giving safe injections
DESCRIPTION
Giving Safe Injections. Presented by :Dr Esteghamat. Unsafe Injections. Injections that harm the recipient , the provider , or that result in waste that is dangerous for other people . Unsafe injections can cause disease, injury and death. Causes of Unsafe Injections. - PowerPoint PPT PresentationTRANSCRIPT
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Giving Safe Injections
Presented by :Dr Esteghamat
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Unsafe Injections
Injections that harm the recipient, the
provider, or that result in waste that is
dangerous for other people.
Unsafe injections can cause disease, injury
and death.
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Causes of Unsafe Injections
• World Health Organization estimates:
– 12 billion injections administered each year
– 50 % (6 Billion) are unsafe
– 95% of injections are therapeutic
– 25% to 95% of outpatient visits resulted in an injection
• Many injections may be unnecessary, ineffective or
inappropriate
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Causes of Unsafe Injections
• In a year, unsafe injections may be responsible for:– 8 to 16 Million cases of Hepatitis B
– 2 to 5 Million cases of Hepatitis C
– 80,000 to 160,000 cases of HIV
– Others: Parasitic (Malaria), bacterial (abscess), fungal and other infections
• Some infections may not be obvious for years
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Causes of Unsafe Injections
• Poorly administered injections can cause injuries or drug toxicities when:–Wrong injection site used
– Incorrect drug used
–Wrong diluents used
– Incorrect dose used
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Rules of Safety
• Assume all body fluids contain pathogens
• Assume the skin and the environment contain microorganisms
• Unsafe injections can spread pathogens more easily than inhalation, swallowing or sex
• Do No Harm: Health Worker responsibility
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Body Fluids
• Any body fluid may contain pathogens and spread disease
• Treat all human and animal body fluids as contaminated by pathogens
Wash hands thoroughly with soap and water until visible dirt is gone.
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Clean Skin
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Unsafe Injections Can Cause Infections
• Unsafe injections can transport microorganisms into the body, that are:– transferred from fingers or objects to the
needle
– present on the skin and picked up by the needle
– in the medication to be injected
– inside the syringe or needle that has been previously used
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Unsafe Injections Can Cause Infections
Unsafe Injections Can Kill
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Health Worker: Do No Harm
• Give only necessary injections• Use sterile syringe and sterile needle
for every immunization or DO NOT immunize
• Arrange the workspace and institute disposal practices to prevent needlesticks to self and others
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Why Re-Use Occurs
• Re-use of contaminated syringes/needles:
– Inadequate supply–Lack of understanding of danger–Unmonitored/inadequate sterilization– Inadequate disposal and distribution
(public access to contaminated equipment)
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Unsafe Injections Can Cause Infections
Today:• Millions of people have weakened immune
system• Billions of injections are given by untrained
and unaware people.• New pathogens have been recognized
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Practices That Can Harm Recipients
• Giving unnecessary injections• Loading syringes with multiple doses and
injecting multiple people • Leaving the needle in the vial• Touching the needle
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Practices That Can Harm Recipients
• Mixing two partially opened vials of vaccine• Keeping freeze-dried vaccine more than 6
hours.• Storing medication and vaccine in same
refrigerator• Applying pressure to bleeding sites with
used material or finger• Vaccinating infants in the buttocks
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Practices That Can Harm Health Care Workers
• Re-using needles and syringes.• Carrying needles or placing them on a
surface prior to disposal• Recapping needles
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Practices That Can Harm the Community
• Leaving needles and syringes in areas
where children can take them
• Leaving needles and syringes in areas
accessible to the public
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Vaccines Safety
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Checking Vials and Labels
1. Label
2. Age of the vaccine (expiration)
3. Signs of contamination
4. Exposure to freezing
5. Exposure to excessive heat
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Assessing Contamination
discard it if:• Leaks or cracks are present,• Change in appearance or floating particles
are seen• Submerged in water• Pierced with used needle.• Vaccine was reconstituted more than 6
hours before.• Vial opened for more than 4 weeks.
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Assessing Exposure to Freezing
• DPT, DT, Td, TT, hepatitis B, diluents and Hib should be discarded if you highly suspect or are certain that they are/were frozen
• “Shake taste” DPT, DT, Td and TT (contain aluminum hydroxide adjuvant) when refrigerator log shows subfreezing temperatures. If failed, discard.
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Assessing Exposure to Freezing
• Hepatitis B and Hib vials should be
discarded if frozen or suspected of
freezing. The “shake test” doesn’t work
for them.
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Freeze Watch
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Freeze-tag
Shelf life is 5 years.
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Assessing Exposure to Heat
• Vaccine Vial Monitor (VVM) Present:– If VVM inner square is the
same color or darker than the outside circle, discard the vial
• Vaccine Vial Monitor (VVM) Not Present:– Check temperature log and
cold-chain monitoring cards. If exposed to temperatures above 8º C, discard it.
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Checking Vaccine Vial Monitors
• VVM is a label made of heat-sensitive
material, placed on the vial to show
cumulative heat exposure over time
• VVM reduces waste of vaccine,
ensuring that only good vaccine is used
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Storage
ThermostatThermostat
Ice Packs in freezing
compartment
Ice Packs in freezing
compartment
“Returnedbox
“Returnedbox
Oral Polio, MeaslesOral Polio, Measles
BCG, DPT, TT, diluentBCG, DPT, TT, diluent
Ice packsIce packs
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Checking the Vaccine and Diluent Vials
• Before use, check the following:– Is the label still attached to the vial?– Is the right vaccine and right diluent?– Expiration date?– Contamination (discard reconstituted
vaccine 6 hours after reconstituted)– Cold sensitive vaccines show no signs of
freezing– No signs of heat exposure
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Vaccines Which Require Specific Diluent
• BCG vaccines
• Measles-containing vaccines
• Freeze-dried Haemophilus Influenza type
b (Hib) vaccines
• Yellow fever vaccines
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Reconstituting Vaccines Safely
• Reconstituted vaccines should be kept cool,
between 2º and 8º C to maintain their potency
• Place reconstituted vaccines in slits made in a
foam piece that sits in the top a vaccine carrier
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Reconstituting Vaccines Safely
• Discard reconstituted vaccine after 6 hours.
BCG, measles-containing vaccines, yellow
fever vaccines and freeze-dried Hib
vaccines do not have preservatives. Death
may occur
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Reconstituting Vaccines Safely
• Store only vaccines in the refrigerator.
Medications can accidentally be
administered instead of vaccines
• Do not reconstitute vaccine until the
person needing the vaccine injection is
present
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Reconstituting Vaccines Safely
• Use a new syringe and needle to reconstitute
each vial of vaccine
• Check that the diluent is the one provided by
the manufacturer
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Reconstituting Vaccines Safely
• Discard the used mixing syringe and needle
in a sharps container
• Do not leave the mixing needle in the vial
(contamination)
• Mix the contents of vial by rolling the vial
between your fingers. Note date and time of
reconstitution
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Safe Disposal of Injection Equipment and Other Sharps
• To further prevent needlesticks use leak-proof, puncture-proof containers for needles, syringes and other medical waste that might cut or puncture the skin (broken vials, etc)
• Sharp containers• Safety boxes• Needle-disposal boxes
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Sharp Containers
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Sharp Containers
• Leak-proof
• Puncture-proof
• Clearly labeled with warning (easy for the community to understand)
• Do not overfill (only 3/4 is safe)
• Do not transfer contents to other container
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Sharp Containers
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