Risk of Needle-Stick Injuries Associated With the Use of Subdermal Needle Electrodes During Intraoperative Neurophysiologic Monitoring

Abstract

Needle-stick exposure from subdermal needle electrodes during IONM is an infrequent but distressing event occurring in 0.34% of our study group and was not limited to the IONM technologist. Although no infections occurred as a result of needle-stick exposure in this study, steps to minimize needle sticks should be taken during IONM.

Sharps Injuries Related to Subdermal Needles in the Orbicularis Oris During Intraoperative Neurophysiologic Monitoring

“…Regarding sharps injuries from IONM needles not specifically attributed to those in OO, our annual sharps injuries incidence (0.3%-0.5%) is on par with that published in the literature. 5 Strikingly, this rate did not appreciably change over the 3 years evaluated; even during the year with a significant number of additional sharps injuries from needles in OO, the incidences of sharps injuries NOT including those from OO was still 0.5%. Our technologists use a variety of safety measures to prevent sharps injuries, such placing corkscrew electrodes for the scalp, covering needles with specially labeled tape (NeedleTape; Marea Enterprises, Inc, Agoura Hills, CA), and warning other staff members of the presence of needles before patient positioning.…”

“…Although it is somewhat difficult to study, rates of sharps injuries NOT reported to occupational health have been estimated to range from 18.5% to 95%. 5 At one institution, surgical techs and OR nurses most frequently reported every sharps injury they sustained, whereas surgical residents least frequently reported injuries. 2 Several studies have found that a "time-consuming process" and perception of a "low-risk" incident were barriers to reporting sharps injuries.…”

“…4 All of these techniques typically use sharp electrodes (either standard straight subdermal needle electrodes or “corkscrew” subdermal electrodes), and any particular case may have between 10 and 60 electrodes. 5 However, little is known about the incidence and nature of sharps injuries caused by subdermal IONM needles. Limited literature suggests that the primary time for needlesticks is during patient positioning, 5,6 and the most frequent location of needle placement in the patient is in the wrist/hand.…”

The use of thyroid cartilage needle electrodes in intraoperative neuromonitoring during thyroidectomy: Case–control study

“…In this study, no needle‐related complications occurred during IONM. Notably, a risk for needle‐stick injury exists in the use of needle electrodes during IONM 20 …”

“…Notably, a risk for needle-stick injury exists in the use of needle electrodes during IONM. 20 This study has several limitations including the following: its retrospective nature, lack of external branch of superior laryngeal nerve (EBSLN) data, and the comparison of two different recording-side systems applied in different patients. For more confident and accurate results, a study could be designed to use two different recording-side systems in the same patient.…”