2/7/2013
In response to local shot reactions, I know nurses and allergy physicians who will recommend "wiping the needle" between withdrawing from the allergen vial and injecting the patient. Is there any information or tradition supporting this practice? I didn't turn up anything with a literature search. I would also have some concern about the possibility of clean needle sticks and about breakdown of clean technique. Some patients are believers and specifically request a needle wipe.

Similarly, is there any information supporting admixing ("rinsing the syringe") small amounts of diphenhydramine or corticosteroids with the allergen injection in order to help reactions?

Thank you for your inquiry.

I must profess ignorance in that I have never previously heard of either of the two practices ("wiping the needle" or "rinsing the syringe"). My literature search, as yours, was not productive in this regard. Thus, my opinion would be, based upon these observations, that there is no evidence in the literature to support either practice. In addition, I share the concerns expressed in your letter regarding "wiping needles."

In summary, I can find no evidence to support either of the practices that you mentioned, and would be worried about the practice of "wiping the needle" prior to the injection. I really cannot offer any specific advice as to how you should approach the "believers" who specifically request a "needle wipe." Until there is evidence, however, to support either of these techniques, I am afraid there can be no definitive answer as to whether the practices would be helpful.

I hope this information is of help to you, and thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.