The Association of Paediatric Anaesthetists of Great Britain and Ireland publish guidance on the use of safety cannulae


Intravenous news: The Association of Paediatric Anaesthetists of Great Britain and Ireland report “The Health and Safety Executive (HSE) has published its guidance to employers and employees on the ‘Sharp Instruments in Healthcare regulation 2013’. This regulation is based on European Directive 2010/32/EU and comes into force on 11th May 2013. The full directive is available free at and the most relevant section is on page 2.

Following the membership survey, APAGBI submitted evidence to the HSE, which it took account of in its deliberations. In particular, we said: “To summarise, the APAGBI is strongly of the opinion that there is a significant potential to cause both harm and distress in children if the standard cannula is totally withdrawn at the present time”.

The relevant final advice of the directive requires employers to “substitute traditional, unprotected medical sharps, where it is “reasonably practical” to do so”. There is no compulsion to use safer sharps and there is a specific comment that the use of safer sharps “should not compromise patient care” and that “ease of use” should be considered.

From our membership survey, 75% of you were not sure whether the use of safer sharps would be compulsory (it is not). 56.7% of you currently have both types available and 63.2% of you have cannulated over 20 veins using the safety cannula. 39.6% of you consider that they are harder to insert, even in good veins, although 57.5% think they are no different. Only 2.9% consider they are easier to insert. The most striking finding was that, even though many of you are experienced with using safety cannulae, 79.8% consider they are harder to insert in ‘difficult veins’. There were several comments to the effect that the enforced use of safety cannulae would result in more cannulation attempts. We think this is adequate evidence that the exclusive use of safety cannlae may significantly compromise patient care and is highly likely to cause distress in children. We are happy for you to present this information as evidence to ensure that standard cannulae are not withdrawn in your institution, should you wish to do so.”

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