8. Occupational Health and Environmental Emergencies Flashcards
if we break this down further and look @ the occupational hazards:
____ including traumatic injuries like burns
working on pts with handpieces - sometimes they are hot and you can burn yourself (this doesn’t happen often b/c we wear gloves) need to wear protective eyewear w/side visors in order to protect from aerosols or blood born pathogens from contaminating eye acoustic injuries relating to drills we use
\_\_\_\_: dental materials (acrylics, ceramics, impression materials like alginates, elastomers) other solutions and waxes ‣ lab fumes latex gloves (many allergic) ‣
____ include bacterial contaminations of casts, suction, water line units, ◦
blood from accidental wounds and cuts, needle stick injuries
(____) musculoskeletal disorders - not gonna talk too much even tho ◦
that’s an issue for many of us after practicing for many years. just focus on
ergonomics now to make sure you’re not putting additional strain on neck and back
____: burnout, suicidal tendencies, stress related disorders like ◦
anxiety and OCD)
physical hazards chemical hazards biological hazards ergonomic hazards psychosocial hazards
“this is interesting” these are traumatic injury rates among healthcare personnel 114 (many) facilities across the country from 2012 to 2014
Y-axis is ____ per 10,000 workers in these months (24 months) incidence for all healthcare personnel is 27 or so per 10,000 workers
highest amongst ____
◦ actually lowest amongst physicians, dentists, interns, residents group
‣ maybe it’s better education, maybe it’s various parts of pt care that nurses and nursing assistants manage that put them at higher risk for traumatic injuries
incidence rate
nursing assistants
break this down further:
pt handling and movement is highest among ____ and nurse assistants
◦
‣
these are gonna be prob a lot of ____ injuries related to that she did have a pt she’s been treating who was a radiology tech who was assaulted by a psych pt…at the time she was in her late 20s when it happened and has never recovered (had bilateral TMJ arthroplasties) and chronic pain from this – career ending
____, trips, and falls – still higher w/nurses and nurse assistants
◦
workplace ____ as she mentioned as well…all low for physicians/dentists/interns/
◦
residents
nurses
musculoskeletal
slips
violence
OSHA has standards related to ____ and we looked @ the most frequently cited standards for federal OSHA from 2015 to 2016 and at the top of that list was blood borne pathogens and you can see some of other things we talked about and how to protect yourself by preventing the
dentistry
Needlestick Injuries
❖ Needlestick injuries are wounds caused by ____ that
accidentally puncture the skin.
❖ These injuries can occur at any time when people use,
disassemble or dispose of needles.
needles
Epidemiology
❖ The WHO estimated annual global needlestick injuries at ____
million per year.
❖ OSHA estimates ____ million workers in the healthcare
industry are at risk of occupational exposure to blood borne diseases via percutaneous injury
❖ The CDC estimates more than ____ needlestick injuries
occur among US healthcare workers annually.
❖ It is estimated that half of all occupational needlestick
injuries are not ____.
2
5.6
600,000
reported
During or after disposal: ____%
◦ In transit to disposal.
◦ Improper disposal.
◦ During disposal.
• After use, before disposal: ____%
◦ Activation of safety feature.
◦ Recap needle.
◦ During clean up.
• During use: \_\_\_\_% ◦ Access IV line. ◦ Transfer/process specimens. ◦ Pass/transfer equipment. ◦ Collision with sharp or worker. ◦ Insertion or removal of needle. ◦ Other.
22
19
52
so what happens when you do have a needlestick injury?
take glove off and ____ area
◦
did you poke through glove? just scrape it? ◦ ◦ ◦
◦
a handy trick: fill up ____ w/water and see if there’s a hole in there
inspect hand
if you think you got a needlestick injury, you probably did
wash ____
‣
there’s ____ in OS clinic under the sink – probably doesn’t do anything but it is
a good measure if anything near surface of the skin and prevent contamination
inspect
glove
thoroughly
betadine
in terms of OSHA's controls... reads all the stuff ◦ \_\_\_\_ is key - like a seatbelt ◦ she thinks training is part of the reason why needlestick injuries occur less in the ◦ physician/dentist group
PPE
Exposure Control Plan
❖ ____ and elements
❖ ____ determinations
❖ ____ for implementing procedures
❖ observing universal precautions
❖ assessing and updating work practice controls
❖ handling regulated waste
❖ cleaning and decontamination of the worksite
❖ promoting good hygiene
❖ communicating hazards to employees Provision for the initial reporting of exposure
incidents
❖ Post-exposure ____ and follow-up
policy
exposure
schedule
evaluation
Prevention of Needlestick Injuries
❖ Use of taper-point versus cutting suture needles. ____-tip suture needles were found to reduce the risk of needlestick injuries by 69%.
❖ ____-bore versus solid needles pose a greater risk of injury.
❖ 25% of hollow-bore needle injuries can be prevented by
using ____ needles.
❖ Double gloving can ____ the risk of needlestick injury.
blunt
hollow
safer
halve
Occupational Transmission Rates
❖ HCV = ____%
❖ HIV = ____%
- 8
0. 3
Post-Exposure Prophylaxis: HCV
❖ No clinical trials have been conducted to assess post-
exposure use of ____ agents (i.e. interferon).
❖ Available data suggests that an ____ infection
might need to be present before interferon can be an
effective treatment.
antiviral
established
Risk Factors: HIV ❖ Larger quantity of \_\_\_\_ ❖ Device visibly \_\_\_\_ ❖ Procedure that involves needle directly into \_\_\_\_ or artery ❖ \_\_\_\_ injury ❖ Higher \_\_\_\_ load
blood contaminated vein deeper viral
Pathogenesis: HIV
❖ Systemic infection does ____ occur immediately.
❖ Over the next ____ hours, migration of these cells to
regional lymph nodes occurs.
❖ The virus is detectable in the peripheral blood within ____
days.
not
24 to 48
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