universal safety (health) precautions

8/12/2019 Universal Safety (Health) Precautions

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UNIVERSAL HEALTH

PRECAUTIONS and

BiohazardsTo Health Care

Workers

Dr.T.V.Rao MD


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What are Universal Precautions

Universal precaution are control

guidelines designed to protect workers

from exposure to Diseases spread by

Blood and other Body fluids.

CDC


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Why Universal health

Precautions.

The concept of Universal Health Precautions

emphasizes that all our patients should be

treated as though they have potential

blood born infections, and can infect the

caring health care workers. ( CDC )


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Human materials/Tissues

considered Highly Infectious

1 Blood

2 Semen

3 Vaginal secretions 4 C S F

5 Synovil fluids

6 Amniotic fluid 7 All other body fluids


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Not Infectious unless

contaminated with Blood or Body

fluids. Feces, Nasal secretions,

Sputum, Sweat,

Tears,

Urine / Vomitus, Saliva unless blood stained.


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How to Wash our hands


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Indications for Hand Washing

In prolonged contact with patient.

Before taking care of Immune supressed,New

born infants, patients in ICU / ICCU, Dialysis

Units, Burns Units. Before and after touching wounds.

When Microbial contamination of Hands, likely to

occur when in contact with mucous membranes,body fluids, and other secretions contaminated

with Blood, and serous fluids.


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What to be used for hand washing

In most circumstances Non medicated soapsand detergents are effective in removing most

transient contaminants. In demanding circumstances, in handling

potentially harmful infections, use Ethyl orIsopropyl alcohol.

Detergent formulations containing ChlorhexidinePovidone,or Hexachlorophene are effective inprevention of spread of infections.


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Words of Wisdom on Hand

Washing

Soap, water and

Common sense are still

be Best Antiseptics

William Osler


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Use of Gloves

Use of a pair of

disposable plasticgloves can protect if

chances of contact

with Blood or Body

fluid is

anticipated/inevitable.


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Use of Mask, Cap, Eye Wear

Will certainly protect

us from splashes of

Blood or Body fluids.

Don't underestimatethe importance of Use

of Cap and Mask.

It equally protects our

patients.


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Uses of Cap and Mask

Stringent use of Mask

and Cap can save

several Lives in the

Hospital


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Use of Foot wear

Wearing foot wear covering entire soleprotects the entry of Microbes from the

contaminated floors with Blood and Body

fluids.

Remember many of us have cracks on our

feet.


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Use of Impervious Gown

A simple thin Plastic apron underneath thelinen is of great help in preventing the

soaking our inner clothes and exposure to

harmful microbes.


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Disposal of Needles and Sharps

All used needles and sharps should bedeposited in thick walled punctureresistant containers.

Bending, Reshaping, should be prohibited. Do not recap the needles to avoid needle

stick injures,

All used Disposable syringes and needlesshould be discarded into Bleach solutionat the work station before final disposal.


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Dealing with Used Needle

Shredding continues to

be Important Method

Of dealing with used

Needle


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Dealing with Needle stick

Injuries Consider all Needle stick injuries as a serious

health hazard in the era of AIDS

All events of Needle stick injuries to be reportedto the supervisory staff.

Wash the injured areas with soap and water. Encourage bleeding if any.

Prophylaxis for prevention of HIV/HBV is toppriority.

Anti retroviral prophylaxis, if necessary shouldstarted within 2 hours, ( if injury is from HIVpositive or high risk group).


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Avoid Needle Stick Injuries


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Hazards of Needle stick

Injuries

HIV HBV and HCV viral infections

can spread by Needle stick Injuries

Nursing staff are at greater riskSeveral Injuries are preventable


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Decontamination of Hospital Linen

All the linen contaminated with Blood or

Body fluids should be soaked in 1: 100

bleach solution for 30 minutes.

Advised Autoclaving, as the most ideal

procedure for decontaminating Linen


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Spillage of Blood/Body fluids

A common health hazard in the working

environment.

Never wipe the spillage with working wet

mop.

Always cover the spills with paper and pour

1 % Hypochlorite or Bleaching powder to

decontaminate the spills with HIV/HBV

virus.


