We have probably all had the opportunity to be pricked by an epicranial needle, or epicranial device, whether it is for a blood test or an infusion in the hospital. But it is unlikely that we knew his name then …

The epicranial are these small very short needles equipped with fins that make you think of butterfly wings. Unlike conventional syringes, they are not attached to a rigid tube enclosing a plunger, but connected to a long flexible tubing.

Composition

The epicranial device is made up of 5 elements:

• the needle: it is short (10 to 25 mm), very fine (diameter from 0,5 to 1,1 mm), made of stainless steel, covered with silicone and triply bevelled at the end to facilitate its penetration through the skin;
• the needle sheath;
• a plastic base on which the needle is fixed, the two wide and flexible fins allowing the gripping and handling of the device and the needle safety system;
• a 30 cm long PVC tubing resistant to kinking and always returning to its original shape;
• a diaphragm or locking cap fitting that fits the Luer Lock infusion system or Vacutainer collection system.

The device is sterile and individually wrapped. It can be used both at home and in the hospital.

Epicranial devices have two uses: intravenous injection and biological sampling.

Intravenous injection

Epicranial microperfusers are used to give short-lasting peripheral intravenous infusions. This technique makes it possible to parenterally administer physiological solutions, drugs, solutes (glucose, potassium, sodium) or products derived from the blood. The infusion can be done continuously or drip.

The epicranials can also be used for discontinuous but repeated injections, without having to transplant the patient each time, which allows to respect his venous capital.

In some cases, the insertion of the epicranial in the peripheral way is impossible. In this case, the infusion is done by central venous route, a much more complex technique to perform.

Biological sampling

To take biological samples from people with weakened veins, and to avoid damaging said veins or collapsing them, an epicranial can be chosen.

The stages of operation

For a direct debit

• Place the tourniquet upstream of the sampling site (on the arm for sampling from the inside of the elbow) after having identified a “good” vein;
• patient’s skin antisepsis;
• firm holding of the epicranial needle by tightening the two fins against each other and penetrating accurately tangentially to the vein;
• as soon as the needle is placed, the 1st collection tube is clipped into the Vacutainer by piercing the stopper;
• blood begins to flow into the 1st tube;
• the tourniquet is removed;
• as soon as the 1st tube is filled, it is withdrawn and the 2nd is put in place, and so on;
• when the sample is finished, the needle securing system is released and positioned above it;
• the needle is withdrawn and secured: a “click” is then heard;
• firm pressure is maintained on the puncture site for a few seconds, then a bandage is applied to it;
• the waste is discarded in a sharps sharps contaminated waste container.

For an infusion

The use of epicranials to make infusions is mainly reserved for ambulatory infusions (of short duration) or for veins with difficult access.

The handling for inserting and removing the needle is the same as for the sample above. The infusion will be administered through a Luer Lock infusion system.

Choosing the right needle

Several criteria guide the choice of the needle diameter: the size of the patient (for children the thinnest needles are chosen), the viscosity of the product to be infused and the condition of the patient’s veins.

A color code, in accordance with the ISO 6009 standard, facilitates the identification of needles:

• orange : 0,5 x 19 mm; 25G ;
• blue: 0.6 x 19 mm; 23 G;
• noire : 0,7 x 19 mm; 22G ;
• green: 0,8 x 19 mm; 21 G;
• beige : 1,1 x 19 mm; 19G.

G stands for gauge, an English unit of measurement characterizing the external diameter of the needle: the larger the gauge, the thinner the needle.

The sale of epicranial devices is restricted to medical professionals.

The epicranials are individually packaged. They are sold individually, or in boxes of 25, 50, 100… They must comply with European standards (medical device with CE marking).