January 06, 2021

Glass ampoule contamination

By Dr. Volker Luibl, MBA, Cytiva

Glass ampoules containing drugs used in patient therapy are the most common cause of occupational injury among healthcare workers, particularly nurses (1).

Glass particles have also been shown to contaminate the ampoules during ampoule breaking. These can then be transferred to the patient by injection (2,3,4). Injected glass particles can travel through the blood vessels and may cause several harmful side effects, including pulmonary thrombi, micro-emboli, (5,6) infusion phlebitis, end-organ granuloma formation and inflammation (7-11).

IV in-line filters offer the advantage of removing inadvertent particulates which would include glass particles (11).



References

  1. Chiannilkulchai N, Kejkornkaew S. A Comparative Study of Ampoule Breaking and Resultant Injury among Registered Nurses. Pacific Rim Int J Nurs Res. 2020;24(1):89-101.
  2. Joo GE, Sohng KY, Park MY. The effect of different methods of intravenous injection on glass particle contamination from ampules. Springerplus. 2016;5:15. Published 2016 Jan 6. doi:10.1186/s40064-015-1632-0.
  3. Caudron E, Tfayli A, Monnier C, Manfait M, Prognon P, Pradeau D. Identification of hematite particles in sealed glass containers for pharmaceutical uses by Raman microspectroscopy. J Pharm Biomed Anal. 2011;54(4):866–868. doi:10.1016/j.jpba.2010.10.023.
  4. Preston ST, Hegadoren K. Glass contamination in parenterally administered medication. J Adv Nurs. 2004;48(3):266-270. doi:10.1111/j.1365-2648.2004.03195.x.
  5. Stehbens WE, Florey HW. The behavior of intravenously injected particles observed in chambers in rabbits’ ears. Q J Exp Physiol. 1960;45: 252-264. doi:10.1113/expphysiol.1960.sp001470.
  6. Lockhart JD. The medical significance of particulate matter in large volume parenteral solutions. Safety of large volume parenteral solutions. National Symposium Proceedings, FDA, Washington, DC. p. 28. 1966.
  7. Garvan JM, Gunner BW. The harmful effects of particles in intravenous fluids. Med J Aust. 1964;2:1-6. doi:10.5694/j.1326-5377.1964.tb114892.x.
  8. Michaels L, Poole RW. Injection granuloma of the buttock. CMAJ. 1964;102:626–628.
  9. Furgang FA. Glass particles in ampoules. Anesthesiology. 1974;41(5):525. doi:10.1097/00000542-197411000-00027.
  10. Bélanger-Annable MC. Long acting neuroleptics: technique for intramuscular injection. Can Nurse. 1985;81(8):41-43.
  11. Shaw NJ, Lyall EGH. Hazards of glass ampoules. Br Med J. 1985;291(6505):1390. doi:10.1136/bmj.291.6506.1390.
  12. Perez M, Décaudin B, Chahla WA, Nelken B, Storme L, Masse M, et al. Effectiveness of in-Line Filters to Completely Remove Particulate Contamination During a Pediatric Multidrug Infusion Protocol. Sci Rep. 2018; 8(1):7714. Published 2018 May 16. doi:10.1038/s41598-018-25602-6.

Author bio

Dr. Volker Luibl, MBA

Dr. Volker Luibl, MBA

Dr. Luibl is a Demand Generation Marketing Manager at Cytiva with knowledge in medical device and clinical science.