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Care of Endoscopes

Endoscopes are delicate/preciousinstruments.

Follow the instruction of Manufacturers.

It is commonly cleaned with 2 %Glutaraldehyde solution.

Specified time schedules to be followed to

decontaminate for HIV. Mycobacterium needs even > 2 hours for

decontmination.


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Decontamination of Metal

Instruments

Hold all contaminated instruments withGloved hands.

Subject all metal instruments to washing

with soap and water. Treat all contaminated instruments with

2% Glutaraldehyde. For at least 30

minutes. Many consider sterilizing in Hot air oven if

not sharp instruments.


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Anesthetic Tubing's and other

Equipments

Since they are in intimate contact withHuman secretion need utmost attention indecontamination.

Treat all Non disposable as highlyhazardous, if used without safe practicescan infect the next patient undergoingprocedures.

Soaking in 2 % Glutarladehyde iscommon practice in Developing world.


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Pregnant Health Care Workers

Not at more risk than other, Health careworkers.

Should adopt Universal Health

Precautions with more dedication, If neglected the Unborn is at grave risk of

attaining congenital infections.

The Laboratory supervisors shouldmonitor/ guide the HCWs for adherence toscientific practices.


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Operating on HIV/High risk groups

It is a concern all should be cared equally.

HIV infected carries the risk of being neglectedat the time of crisis.

Law many not change for equality but motivatedhealth workers should bring in change ofattitude.

Adherence of Universal Health precaution bringin safety to all HCW.

Follow the precautions even in Non HIV patientsas some of our patients are in window periodand more dangerous than truly positive withSero testing.


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Caution on Operating HIV

Sero Negative Patients

Universal precaution apply to all our patients irrespectiveof Blood tests we undertake.

We handle so many patients in emergency situation without any details.

Education on Universal precautions

participation of you and educating yoursubordinates/Juniors will make a lot of Difference in the

work Environment.


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Precaution for Invasive Procedures

All HCWs who participate in invasiveprocedures must routinely use appropriatebarrier precautions.

All Health care workers who perform/assistvaginal, and cesarean deliveries should weargloves and gowns when handling, the placenta,and the new born, till blood and amniotic fluidhas been removed from infants.

Amniotic fluid is rich in HIV/HBV virus, ininfected mothers.


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Handling Dentistry Patients

Blood,Saliva,Gingival fluid from all Dentalpatients should be considered infective,

Dental, workers should wear surgical

mask, gloves and eye wear


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Caring Bleeding Patients

Primary health care workers who handle thepatients in Emergencies, and Accidents to betrained in basic principles of Universal Health

care precautions. Mouth to Mouth resuscitation is life saving in the

Critically injured accident victims. May beneglected because of fear of HIV infection.

If the situation warrants, Bleeding from mouthcan be wiped out with clean cloth, orHandkerchief, and still one can do resuscitation.

Importance of Vaccination in


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Importance of Vaccination in

Hepatitis B Infection.

We have > 400 Million carriers with

Hepatitis B infections.

Every HCW is at risk of Contacting

infection.

Vaccination is safe -Genetically

Engineered vaccination remains the great

hope for prevention, apart from Majorcomponent of Universal precautions.


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Vaccination for HBV infection

All HCWs must take at least three dosesof Vaccine,

At 016 months. without discontinuation

of the schedule.All Health care workers many not attain

equal response.

High risk HCWs should undergoestimation of anti HB s ( antibodies ) toknow whether they were well protected.


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Problem of HBV vaccines in the

Developing world

Who pays for the Vaccine.

Many who work in unorganized sector, donot get Institutional support of Vaccine.

Life, at risk if Infected with HBV

More Awareness to be brought in byManagers of the Hospitals, to promote to

vaccinate their Employees.


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Never forget to take Hepatitis B

Vaccine if You are a HCW


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Majority of OSHA CDC, and NIOSHguidelines are incorporated.


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Created for benefit of Medical and Paramedical

Health care workers in the

Developing worldDr.T.V.Rao, MD

E mail : [email protected]

universal safety (health) precautions

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