Surgical pearl: A simple means of disarming the "locked and loaded" needle

Abstract

Background: Surgery, in any setting, has several inherent risks not only to the patient, but the physician and his assistants as well. Safe handling and management of the sharps to prevent inoculation injuries is one of these risks, in particular: 1) instrument hand-off of the needle and needle driver between the physician and his assistants; 2) retrieval of instruments from the surgical tray. Objective: The authors' review a simple means of disarming the needle loaded in the needle driver to reduce sharps injury. Methods: Before the needle and needle driver are either handed off to the assistant or returned to the surgical tray, pivot the needle 90 degrees toward the instrument joint. The needle's point should be directed toward and touching the needle driver, and thereby, disarming the needle. To avoid dulling the needle, the point should not be grasped by the needle driver. Conclusions: Disarming the loaded needle may reduce the chance of sharps injury during instrument hand off and retrieving instruments from the surgical tray. © 2008 International Society of Dermatology.