Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Ashish Jawarkar
THE PROBLEM
~385,000 sharps injuries annually among hospitalbased healthcare personnel (>1,000 injuries/day)
Many more in other healthcare settings (e.g., emergency services, home care, nursing homes)
Dentists
Health cleaning/ mortuary staff / Waste Handlers
5
Occupational Groups of Healthcare Personnel Exposed to Blood/Body Fluids, NaSH June 1995 December 2003 (n=23,197)
Other 5%
Technician 15%
Nurse 43%
Physician 28%
Recap Needle 6%
14
15
17
PROTECTING YOURSELF
Report all needle stick and sharps-related injuries promptly to ensure that you receive appropriate follow-up care.
Tell your employer about any sharps hazards you observe.
19
A. CATEGORIES OF EXPOSURE
Category
Mild exposure
Moderate exposure
Mucous membrane/non-intact skin with large volumes or percutaneous superficial exposure with solid needle e.g. a cut or needle stick injury penetrating gloves.
Severe exposure
percutaneous exposure with large volumes e.g. an accident with a high caliber needle visibly contaminated with blood, a deep wound, an accident with material that has been previously been used intravenously or intra-arterially
20
Risk Assessment Counseling PEP drugs (4Weeks) depending upon risk assessment Relevant Lab Investigation on informed consent of the source and exposed person Follow up and support
21
the pricked finger in mouth. Wash with soap &water, dont scrub, no antiseptics or skin washes (bleach, chlorine, alcohol, betadine). contact lens immediately if wearing, no soap or disinfectant.
Mouth: spit fluid immediately, repeatedly rinse the mouth with water and spit / no soap/ disinfectant .
22
transmission HIV status of the source of exposure HIV status of the exposed individual
23
HIV
Positive
Negative
Counselling only
Do
HBV
[psotove
Not required
Negative
Counselling
Not required
HCV
Positive
QUICK FACT:
HBV VACCINATION IS RECOMMENDED FOR ALL HEALTHCARE WORKERS (UNLESS THEY ARE IMMUNE BECAUSE OF PREVIOUS EXPOSURE). HBV VACCINE HAS PROVEN TO BE HIGHLY EFFECTIVE IN PREVENTING INFECTION IN WORKERS EXPOSED TO HBV. HOWEVER, NO VACCINE EXISTS TO PREVENT HCV OR HIV INFECTION.
25
SUPREME COURT DIRECTIVE TO ENSURE PEP DRUGS IN ALL GOVERNMENT HOSPITALS IN INDIA
1. 2. Universal Work Precautions (UWP) and PEP guidelines should be followed by HCPs to prevent occupational transmission of HIV, Hepatitis B and hepatitis C. This will develop confidence in HCPs while working with patients some of whom might be infected with HIV/HBV/HCV.
3. PEP drugs should be available in all Govt Hospitals to enable protection of HCPs dealing with potentially infected patients to make sure that no patients suffering from HIV be denied treatment/surgery/ procedures etc
4. 5. Availability of UWP and PEP can minimize the stigma and discrimination against PLHIVs in Health Care facilities. Above regulations to be practiced in Private hospitals and Establishments
26
28
Eliminate or reduce the use of needles and other sharps Use devices with safety features to isolate sharps Use safer practices to minimize risk for remaining hazards
29
30
THANK YOU