tag:blogger.com,1999:blog-4968787219619380438.post4756292116897411557..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Are "safety scalpels" safer than standard scalpels?Skeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger16125tag:blogger.com,1999:blog-4968787219619380438.post-23271471895288890592013-11-20T09:48:59.880-05:002013-11-20T09:48:59.880-05:00There was a time when nurses slapped the instrumen...There was a time when nurses slapped the instruments into surgeons' hands. It always worked better with clamps or scissors than with scalpels. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-31226261464077019702013-11-20T08:14:28.120-05:002013-11-20T08:14:28.120-05:00So scrub nurses don't slap the scalpel into th...So scrub nurses don't slap the scalpel into the surgeon's hand? Has Hollywood gotten it wrong for all of these years? I am shocked, shocked!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-26364184741136814652013-11-14T13:02:57.842-05:002013-11-14T13:02:57.842-05:00Anon, I appreciate your clarification of the OSHA ...Anon, I appreciate your clarification of the OSHA standards. I was unable to find any of those references on its website. <br /><br />A single handed scalpel blade remover is not the same as a safety scalpel though. It's a device that removes blades from standard (non-safety) scalpels.<br /><br />The 09/01/2004 reference--does it say safety scalpels MUST be used.<br /><br />And the 6/30/2005 one--does it specifically mandate safety scalpel use? And what is "ECP"?<br /><br />I would like to see links to those items you listed, please.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-39770786191275881902013-11-14T12:41:53.937-05:002013-11-14T12:41:53.937-05:00I really disagree with the statement that safety s...I really disagree with the statement that safety scalpels are not required by OSHA, actually you said the Needlestick Safety and Prevention Act of 2001. OSHA expects safety scalpels to be used in conjunction with work practice controls, as long as patient safety is not compromised. See standard interpretations:<br />• 12/22/2005 - Use of passing trays and single-handed scalpel blade remover in a surgical setting<br />• 09/01/2004 - Limiting factors for implementing the use of engineering controls, i.e., safety scalpels, under the Bloodborne Pathogens standard.<br />• 06/03/2005 - Definition of contaminated sharps; engineering controls and good work practice controls must be implemented; ECP must be reviewed annually. <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-14069877613502649602013-11-14T08:46:41.233-05:002013-11-14T08:46:41.233-05:00First Anon, thanks for the comment. Sorry that you...First Anon, thanks for the comment. Sorry that you suffered an injury from a "safety scalpel." But that is my point (no pun intended).<br /><br />Second Anon, of course, just kidding. I used to wear Kevlar gloves whenever I scrubbed with a gynecologist. :-)<br />Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-30602393777914037802013-11-13T23:53:27.942-05:002013-11-13T23:53:27.942-05:00THis gynecologist enjoys your blog and is certain ...THis gynecologist enjoys your blog and is certain that you and Kor are just joking :)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-27779153711217178012013-11-13T20:54:51.967-05:002013-11-13T20:54:51.967-05:00During my general surgery internship year, I intro...During my general surgery internship year, I introduced a 11 blade "safety" blade right into my index finger as I was doing dialysis catheter. Your point about variance is correct - many of them have different safety mechanisms. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-87711667509594717562013-11-12T21:13:27.208-05:002013-11-12T21:13:27.208-05:00I don't have too much of a problem with today&...I don't have too much of a problem with today's safety scalpels, although I do find them slightly cumbersome. After a while, it's no big deal. <br /><br />I first became acquainted with the hands free passing technique (aka, using a pan or basin) in 1991, on my 3rd year rotation on ortho, of all places (I was assigned to the reconstruction team, if I recall correctly). Back then, when I was only slightly dumber and more ignorant than I am now, I thought it was a pretty ingenuous idea. Who says orthopods aren't good for something?<br /><br />These days, I ask that the scrub just put the scalpel down on the field, even with the safety, and let me pick it up. When I'm done with it, I just set it back down to let the scrub pick it back up. