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Quality, management and safety > Safety > Flashcards

Safety Flashcards

1
Q

List the main types of hazards in a laboratory (7)

A
  1. Infectious/Biologic including blood products
  2. Chemicals and noxious fumes
  3. Physical hazards
    4 .Sharps
  4. Fire safety
  5. Electrical injury
  6. Ergonomic
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2
Q

To prevent sharps injury, list 4 features of proper sharps handling and disposal

A
  1. Do not re-cap needles
  2. Dispose of sharps immediately after use
  3. Sharps disposal container must be within arm’s reach
  4. Disposal containers must be rigid and discarded when full
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3
Q

What are the 3 main routes of infectious disease transmission in the laboratory?

A
  1. Contact e.g. touching face/hands with contaminated hands, sharps injury (mucous membranes and broken skin = higher risk)
  2. Droplet transmission e.g. splashing or splattering on the body
  3. Airborne transmission e.g TB disseminated in ventilation system
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4
Q

List 7 ways to prevent laboratory-acquired infection?

A
  1. Standard precautions
  2. Hand-washing
  3. Immunisation
  4. Laboratory design
  5. Biological safety cabinets (HEPA filters)
  6. Disinfectants/cleaning
  7. Proper waste disposal
    * *staff training, SOPs and guidelines, monitoring and audits**
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5
Q

What are standard precautions?

A

Standard precautions are the minimum infection prevention measures that apply to all patient care and specimen handling. They imply that all blood and bodily fluids are potentially infectious and should be treated accordingly.

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6
Q

What components are included in standard precautions? (4)

A
  1. Hand washing and good personal hygiene (tie hair back, jewellery off, proper footwear)
  2. Proper handling and disposal of sharps and contaminated waste
  3. Cover any breaks in the skin (waterproof coverings)
  4. Use of person protective equipment (N.B. this is last line of defence)
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7
Q

List the 3 types of safety cabinets and their uses

A
  1. Biological safety cabinets - for infectious tissues. Cabinets contain a HEPA (high efficiency particulate air) filter
  2. Fume hood - for chemicals (strong exhaust pressure, lack of filter)
  3. Laminar flow hood - protects the tissue/work in the cabinet from contamination, not the worker
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8
Q

What to do if you are exposed?

A
  1. Wash site immediately with soap and water, antiseptic to wound
  2. Remove contaminated clothing
  3. Decontaminate surfaces with sodium hypochlorite
  4. Inform supervisor/Safety officer
  5. Obtain BBFA pack and complete information and blood testing.
  6. Must ascertain HIV, HBV and HCV status of the source. May need to contact ID team
  7. Incident report (DATIX)
  8. Contact EAP if psychological support is required.
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9
Q

When should routine hand-washing be performed?

A
  1. When coming on duty/entering lab
  2. When leaving the lab
  3. Before and after eating
  4. Before and after using the bathroom
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10
Q

When should anti-septic washing be performed?

A
  1. After contact with contaminated objects/patient specimens

2. After removing protective gloves

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11
Q

What is the difference between flammable and combustible?

A

The main difference between the two is that flammable liquids can catch fire and burn easily at normal working temperatures, whereas combustible liquids require higher temperatures to ignite.

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12
Q

How are hazardous chemicals classified and labelled?

A

According to the Globally Harmonised System for the classification and labelling of chemicals (GHS)
There are 9 hazard pictograms in the GHS that represent different hazards of chemicals

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13
Q

What are Safety Data Sheets?

A

Documents that contain critical information about hazardous chemicals - SDS must be supplied by chemical manufacturers and distributors

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14
Q

What information is contained in a SDS? (10)

A 
Identification and name of chemical
Ingredients/composition
Chemical and physical properties
Stability and reactivity
Hazards
Toxicology information
First air measures
Fire-fighting measures
Handling and storage
Exposure controls and personal protection
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15
Q

How should chemicals be stored?

