Contribution of a Winged Phlebotomy Device Design to Blood Splatter

Background: There has been a proliferation of devices with engineered sharps injury protection (ESIP) for phlebotomy. A previous study of phlebotomy devices demonstrated that one winged model had the potential to produce blood splatter during activation of the safety feature. The impact of the varying winged device designs on blood splatter during the venipuncture procedure has not been explored.

Objective: The primary objective of this study was to evaluate the blood splatter potential of six different designs of winged phlebotomy devices. A secondary objective was to identify device designs which increase the likelihood for occupational blood exposures. 

Methods: A laboratory-based experiment assessing blood splatter was conducted using a vascular system with simulated veins containing mock venous blood. A total of 18 devices, representing six device designs (A-F), were tested. Scientific filters were positioned around the devices and weighed with an analytical scale, both before and after the venipuncture. The presence or absence of visible blood on exam gloves and devices, and the incidence of measurable blood splatter, were the primary units of analysis. Data were analyzed using descriptive statistics and complementary log-log transformation models. 

Results: The percentages of devices and gloves with visible blood in addition to filters with measurable blood splatter among the six device designs ranged from 0-20%. Overall, there was a statistically significant association between device design and visible blood on the device (p< 0.0001), and between device design and filters with measurable blood splatter (p<0.0001), but not between device design and visible blood on gloves. Designs B & C were associated with the highest frequency of visible blood on device but only Design C had the highest incidence of measurable blood splatter. Designs A, D, E & F had little to no incidence of any of the three blood parameters. In addition, a wide range of associations between device design and visible blood on gloves/device, as well as blood splatter incidence, were demonstrated when comparing designs.  

Conclusions: Data from this experiment illustrate that the design of winged phlebotomy devices with ESIP can contribute to the likelihood of blood splatter during the venipuncture procedure. Blood splatter has important implications for the occupational safety of healthcare workers as well as to other individuals in the immediate vicinity of the venipuncture procedure (ancillary personnel, volunteers, family members). It is recommended that future studies focus on evaluating additional designs of intravascular devices (intravenous catheters, other phlebotomy devices) for blood splatter.