1. Infection Control with Needles Reina Ligeralde DEH 13 Fall 2007

2. Guidelines for Infection Control in Dental Health-Care Settings Percutaneous injuries among dental health-care personnel usually  Occur outside the patient's mouth  Are caused by syringe needles, burs, laboratory knives, and other sharp instruments  Involve limited amounts of blood

3. Needle Stick Injury Facts Estimated 600,000-800,000 needle stick injuries occur annually involving contaminated needles Others estimate that a needle stick injury is reported every 30 seconds  over 1 million such cases per year Resulting diseases: hepatitis, AIDS, diphtheria, typhus, herpes, malaria, tuberculosis, spotted fever, syphilis, gonorrhea

4. Health Care Workers  Annually,12,000 healthcare workers contract hepatitis  Up to 300 of them die as a result of an accidental needle stick  18,000 are infected with hepatitis, HIV, and other blood-borne diseases  86% of all occupationally related infectious disease transmissions result from accidental needle sticks  CDC estimates 62-88% of sharps injuries can potentially be prevented by the use of safer medical devices

5. Methods to Reduce the Risk of Blood Contacts Use of standard precautions Use of devices with features engineered to prevent sharps injuries Modifications of work practices

6. Standard Precautions Use of PPEs Other protective equipment  e.g. finger guards while suturing

7. Engineering Controls Often incorporate safer designs of instruments and devices  e.g. self-sheathing anesthetic needles

8. Self-Sheathing Safety Needle A. Syringe with protective sheath over the needle B. As the injection is made, the sheath slides back. C. After injection, the sheath returns to cover the needle and protect the clinician during disposal.

9. Traditional Injection System vs. Safer Injection Systems A. Before use B. After use

10. Work-Practice Controls Involve aspirating anesthetic syringes Entail used needles never manipulated by using both hands Include used needles never directed toward any part of the body

11. More Work-Practice Controls  A one-handed scoop technique  A mechanical device designed for holding the needle cap to facilitate one-handed recapping Should be employed for recapping needles between uses and before disposal:

12. Even More Work-Practice Controls Never bend, break, or shear needles before disposal. Avoid passing a syringe with an unsheathed needle. Recap needles before attempting to remove them from nondisposable aspirating syringes.

13. Work-Practice Controls …Last but not Least Dispose syringes and needles in appropriate containers that are:  Closable  Leakproof  Puncture-resistant  Located as close as feasible to where the items were used

14. References http://www.cdc.gov/mmwR/preview/mmwrhtml/rr5217a 1.htm http://www.needle-stick-syringe- injury.com/pgs/needle-stick-facts.html Miller, C.H., & Palenik, C.J. (2005). Infection control & management of hazardous materials for the dental team (3rd ed.). St. Louis: Elsevier Mosby. Wilkins, E.M. (2005). Clinical practice of the dental hygienist (9th ed.). Baltimore: Lippincott Williams & Wilkins.