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

• Email

• doctortvrao@gmail.com