Lancets for INR testing

[pellicle]

You haven't run into infection issues or similar reusing the same lancets (assume not, otherwise you would've stopped reuse)?

correct, not in the least. There are single use ones, but I eschew them because it seems like needless waste to me. I follow the following process

1. wash hands
2. lay out my coaguchek
3. cock the lance
4. power on machine (not by pressing M, but the power button on the right)
5. insert strip
6. press M
7. wait with my hands at my side and my rubber band strap in my hand
8. when "strip ready" alarm goes off I wrap, and then lance and apply to strip

HTH

PS; can you imagine how filthy things are which give you deeper scratches in the normal environment? If you are worried about your lance then unscrew the tip (carefully, I've seen breakages from foolhardy operations) and inspect visually. Clean with a cotton bud wetted in isopropyl alcohol sweeping (and rolling the bud stalk gently) from base to tip on at least 3 "sides".

refer again to my above post for shape of lancet

 

[Superman]

Mine are blue with a white tip. Single use and spring loaded. I don’t think I could expose the tip for a photo. I apply pressure, a spring activates the needle, it stabs and then contracts. I throw it away.

 

[Beach77]

@Superman I also use the single use lancets. During the summer my hands are warm enough but when it's cooler, I put my hand under my arm or on my tummy. Then I use the rubber band method (thanks @pellicle ). The times I have problems getting a sample is when my fingers won't get warm enough. With my thyroid problems, my body temperature is low often, sometimes it's challenging getting warm enough. Frustrating! Next, I put the used lancets in a little "hazard" bin.

 

[ATHENS1964]

@Superman I also use the single use lancets. During the summer my hands are warm enough but when it's cooler, I put my hand under my arm or on my tummy. Then I use the rubber band method (thanks @pellicle ). The times I have problems getting a sample is when my fingers won't get warm enough. With my thyroid problems, my body temperature is low often, sometimes it's challenging getting warm enough. Frustrating! Next, I put the used lancets in a little "hazard" bin.

Υou can warm the hands Wrapping my hands around the warm mug .

 

[pellicle]

Mine are blue with a white tip. Single use and spring loaded. I don’t think I could expose the tip for a photo. I apply pressure, a spring activates the needle, it stabs and then contracts. I throw it away.

I tried them when I was starting out. I didn't really like the idea of creating so much waste, and as they didn't work significantly better than my "it came in the box" lance tool I've kept using that.

I'm still on my first bag of lances.

 

[Protimenow]

So a box of 50 lancets will last 8 years or more? By that measure, I probably have enough lancets to last me until I die, assuming I've got less than 30 or 40 years left.

I'm currently using the extraordinarily expensive (about a quarter each) non-reusable lancets. I also have the ones that you use, but seem to be getting better results from the 200 or so of those extravagant lancing devices.

If I outlive these money eaters, or just tire of them, I'll go back to the reusable 21 gauge lancets.

 

[pellicle]

I'm currently using the extraordinarily expensive (about a quarter each) non-reusable lancets. I also have the ones that you use, but seem to be getting better results from the 200 or so of those extravagant lancing devices.

While price wasn't my factor, I just got better results with the ones that fit into my lancing tool that came with my Coaguchek

As always, use what works for you (3rd person infinitive)

 

[ATHENS1964]

I prefer to use a new needle for each use as the instructions say.
Of course, the needles we use for medical reasons have a hole for the medicine to pass through. This hole is very narrow and steam or hot water cannot pass through. The needles that we simply pierced the finger do not have a hole, so it is easier to sterilize.

https://www.healthline.com/health/how-to-sterilize-a-needle#boiling-water-or-steam

 

[pellicle]

I prefer to use a new needle for each use as the instructions say.
Of course, the needles we use for medical reasons have a hole for the medicine to pass through. This hole is very narrow and steam or hot water cannot pass through. The needles that we simply pierced the finger do not have a hole, so it is easier to sterilize.

https://www.healthline.com/health/how-to-sterilize-a-needle#boiling-water-or-steam

Way too much effort when a quick wipe with alcohol would do it.

The instructions are in all probability also aimed at clinics and nursing home situations where protocols are by necessity very different. For a start many diseases are transferred by blood. Hepatitis is a classic.

But as I said I've had no problem, and I'm unlikely to transfer a blood borne disease to myself.