A

Low shelves with a lip - so they can’t fall
Avoid exposure to heat or light
Store alcohol and other flammable liquids in approved storage cabinets away from a heat source (minimum 1.5m)
Separate chemicals that are potentially incompatible
Secure cylinders of compressed gases to a wall and a well-ventilated area

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16
Q

What is the procedure if there is a SMALL spill/exposure of a chemical?

A
  1. Report the incident to the person in charge/lab safety manager
  2. Alert others of the spill
  3. Assist others who have been contaminated
  4. Evacuate and secure the area and isolate individuals if exposed/contaminated.
    ⇒ If injured/contaminated people require assistance then dial 777.
  5. Refer to SDS for chemical involved to guide procedure of clean up, hazards and disposal
    E.g. for a flammable liquid this may include: avoid breathing vapors, remove all sources of ignition and evacuate the area immediately.
  6. Arrange for the safe cleanup of the chemical
    ==> Small spills:
    - Locate spill kit and only use if safe to do so using two people and safety gear (goggles, gown, gloves, respirator)
    - Use absorbent pads and socks to contain and mop up the spill
    - Double bag the material, seal off and label towels and socks while wearing personal protective gear
  7. Disposal depends on the chemical involved
  8. Fill out incident report
17
Q

What is the procedure if there is a LARGE spill/exposure of a chemical?

A
  1. Report the incident to the person in charge/lab safety manager
  2. Alert others of the spill
  3. Assist others who have been contaminated
  4. Evacuate and secure the area and isolate individuals if exposed/contaminated.
    ⇒ If injured/contaminated people require assistance then dial 777.
  5. Refer to SDS for chemical involved to guide procedure of clean up, hazards and disposal
    E.g. for a flammable liquid this may include: avoid breathing vapors, remove all sources of ignition and evacuate the area immediately.
  6. If major spill and unsure about safety, activate a HAZMAT alert and follow SOP
  7. Wait for medical/fire teams to arrive
  8. Fill out incident report
18
Q

What is a biohazard?

A

An infectious agent or hazardous biological material that presents a risk or potential risk to the health of humans, animals or the environment.

19
Q

What is the hierarchy of hazard control?

A

The hierarchy of hazard control as per the legislation is:

  1. Elimination, where practicable,
    e. g. substituting a less hazardous substance
  2. Isolation; where elimination is not practicable
    e. g. exclusion of individuals not involved in the procedures.
  3. Minimisation, where elimination and isolation are not practical controls.
    e. g. minimise use of needles, scalpels, glass Pasteur pipettes, minimise generation of aerosols, centrifugation should be carried out in sealed tubes or a sealed rotor
20
Q

Discuss important elements when handling chemicals (5)

A
  1. Exposure to chemicals should be minimised, even if there is no known significant hazard.
  2. Staff training - staff must know how to identify hazardous chemicals and know what special warning labels mean.
  3. Refer to the SDS to learn specific hazards of a chemical as well as any special handling requirements and emergency and first aid requirements.
  4. Ensure ventilation is adequate for the chemical being handled and use a fume hood for any procedure which might result in the release of toxic chemical vapors.
  5. Use personal protective equipment and know the location of safety showers and eye wash stations
21
Q

STORAGE OF CHEMICALS (6)

A
  1. If possible, store chemicals on low shelves with lips or raised edges to reduce the possibility of a container falling off and to minimise leaks or spills should they occur.
    Storage on bench tops, open shelves or in fume hoods is inadvisable.
  2. Exposure to heat or direct sunlight should be avoided.
  3. Store alcohol and other flammable chemicals in approved safety cans or storage cabinets at least 1.5 metres away from a heat source. The storage of flammable liquids requires special procedures in accordance with SDS.
  4. Separate chemicals that are potentially incompatible and that might react with one another to produce an explosive, toxic, or flammable product. For example, store acids in an acid cabinet and flammable chemicals in a fireproof cabinet.
  5. Stored chemicals should be examined periodically for replacement, deterioration and container integrity.
  6. Secure cylinders of compressed gases to a wall or counter and stored in well-ventilated, dry areas and away from corrosive chemicals, vapors, or sources of ignition.
22
Q

How would you manage a spill in a centrifuge?

