Risk of needle-stick injuries associated with the use of subdermal needle electrodes during intraoperative neurophysiologic monitoring.

BACKGROUND: Subdermal needle electrodes are commonly used during intraoperative neurophysiologic monitoring (IONM). However, there is an associated risk of needle-stick exposure to the IONM technologist as well as other operating room personnel. We performed a retrospective study to investigate the incidence and circumstances of needle sticks related to the use of subdermal needle electrodes. METHODS: IONM was performed on 50,665 consecutive surgeries with an estimated use of approximately 2,000,000 needle electrodes. Incident reports of needle exposures were analyzed for personnel, location, and circumstances. Associated Worker's Compensation expenses for the technologists were analyzed. RESULTS: There were 174 reported needle-stick exposures (0.34% incidence) occurring during 173 surgeries, which included 75 IONM technologists (43.1%), 38 anesthesia personnel (21.8%), 34 nurses (19.5%), 16 surgeons (9.2%), and 11 other staff (6.3%). No infectious disease transmission was reported. Fifty-seven technologists incurred expenses totaling $24,174 (average $424 per exposure). The cost for non-IONM personnel was not available. Most needle sticks for technologists occurred during the removal of needles (52.0%) and during patient positioning (67.7%) for non-IONM personnel. CONCLUSIONS: Needle-stick exposure from subdermal needle electrodes during IONM is an infrequent but distressing event occurring in 0.34% of our study group and was not limited to the IONM technologist. Although no infections occurred as a result of needle-stick exposure in this study, steps to minimize needle sticks should be taken during IONM.