I would never use someone else's kit nor allow anyone else to use mine.

 

[Gail in Ca]

I am surprised to read so many reuse needles for testing. Since I had bacterial endocarditis from a particularly nasty bacteria that lives on the skin of 20% of the population (also in nose, mouth) I wouldn’t even consider reusing the lancet needle! Yikes!

 

[pellicle]

Hi Gail

I am surprised to read so many reuse needles for testing. Since I had bacterial endocarditis from a particularly nasty bacteria that lives on the skin of 20% of the population (also in nose, mouth) I wouldn’t even consider reusing the lancet needle! Yikes!

the issue is that you lance on an extremity right at the most small capillary level. Endo (in the main) comes in via the mouth which has a much shorter pathway to the heart and a FAR WORSE (nay disgusting) flora of bacteria right there. So the risk of infection from a lance is so much smaller than just biting your lip.

I'm not proposing you do it, just giving my reasons for not worrying about it.

Also if you look at the macro pictures of my lance, you'll note how clean it is (although a sharp eye will see a tiny amount of stain on the tip under that magnification). That is despite having been used many times. Lastly, nothing grows on surgical steel without a lot of other supporting tissue or gunk.

If you do gardening then you'll find a rose thorn has way more stuff on it, so a prick with a rose would be far far be worse.

Best Wishes

 

[carolinemc]

I am surprised to read so many reuse needles for testing. Since I had bacterial endocarditis from a particularly nasty bacteria that lives on the skin of 20% of the population (also in nose, mouth) I wouldn’t even consider reusing the lancet needle! Yikes!

There are those diabetics that use the lancets for finger pricks that way also, reuse for a one use. I always use and throw away. Rarely do I reuse unless I need to. Cannot chance infection as well. People are silly.

 

[carolinemc]

Hi Gail

the issue is that you lance on an extremity right at the most small capillary level. Endo (in the main) comes in via the mouth which has a much shorter pathway to the heart and a FAR WORSE (nay disgusting) flora of bacteria right there. So the risk of infection from a lance is so much smaller than just biting your lip.

I'm not proposing you do it, just giving my reasons for not worrying about it.

Also if you look at the macro pictures of my lance, you'll note how clean it is (although a sharp eye will see a tiny amount of stain on the tip under that magnification). That is despite having been used many times. Lastly, nothing grows on surgical steel without a lot of other supporting tissue or gunk.

If you do gardening then you'll find a rose thorn has way more stuff on it, so a prick with a rose would be far far be worse.

Best Wishes

Not for a use once and dispose. Not very sanitary to keep using over and over. Cleaning does not guarantee that it is germ free.

 

[Gail in Ca]

My lancet needles are free, but even if I did pay for them ( I used to pay), I would not reuse one. I was wrong about my bacteria living in the mouth, actually it’s just the nose and skin. I don’t think all BE starts in the mouth. My infectious disease doc said he didn’t know how I got it, even saying maybe a mosquito bite! But, I rarely got a mosquito bite. So, I’m left wondering and occasionally read up about any news on my bacteria.

 

[pellicle]

t my bacteria living in the mouth, actually it’s just the nose and skin

actually the nasal mucosa is continuous with your mouth and saliva often makes its way up into the mucosa

My infectious disease doc said he didn’t know how I got it, even saying maybe a mosquito bite!

I'm sorry, but I really think its time you found another doc ...

 

[carolinemc]

My lancet needles are free, but even if I did pay for them ( I used to pay), I would not reuse one. I was wrong about my bacteria living in the mouth, actually it’s just the nose and skin. I don’t think all BE starts in the mouth. My infectious disease doc said he didn’t know how I got it, even saying maybe a mosquito bite! But, I rarely got a mosquito bite. So, I’m left wondering and occasionally read up about any news on my bacteria.

Bacteria is in the mouth and can travel to the heart and lungs. But with the lancets, you can have other ways of bacterial infection. Good that you do not reuse the lancets.

 

[tom in MO]

actually the nasal mucosa is continuous with your mouth and saliva often makes its way up into the mucosa


I'm sorry, but I really think its time you found another doc ...