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-2406397266404868252013-11-12T21:04:30.094-05:002013-11-12T21:04:30.094-05:00Clark, good comment. They can say they made a syst...Clark, good comment. They can say they made a system change.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-58967915741565993362013-11-12T17:59:23.251-05:002013-11-12T17:59:23.251-05:00Because it allows an administrator to claim they d...Because it allows an administrator to claim they did something about sharps injuries in the OR.Clark Venablehttps://www.blogger.com/profile/04340887592060781358noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-36143061672937449292013-11-12T15:34:43.668-05:002013-11-12T15:34:43.668-05:00Kor, Yes, they can't be trusted with sharp ins...Kor, Yes, they can't be trusted with sharp instruments.<br /><br />First Anon, good point. They are more expensive.<br /><br />Pam, I was stabbed by a resident once. He swears it was an accident. A safety scalpel wouldn't have helped because it was in the field. I reached for a clamp and he moved the knife into my path. I had a longitudinal tendon injury that sidelined me for 3 weeks.<br /><br />Second Anon, I agree that cleared by the FDA means nothing. I found that many of the safety scalpels do not have the same "feel" as a regular scalpel, which is what the authors of the paper I mentioned in the post found too.<br /><br />Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46030202413007741822013-11-12T15:26:28.496-05:002013-11-12T15:26:28.496-05:00This comment has been removed by the author.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13502429424423514142013-11-12T14:44:44.540-05:002013-11-12T14:44:44.540-05:00The key to actual sharps safety is in the design o...The key to actual sharps safety is in the design on the device. It must be capable of being really used by the real people that it in the real environment of use, and then achieving the desired goal of reducing sharps injuries. This requires ease of use and intuitiveness without adding any new hazards arising directly from trying to operate the sharps feature. It must also be compatible with the original function of the device, i.e. not interfere with the primary purpose. In this regard there is a world of difference between a safety device that could theoretically provide some safety and the ability to actually do so. Note here that the devices currently marketed have been "cleared" by the FDA, not "approved". Clearance requires a much lower standard of proof of safety and efficacy.<br /><br />The same issues arise with needle "safety" devices. Some provide safety and others do not (and some are worse) as demonstrated by the ongoing rate of needlesticks.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-10587252777013779002013-11-12T14:06:26.050-05:002013-11-12T14:06:26.050-05:00at our hospital we still pass sharps in the kidney...at our hospital we still pass sharps in the kidney basin. on the floor/ER we use safety scalpels. I like the safety scalpels with the plastic top that can come off with a easy thumb motion. I've used the box cutter type safety scalpels and they were a little clumsier. The only time I had a scalpel injury was when I was in a rush as a resident doing a central line. This was frustrating because it was a medicine patient and my vascular attending volunteered the surgical resident (me). I was very busy and needed to get it done quickly because I had to rush to the operating room to help with an appendectomy. when I was cleaning up, I forgot about the scalpel and when I rolled up the wrapper/kit to dispose of, I put the non protected 11 blade into the palm of my hand. I saw the blood fill the inside of my glove. I started to cry because it was also my birthday. I'm of the male gender. My lesson? be more careful when rushing on your birthday.pamchenkohttps://www.blogger.com/profile/09133386882298582862noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-31838551611325563952013-11-12T13:52:31.714-05:002013-11-12T13:52:31.714-05:00The "standard" scalpel suppliers don'...The "standard" scalpel suppliers don't have a Washington lobbyist. Take away a 30 cent tool and mandate use of a $2 one, yet another way to siphon "healthcare dollars" away from the actual delivery of healthcare.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-52875072734288747902013-11-12T12:28:50.472-05:002013-11-12T12:28:50.472-05:00Interesting. For a very long time, we used the sha...Interesting. For a very long time, we used the sharps in a kidney dish technique. Only once had a scalpel injury; but that was from a gynaecologist, so it doesn't count!Korhommehttps://www.blogger.com/profile/02290764661952746389noreply@blogger.com