Professional Documents
Culture Documents
Community Medicine
Fourth year
Dr Kamel A Elazzabi
Introduction
• A safe injection does not harm the recipient, does not expose the provider to
any avoidable risks and does not result in waste that is dangerous for the
community
“WHO Definitions”
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Fact sheet
• The global burden of disease from unsafe medical injections has been
estimated for the year
- 8% of HCV infections
- accounted for 28 million disability adjusted life years, from AIDS, acute
hepatitis, liver cancer, end-stage liver disease and fatal sepsis.
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• Estimated proportion of viral hepatitis due to unsafe injection practices in
selected countries where information is available:
• Hepatitis B
- India: 60%
• Hepatitis C
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Needle stick Injuries Among Health Care Workers
Nurses reported almost 50% of needle sticks. The reasons for this high percentage
include the larger number of nurses employed in the hospital setting as compared
to other groups, the higher rate of reporting compliance, and the high proportion of
nursing tasks which involve needles.
Nursing assistants and housekeepers/laundry workers report 5.3% and 5.1% of the
exposures respectively.
The large “other” category in this pie chart includes students, respiratory
therapists, dental workers, emergency personnel, IV teams, dialysis workers, and
other “others”.
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When Do Needle sticks Happen?
About 20% of injuries occur before or during use.
These injuries usually involve clean needles and present a lower risk to
employees.
Up to 70% of needle sticks occur after the needle has been used (is
contaminated) and before disposal.
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What are some of the incorrect practices that have resulted in
transmission of pathogens?
• Using the same syringe to administer medication to more than one patient,
even if the needle was changed.
• Using a common bag of saline or other IV fluid for more than one patient,
and
• Accessing the bag with a syringe that has already been used to flush a
patient’s IV or catheter
• Accessing a shared medication vial with a syringe that has already been used
to administer medication to a patient.
• Recapping needle .
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Unsafe injection…… example
- This is a picture show Uncapped syringes for flushing IVs, blood drawing
equipment in the area of medication preparation, medication prepared in
advance, and medication prepared in the hood in the patient treatment area.
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Unsafe injection example
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Main factors contributing to transmission of blood borne pathogens
through injections
1- Overuse of therapeutic injections.
3- Lack of syringe and needle supplies leading to syringe and needle reuse.
1- Auto-disable syringes
equipment of choice
Advantages of AD syringes:
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Part of syringe :
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3-Reusable syringes and needles (boiling) .
not recommended.
Needle Size
25 mm long
Route of Injection
Vaccines should not be given intravenously
Most vaccines* should be given intramuscularly:
This reduces the chance of local reactions and leads to a better
immune response to the vaccine.
It is important the vaccine is injected into muscle and not into fat.
This is why the deep subcutaneous route is no longer
recommended for most vaccines.
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Simple ways to improve injection safety
- Prepare injections in a clean designated area where blood and body fluid is
unlikely.
- Make sure you have the CORRECT diluent for each product check that both
diluents and powder are produced by the same manufacturer.
- Use a sterile syringe and needle to reconstitute each vial. Use all the diluent
provided for the vial. After use, place the syringe into a safety box .Inspect the
packaging very carefully. Discard a needle or syringe if the package has been
punctured, torn or damaged in any way.
- Do not touch any part of the needle. Discard a needle that has touched any non-
sterile surface.
- Hold the child firmly. Anticipate sudden movement during and after injection.
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1. The shaft of the needle
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Waste management
- Incineration
- Burning in a metal drum
- Open burning in a pit
- Encapsulation
- Buried in a disposal pit
Good Luck
Dr Kamel A Elazzabi
2014
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