A
  1. Inform safety officer
  2. Put a sign on centrifuge to indicate it is out of order/equipment is contaminated.
  3. Wait 60 minutes after the centrifuge has stopped operating to initiate clean-up. This allows aerosols to settle.
  4. Put on lab coat, apron, gloves and a face shield prior to opening centrifuge. Open carefully to assess the damage.
  5. If the spill is contained within a closed cup, bucket or rotor, spray the exterior with disinfectant (Trigene) and allow at least 10 minutes of contact time. Remove the carrier to the nearest biosafety cabinet (BSC).
  6. Gather supplies needed, such as a sharps container for broken glass and bins filled with disinfectant and place into the BSC. Use forceps to remove broken glass and place directly into sharps container. Carefully remove any unbroken tubes and place into a bin filled with disinfectant for 20 minutes. Wipe carrier/bucket with disinfectant.
  7. Spray the interior of the centrifuge chamber with a disinfectant, let sit for 20 minutes and then wipe down.
  8. Dispose of all biological waste appropriate
  9. Incident report - DATIX
23
Q

How would you manage a BBFA or biological spill in the laboratory?

A

Must assume that the spill / biological material is potentially infectious and apply universal/standard precautions

  1. The person:
    - Remove contaminated clothing
    - Wash wounds and skin sites in contact with blood or body fluid with soap and water. Do not squeeze or rub the injured site.
    - Irrigate mucous membranes with copious amounts of water or saline. If contact lenses are worn, eye irrigation should take place before and after removing the lenses. Rinse eyes gently, holding open with water or saline for at least 30 seconds
    - Apply antiseptic to wound. Cover any bleeding wounds with plaster.
  2. Decontamination of inanimate surfaces
    - Deal with the spill as soon as possible.
    - Cordon off the area / inform others around you of the spill.
    - Protect yourself by wearing disposable rubber gloves.
    - Eye protection and a plastic apron should be worn where there is a risk of splashing.
    - Remove as much of the spill as possible with a paper towel. Clean and disinfect the area
    - Try to avoid creating aerosols
    - Remove and dispose of gloves, paper towels and cleaning cloth in a sealed plastic bag after use. The plastic bag may then be thrown away with household waste.
    - Wash hands thoroughly with soap and warm water.
  3. Report the exposure to the person in charge of the work area who should assist in coordinating the process.
    - Obtain BBFA response pack and complete.
    Responsibilities of manager/occ health:
    The exposed person should not be left to deal with the process alone.
    - Document the date and time of exposure, how the incident occurred and the name of the source if known
    - Every attempt should be made to ascertain the viral status of the person whose tissue it belongs to and the immunity status of the person involved.
    - Does any medical treatment e.g. HBV immunoglobulin or vaccination, HIV PEP need to be given? Contact ID team for advice.
    - EAP. Does any psychological support need to be given?
  4. DATIX (Incident report) should be completed.
  5. Following the incident there should be a review to see if any changes can be made to prevent it occurring again e.g. education for staff, sharps disposal improvements
24
Q

Strategy for managing laboratory waste?

A

Maximise safety, minimise environmental impact.

As a rule, you should not begin an activity unless there is a plan for the disposal of waste that will be generated.

25
Q

Types of waste

A
  1. General / non-hazardous
  2. Infectious and pathologic
  3. Chemical
  4. Sharps
  5. Radioactive
  6. Heavy metals
  7. Genotoxic
  8. Pharmaceuticals
26
Q

Steps in disposal of waste

A
  1. Separate different sorts of waste
  2. Store - secure locations, set amount of time, containers fit for purpose and labelled
  3. Transport - around hospital e.g. trolleys and from lab to facility
  4. Disposal - incineration, chemical vs thermal cleaning
27
Q

3Rs of waste

A

Reduce
Re-use
Recycle

Quality, management and safety (4 decks)

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