Friday, February 21, 2020

The Disappearance of Needle Stylets

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A thing of beauty is a joy forever. A stylet at home in the bevel of a needle



New fangled disposable injection needles with their cheap looking plastic syringes were just beginning to show up on wards at the beginning of my nursing journey. I just love that "journey" vernacular so common in today's healthcare lingo. See, I can talk just like a whippersnappern if I try really hard.  Anyhow, old school nurses had lots of laments about disposable equipment of any permutation because it  went against the grain. We were taught to reuse just about everything. Throwing away Monoject disposable syringes was bad, but the elimination of stylets was even worse.

Reusable injection needles always had a stylet running the length of the needle bore that terminated at the beveled business end of the needle. Whippersnapperns might start out their day by logging on to a computer, but their predecessors started out by sharpening injection needles. The stylet was a vital component to reusable needle maintenance and sharpening. Ramrodding a stylet through the needle served to clean the bore of any residual debris. When sharpening was completed the stylet served to clear the needle bore of any residual micro shards from the grinding process.

Stylets also served as a template to maintain the appropriate angle of the needle bevel during the sharpening operation. Minimalist minded nurses could sharpen a dulled needle on an ever present match book striker. Needle sharpening was one of those rare instances when a nurse was off her feet and the matchbook was a cue for a quick smoke. Smoking and sharpening needles went together like peanut butter and jelly. Mechanical devices for needle sharpening were most commonly hand cranked gizmos where the bevel of the needle was rocked back and forth by a cam while pressed against a rotating wheel all the while an indwelling stylet maintained the bevel angle.
Every nurse's station needs a needle sharpener

Biopsy needles with their very shallow bevel always have a stylet as a stiffening mechanism and as a control over the cored tissue sample. When sampling liver tissue from an obese patient the stylet is left fully engaged during it's journey (oops..here I go again with that "J" word) through the subcutaneous tissue. When the final liver destination is reached the stylus is withdrawn to snatch a core of tissue. Stylets are also needed to expel the cored tissue from the biopsy needle.

When performing spinal taps or removing fluid from a body cavity, the stylet is also necessary to control the flow of fluid. No stop cock can halt the flow of fluid through the lumen of a needle like a trusty stylet.

Inventive nurses discovered that stylets have  unintended uses that have loads of utility. When the hinge screw mysteriously disappeared  from my ever present eyeglasses a quick fix was needed. I discovered that a stylet from an 18 gauge needle was the perfect diameter to fit the void left by the missing screw. With the stylet in place, it was a simple matter to bend it in the shape of a horseshoe with a needle holder. A perfect fix. It was also common knowledge that a stylet was the perfect instrument to pierce ear lobes for those nurses that liked to decorate themselves with earrings.

It's nice to know that stylets have survived into the present age with spinal tap and biopsy needles, but once upon a time every needle worth it's jab had a stylet.

4 comments:

  1. I'm an OldfooletteRN and we used to sterilize our reusable needles in a saucepan atop the stove in our break room. While pouring a cup of hot water for a cup of instant coffee a needle unexpectedly popped out of the pan into my cup. I discovered that stylets make excellent stirring rods for mixing hot beverages.

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  2. Tongue depressors with their adequate surface area were my favorite coffee stirrers. Stylets were much more versatile.

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  3. Reminds me of a time when one of my mares had retained a placenta too long and after the oxytocin helped expel it I had to put her on penicillin for a few days. The bad part was that I only had two syringes and needles big enough to do the job (two 30cc doses twice a day). I had to boil the needles and after about two days she resented me stabbing her with dull needles. Wish I would have had a sharpener and stylet then. Actually, a 16 penny nail would have been about the right size stylet. Maybe that's a slight exaggeration.

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  4. Veterinary medicine is something else. I remember seeing an OR table for a horse and wondering what the surgical instruments looked like. A fork lift might be more suitable than a scrub nurse!

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