Universal Safety (Health) Precautions

UNIVERSAL HEALTH PRECAUTIONS and Biohazards
To Health Care Workers

Dr.T.V.Rao MD
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
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 )
Human materials/Tissues considered Highly Infectious

1 Blood 2 Semen 3 Vaginal secretions 4CSF 5 Synovil fluids 6 Amniotic fluid 7 All other body fluids
Feces, Nasal secretions, Sputum, Sweat, Tears, Urine / Vomitus, Saliva unless blood stained.
Not Infectious unless contaminated with Blood or Body fluids.
HAND WASHING

There is no Health precaution like Hand washing. Washing with simple toilet soap - reduces the rate of transmission of common infections including the HIV.
How to Wash our hands
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.
What to be used for hand washing
In most circumstances Non medicated soaps and detergents are effective in removing most transient contaminants. In demanding circumstances, in handling potentially harmful infections, use Ethyl or Isopropyl alcohol. Detergent formulations containing Chlorhexidine Povidone,or Hexachlorophene are effective in prevention of spread of infections.
Words of Wisdom on Hand Washing
Soap, water and Common sense are still be Best Antiseptics

William Osler
Use of Gloves
Use of a pair of disposable plastic gloves can protect if chances of contact with Blood or Body fluid is anticipated/inevitable.
Use of Mask, Cap, Eye Wear
Will certainly protect us from splashes of Blood or Body fluids. Don't underestimate the importance of Use of Cap and Mask. It equally protects our patients.
Uses of Cap and Mask
Stringent use of Mask and Cap can save several Lives in the Hospital
Use of Foot wear
Wearing foot wear covering entire sole protects the entry of Microbes from the contaminated floors with Blood and Body fluids. Remember many of us have cracks on our feet.
Use of Impervious Gown
A simple thin Plastic apron underneath the linen is of great help in preventing the soaking our inner clothes and exposure to harmful microbes.
Disposal of Needles and Sharps

All used needles and sharps should be deposited in thick walled puncture resistant containers. Bending, Reshaping, should be prohibited. Do not recap the needles to avoid needle stick injures, All used Disposable syringes and needles should be discarded into Bleach solution at the work station before final disposal.
Dealing with Used Needle
Shredding continues to be Important Method Of dealing with used Needle
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 reported to the supervisory staff. Wash the injured areas with soap and water. Encourage bleeding if any. Prophylaxis for prevention of HIV/HBV is top priority. Anti retroviral prophylaxis, if necessary should started within 2 hours, ( if injury is from HIV positive or high risk group).
Avoid Needle Stick Injuries
Hazards of Needle stick Injuries
HIV HBV and HCV viral infections can spread by Needle stick Injuries Nursing staff are at greater risk Several Injuries are preventable
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
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.
Care of Endoscopes
Endoscopes are delicate/precious instruments. 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.
Decontamination of Metal Instruments

Hold all contaminated instruments with Gloved 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.
Anesthetic Tubing's and other Equipments

Since they are in intimate contact with Human secretion need utmost attention in decontamination. Treat all Non disposable as highly hazardous, if used without safe practices can infect the next patient undergoing procedures. Soaking in 2 % Glutarladehyde is common practice in Developing world.
Pregnant Health Care Workers

Not at more risk than other, Health care workers. Should adopt Universal Health Precautions with more dedication, If neglected the Unborn is at grave risk of attaining congenital infections. The Laboratory supervisors should monitor/ guide the HCWs for adherence to scientific practices.
Operating on HIV/High risk groups
It is a concern all should be cared equally. HIV infected carries the risk of being neglected at the time of crisis. Law many not change for equality but motivated health workers should bring in change of attitude. Adherence of Universal Health precaution bring in safety to all HCW. Follow the precautions even in Non HIV patients as some of our patients are in window period and more dangerous than truly positive with Sero testing.
Caution on Operating HIV Sero Negative Patients

Universal precaution apply to all our patients irrespective of Blood tests we undertake. We handle so many patients in emergency situation with out any details. Education on Universal precautions participation of you and educating your subordinates/Juniors will make a lot of Difference in the work Environment.
Precaution for Invasive Procedures
All HCWs who participate in invasive procedures must routinely use appropriate barrier precautions. All Health care workers who perform/assist vaginal, and cesarean deliveries should wear gloves and gowns when handling, the placenta, and the new born, till blood and amniotic fluid has been removed from infants. Amniotic fluid is rich in HIV/HBV virus, in infected mothers.
Handling Dentistry Patients
Blood,Saliva,Gingival fluid from all Dental patients should be considered infective, Dental, workers should wear surgical mask, gloves and eye wear
Caring Bleeding Patients
Primary health care workers who handle the patients in Emergencies, and Accidents to be trained in basic principles of Universal Health care precautions. Mouth to Mouth resuscitation is life saving in the Critically injured accident victims. May be neglected because of fear of HIV infection. If the situation warrants, Bleeding from mouth can be wiped out with clean cloth, or Handkerchief, and still one can do resuscitation.
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 Major component of Universal precautions.
Vaccination for HBV infection

All HCWs must take at least three doses of Vaccine, At 0 1 6 months. without discontinuation of the schedule. All Health care workers many not attain equal response. High risk HCWs should undergo estimation of anti HB s ( antibodies ) to know whether they were well protected.
Problem of HBV vaccines in the Developing world

Who pays for the Vaccine. Many who work in unorganized sector, do not get Institutional support of Vaccine. Life, at risk if Infected with HBV More Awareness to be brought in by Managers of the Hospitals, to promote to vaccinate their Employees.
Never forget to take Hepatitis B Vaccine if You are a HCW
Majority of OSHA CDC, and NIOSH guidelines are incorporated.
Created for benefit of Medical and Paramedical Health care workers in the Developing world Dr.T.V.Rao, MD E mail : [email protected]

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UNIVERSAL HEALTH PRECAUTIONS and Biohazards

To Health Care Workers

What are Universal Precautions

Why Universal health Precautions.

Human materials/Tissues considered Highly Infectious

Not Infectious unless contaminated with Blood or Body fluids.

How to Wash our hands

Indications for Hand Washing

What to be used for hand washing

Words of Wisdom on Hand Washing

Soap, water and Common sense are still be Best Antiseptics

Use of Mask, Cap, Eye Wear

Uses of Cap and Mask

Use of Foot wear

Use of Impervious Gown

Disposal of Needles and Sharps

Dealing with Used Needle

Shredding continues to be Important Method Of dealing with used Needle

Dealing with Needle stick Injuries

Avoid Needle Stick Injuries

Hazards of Needle stick Injuries

Decontamination of Hospital Linen

Spillage of Blood/Body fluids

Decontamination of Metal Instruments

Anesthetic Tubing's and other Equipments

Pregnant Health Care Workers

Operating on HIV/High risk groups

Caution on Operating HIV Sero Negative Patients

Precaution for Invasive Procedures

Handling Dentistry Patients

Caring Bleeding Patients

Importance of Vaccination in Hepatitis B Infection.

Vaccination for HBV infection

Problem of HBV vaccines in the Developing world

Never forget to take Hepatitis B Vaccine if You are a HCW

Majority of OSHA CDC, and NIOSH guidelines are incorporated.

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