Recapping means putting the protective cap back onto a cannula that has already been used. It is not permitted in any setting where blood is drawn, and the prohibition is not a recommendation to be weighed against convenience. A pharmacy that takes on a blood draw service takes on this rule with it.
The reason is the geometry of the movement. Recapping deliberately brings a contaminated point and a hand together, at a small target, with the cap held in fingers or braced against a surface. The tip is hidden at the moment of contact and the force is directed towards the holding hand. A slip therefore does not produce a scratch but a puncture from a device that has just been inside a vessel, which is the most serious category of Nadelstichverletzung there is.
What happens instead is the whole of the rule.
- The used cannula goes directly from the puncture site into the Kanülenabwurfbehälter in one movement.
- There is no intermediate station on the tray, in a pocket or on the counter.
- An integrated safety mechanism is activated at the arm before the cannula moves anywhere.
- The container stands within reach of the seat, because a container three metres away is what produces the improvised habits the rule exists to prevent.
TRBA 250 sets out both halves, the ban itself and the equipment that makes working without recapping straightforward.
The objection raised in practice is the one handed technique, scooping the cap from a flat surface with the second hand kept away. It is safer than the two handed version, but it is still not permitted, because no situation requires recapping in the first place. A sharp object that has to go somewhere has a container waiting for it, and one that has to be transported is not carried in a hand.
Skill is not the variable that decides the outcome, because the events that are reported come overwhelmingly from experienced staff working quickly at the end of a long day. An absolute rule needs no judgement at exactly the moment when judgement is worst.
Persönliche Schutzausrüstung is no counterargument either, since gloves reduce the volume of blood transferred but do not stop a cannula. The practical test for a pharmacy is simple, because if a cap is ever put back on, the working position is wrong, and the position gets corrected rather than the person.
This glossary entry is general information about German pharmacy law and practice. It is not legal advice. For binding guidance on your own pharmacy, contact your Landesapothekerkammer.