Actually Gail's doctor is telling the truth; The source of an infection can be very difficult or impossible to determine after the fact. Seems to me she should stay with the doctor who states when the truth is not fully known. We get told that teeth cleanings are a source of infection but the bacteria in your mouth can be elsewhere. When I asked my doctor how this was known about teeth cleanings, he said that the source of any individual's infection cannot be known with certainty, but statistics shows that there is a relationship between endocarditis and recent teeth cleanings..

On two occasions I've received an infection from wasp stings. I was given two medications, one for the allergic reaction and one for the infection. A coworker fell in the gym and got a mild abrasion that put him in the hospital within 24 hours due to a virulent infection. His whole arm swelled up and the infection spread through his blood. The source of the infection was the gym floor which was not being properly cleaned.

These are the reasons the first thing one does with a wound is clean it. If you reuse lancets, clean them with isopropyl alcohol before and after use.

 

[Gail in Ca]

Well, since I’ve moved to socal from norcal and I haven’t had any need for infectious disease doctors, I hope to never need their services again. When I got BE in 08, I don’t think they had seen many cases of staph lugdunensis, and that was Stanford. They didn’t even know it lived other than skin at that time. The 3 antibiotics I was given initially didn’t kill it.
He was joking when he said maybe a mosquito bite or maybe not joking.
I had no obvious issues at that time.

 

[pellicle]

I hope to never need their services again. When I got BE in 08, I don’t think they had seen many cases of staph lugdunensis,

well that's interesting and you're right, the wouldn't have.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698201/

Staphylococcus lugdunensis (S. lugdunensis) is a coagulase-negative, Gram-positive bacterium that can be isolated as a component of normal skin flora in humans. However, more recently, it has also been documented as a culprit in skin and soft tissue infections. We describe the clinical features of five individuals with S. lugdunensis-associated skin infections. We review the characteristics of other patients that were previously described with this organism as the causative agent of skin infection.​

Looking at more common sources we see from: https://www.researchgate.net/figure...ive-endocarditis-in-73-children_tbl2_14072211

a small study to be sure, note Viridans Strep of which we can look up to be:

The viridans streptococci are most prevalent in the oral cavity but also reside in the upper respiratory tract, the female genital tract, and all regions of the gastrointestinal tract; they also are occasionally found as part of the skin flora.​

as well as:

Viridans streptococci, a diverse group of streptococcal species, are important causes of sepsis and pneumonia in the neutropenic host and sepsis and meningitis in the neonate. The oral mucosa is the most common portal of entry.​

​

bold mine
Looking for other sources of data:

https://www.ncbi.nlm.nih.gov/books/NBK557641/
we get this confirmation
(bold mine, and don't worry about what gram staining means its becoming less and less important (vs DNA))

Etiology​

The vast majority of infectious endocarditis cases stem from gram-positive streptococci, staphylococci, and enterococci infection. Together, these three groups account for 80% to 90% of all cases, with Staphylococcus aureus specifically responsible for around 30% of cases in the developed world.[1] In addition to various streptococci species, other common colonizers of the oropharynx, such as the HACEK organisms (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella) can less frequently be the culprit bacteria.​

So we see the major culprits here so all most common in the mucosa (mouth and nasal) not mosquito.

Best Wishes

 

[Protimenow]

I guess I'll be guilty of past and future waste of single use lancing devices,

I already have them. I've been using them. I seem to have had more success with them.

I'm guilty of waste when I consider that the ones I've used could have been replaced by lancets that can be used hundreds of times.

If I throw away the single use lancets that I already have, instead us using the other lancets (designed for single use, but, as Pellicle and others said, is that these can be used dozens or more times), I'm still being even more wasteful because the single use lancets have ALREADY been bought, and the waste is already there

(Some of my single use lancets are for veterinary purposes -- if these were otherwise destined for testing animals and destined to be thrown away after a single use, am I wasting resources that would otherwise have been disposed of after a single use, and where the choice of using a lancet vs a single use device was probably not an option have actually been a 'waste'?)

If I live long enough to use all of my single use devices (I have a few hundred - many years' worth), maybe I'll revisit the idea of using the 21 gauge lancets. (I tried these with a lancing 'pen' a few years ago, and still found that I prefer the right (21 gauge, appropriate depth). I still have a few hundred of those lancets - THESE will definitely be available after I'm gone if I use each lancet a dozen or more times.