I hope to increase awareness from the Campaign to young physicians and the general public – bridging the gap between policy and clinical practice and making safe injection practices a good habit for all physicians as they advance in their professional careers.