title: Syringe size: does it matter in physician-performed procedures?
abstract: OBJECTIVE
  We hypothesized that the size of syringe influenced needle control in physician-performed procedures.
  
  
  METHODS
  Operators were tested for their ability to control a 1-, 3-, 5-, 10-, and 20-mL syringe and equivalent sizes of the new safety device, the reciprocating procedure device (RPD), using the quantitative needle-based displacement method. Three hundred twenty clinical syringe procedures were then randomized to either a 3- or 10-mL conventional syringe or to a 3- or 10-mL RPD. Patient pain was measured with the Visual Analog Pain Scale (VAPS).
  
  
  RESULTS
  Increasing syringe size was associated with the undesirable characteristic of unintended forward penetration (loss of control of the needle in the forward direction) (r(2) = 0.97, slope = 2.14, 95% CI: 1.54-2.76, P < 0.002), and unintended retraction (loss of control of the needle in the reverse direction) (r(2) = 0.97, slope 2.15, 95% CI: 1.54-2.76, P < 0.002). In addition, 2-handed operation of a syringe resulted in greater control than 1-handed operation of a syringe (P < 0.001). When 1-handed operation was required, the RPD control syringe reduced unintended penetration by 52.3% (P >or= 0.001), unintended retraction by 56.8% (P >or= 0.001), and patient pain by 54.7% (P >or= 0.001) at each device size.
  
  
  CONCLUSIONS
  For greater safety and control when operating the conventional syringe, smaller syringe sizes and 2 hands instead of 1 hand should be used whenever possible. If 1-handed operation of a syringe is necessary, a safety technology like the RPD control syringe should be used.
authors.affiliation: Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA.
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Michael
authors.forename: Gautam R
authors.initials: GR
authors.lastname: Moorjani
authors.forename: Andres
authors.initials: A
authors.lastname: Peisajovich
authors.forename: Kye S
authors.initials: KS
authors.lastname: Park
authors.forename: Wilmer L
authors.initials: WL
authors.lastname: Sibbitt
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Bankhurst
mesh_terms: D002983:Clinical Competence; D004867:Equipment Design / Q000009:adverse effects; D006801:Humans; D007270:Injections, Intra-Articular / Q000295:instrumentation*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D013594:Syringes / Q000009:adverse effects*