What is the best course of action if a Dexcom (Continuous Glucose Monitoring) needle fractures and remains embedded in the arm?

Management of a Broken Dexcom Needle in the Arm

If a Dexcom continuous glucose monitoring needle breaks off and remains embedded in the arm, seek immediate medical attention for proper removal to prevent infection and tissue damage.

Immediate Actions

When a Dexcom needle fractures and remains in the arm:

1. Do not attempt self-removal of the broken needle fragment

   • Even with smaller gauge needles (30-31 gauge), needle tips can become bent to form hooks that can lacerate tissue 1
   • Self-removal attempts may push the fragment deeper or cause additional tissue damage

2. Apply gentle pressure if bleeding occurs

   • Use clean gauze or cloth
   • Do not apply excessive pressure that might push the fragment deeper

3. Keep the area clean and covered

   • Use a sterile bandage if available
   • Avoid touching or manipulating the area

Medical Intervention

Why Professional Removal is Necessary

• Broken needle fragments can:

  • Cause local tissue inflammation and infection
  • Migrate deeper into tissues if not properly removed
  • Create complications if left embedded in the skin

• Medical professionals have:

  • Proper lighting and instruments for visualization
  • Sterile equipment to prevent infection
  • Local anesthesia if needed for comfortable removal
  • Imaging capabilities (ultrasound or X-ray) to locate deeply embedded fragments

Prevention of Future Incidents

Proper Dexcom Device Handling

• Follow manufacturer's instructions precisely for insertion and removal
• Never reuse needles or sensors beyond their intended duration 2
• Inspect the device before and after use for any defects or damage
• Do not bend, break, or manipulate needles during insertion or removal 1

Proper Technique for CGM Removal

• Remove the sensor at approximately the same angle as it was inserted 1
• Avoid using too steep an angle during removal which may cause the needle's cutting edge to break 1
• Do not apply pressure to the puncture site until the needle has been completely removed 1

Common Pitfalls to Avoid

• Delayed medical attention: Even small needle fragments can cause infection or migrate deeper
• Improper self-removal attempts: May cause additional tissue damage or push fragments deeper
• Reusing CGM sensors: Manufacturers recommend single use only; reuse increases risk of needle breakage 2
• Improper disposal: Always dispose of used needles in appropriate puncture-resistant containers 1

Special Considerations

• For patients with diabetes who rely on continuous glucose monitoring, have a backup monitoring plan while seeking medical attention
• If the patient has received heparin or is on anticoagulants, inform medical personnel as this may affect the removal procedure 1
• After removal, monitor the site for signs of infection (redness, swelling, warmth, pain) and seek additional medical attention if these develop

Remember that proper handling and disposal of all needles, including those in CGM systems, is essential to prevent injuries. The American Diabetes Association emphasizes that recapping, bending, or breaking needles increases the risk of needle-stick injury and should be avoided 1.