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Dr.T.V.Rao MD
NEEDLE STICK INJURIES CONCERNS & DISPOSAL OF NEEDLES
DR.T.V.RAO MD 1
WHAT IS NEEDLE STICK INJURY
• A needle stick injury is a percutaneous piercing
wound typically set by a needle point, but possibly also
by other sharp instruments or objects. Commonly
encountered by people handling needles in the medical
setting, such injuries are an occupational hazard in the
medical community. These events are of concern
because of the risk to transmit blood-borne diseases
through the passage of the hepatitis B virus (HBV), the
hepatitis C virus (HCV), and the Human
Immunodeficiency Virus (HIV), the virus that causes
AIDS. ( Wikipedia ) DR.T.V.RAO MD 2
• WHO reports in the World
Health Report 2002, that of the
35 million health-care workers,
2 million experience
percutaneous exposure to
infectious diseases each year. It
further notes that 37.6% of
Hepatitis B, 39% of Hepatitis C
and 4.4% of HIV/AIDS in Health-
Care Workers around the world
are due to needle stick
injuries
WHO REPORTS ON NEEDLE STICK INJURIES
DR.T.V.RAO MD 3
• Any worker handling
sharp devices or
equipment such as
scalpels, sutures,
hypodermic needles,
blood collection
devices, or phlebotomy
devices is at risk.
Nursing staff are most
frequently injured.
WHO ARE AT RISK
DR.T.V.RAO MD 4
RISKS OF SEROCONVERSION DUE TO SHARPS
INJURY
FROM A KNOWN POSITIVE SOURCE
Virus
HBV
HCV
HIV
Risk (Range)
6-30%*
~ 2%
0.3%
(*Risk for HBV applies if not HB vaccinated)
DR.T.V.RAO MD 5
CENTRE FOR DISEASE CONTROL
CLARIFIES
• According to the Centers for Disease Control and
Prevention (CDC), about 385,000 sharps injuries occur
annually to hospital employees.
Potential Hazard Exposure to blood and other potentially infectious
materials (OPIM) because of: Unsafe needle devices.
• And Improper handling and disposal of
needles and other sharps.
DR.T.V.RAO MD 6
RECAPPING THE LEADING CAUSE OF
INJURY
• Recapping can account for 25 to 30 percent of all
needle stick injuries of nursing and laboratory staff.
Often, it is the single most common cause.
• It is extremely dangerous to hold a needle in one hand
and attempt to cover it with a small cap held in the
other hand. Injuries occur three different ways: the
needle misses the cap and accidentally enters the hand
holding it. the needle pierces the cap and enters the
hand holding it. the poorly fitting cap slips off of a
recapped needle and the needle stabs the hand.
DR.T.V.RAO MD 7
• Needle stick injuries
commonly occur when
workers dispose of
needles. They occur
when staff use special
containers for needles
and sharps. They also
occur when needles are
disposed of improperly
in regular garbage or
lost in the workplace.
DISPOSAL OF NEEDLES
DR.T.V.RAO MD 8
ACCIDENTS OCCUR AT EVERY STEP:
• Up to 30 percent of needle stick injuries of nursing and
laboratory staff occur when workers attempt to dispose
of needles using sharps containers.
Accidents occur at every step:
• while carrying the needle to the disposal container,
especially when the needle is uncapped and mixed with
other trash. while placing the needle into the disposal
container, especially if the container is overfilled. while
emptying disposal containers instead of sealing them
for disposal.
DR.T.V.RAO MD 9
DO NOT LEAVE THE NEEDLE TO THEIR FATE
DISCARD SCIENTIFICALLY
• Virtually all needle stick injuries of domestic and
portering staff are from needles that have either been
lost in the workplace or thrown into regular garbage.
Janitors and garbage handlers can also experience
needle stick injuries or cuts from "sharps" when
handling trash that contains needles or scalpels. Some
attribute the problem to forgetfulness or lack of
motivation or training on the part of people who work
with and dispose of needles. Others feel that
inconvenient disposal systems contribute to these
incidents.
DR.T.V.RAO MD 10
• Workers should place needles
in wide-mouth, puncture-proof
containers. Locate disposal
containers specifically where
needles are used to make safe
disposal possible without
recapping. Replace the
containers before they are
completely filled. Make sure
they are sealed, collected, and
disposed of in accordance
with local regulations for
biomedical waste.
HOW TO DISPOSE THE NEEDLES
DR.T.V.RAO MD 11
NEWER DEVICES TO DISCARD
NEEDLES
DR.T.V.RAO MD 12
• Yellowone Needle
Cap is a non-reusable
sharps container for
disposal of hypodermic
needles. It is designed
for syringes with
luer-slip. The cap fits
over 90 percent of all
beverage cans in the
world.
YELLOWONE NEEDLE CAP
DR.T.V.RAO MD 13
DR.T.V.RAO MD 14
YELLOWONE NEEDLE CAP©
FUNCTIONAL ADVANTAGES • Recycles soda cans, which are readily accessible, into safe and permanent needle disposal
containers
• • With just one click, the cap is permanently locked in place
• • Is easy to use with luer-slip syringes needles
• • Secures needles which may transfer infectious diseases
• • Prevents accidental stick injuries during needle disposal
• • Is ideal for emergency relief efforts, remote clinics and field situations
• • Makes it safe to dispose of infectious disease waste by burying the securely locked can, or placing it in a waste disposal site
• • One can holds over 150 needles (small can of 330 ml) or 400 needles (larger can of 500 ml)
DR.T.V.RAO MD 15
• Discard
contaminated sharps
immediately and
without recapping in
puncture- and liquid-
proof containers that
are closed, sealed
and destroyed
before completely
full.
SAFER WAYS TO DISCARD NEEDLES
DR.T.V.RAO MD 16
• If you suffer an accidental
contaminated needle stick
injury, you should
immediately wash the
wound thoroughly with
soap and water, then report
it to your employer. Do not
hesitate. Universal
precautions require that all
blood and other body fluids
be treated as though they
were contagious. In the
wake of a needle stick
injury,
IF YOU ARE INJURED
DR.T.V.RAO MD 17
• Contaminated needle stick,
sharps injury, bite or scratch -
encourage bleeding, wash with
soap and running water
• Blood or body fluid in eyes or
mouth - irrigate with copious
quantities of cold water
• Blood or body fluid on broken
skin - encourage bleeding if
possible and wash with soap
under running water (but without
scrubbing)
START HANDLE THE PROBLEM WITH
FIRST AID
DR.T.V.RAO MD 18
• Take blood for virology,
(HIV, hepatitis B, hepatitis
C) from the injured worker.
Start PEP where
appropriate and consider
the need for antibiotic
therapy or hepatitis B
immunization. Recheck HIV
status 3 months later and
hepatitis serology 3 and 6
months later.
• Anti retroviral treatments if
warranted
BASIC INVESTIGATIONS AND TREATMENTS
DR.T.V.RAO MD 19
FOLLOW ME MORE ARTICLES OF
INTEREST ON ISSUES OF INFECTIONS
DR.T.V.RAO MD 20
DR.T.V.RAO MD 21
• Needle stick injuries can be preventable if safety is followed in
the work place. Many needle stick injuries cause fear among the
Health care workers, leading to liabilities on the Hospitals. If the
needles handled at the point of work several injuries can be
avoided. Health education, understanding of Universal
precaution using newer devices to dispose needle will be
beneficial to Health work force