LA symposium

Question 1

what are sharps

Answer 1

• sharps are needles, blades and other medical instruments that are necessary for carrying out work and could cause an injury by cutting or pricking the skin

Question 2

what are some sharps routinely used in dentistry

Answer 2

• hand scalers
• ultrasonic scalers
• burrs
• probes
• scalpel
• needles

Question 3

who’s responsibility is it to dispose of sharps

Answer 3

• it is the responsibility of the person using the sharp to dispose of it correctly and safely
• can delegate someone to take care of your sharps but if they get injured it is your responsibility

Question 4

what do the health and safety regulations 2013 require in relation to sharps

Answer 4

• they apply to employers and contractors working in the healthcare sector
• requires effective arrangement in place for the safe use and disposal of medical sharps = avoid unnecessary use, safer sharps where reasonable practicable
• requires information and training to workers
• requires investigation and action taken in response to sharps injuries

Question 5

what do the different colour lids of bins show

Answer 5

• these identify the waste streams

- it is essential that the correct waste stream is used

Question 6

how should the sharps bin be used

Answer 6

• the temporary closure mechanism should be closed when the container is not in use
• the lid should be firmly closed in place
• do not fill above the line = container should be closed once line is reached
• all details should be completed when the container is assembled and prior to disposal

Question 7

what goes in the blue lidded sharps container

Answer 7

• sharps that still have medicine left in the syringe/ampoule

Question 8

what goes in the orange lidded sharps container

Answer 8

• sharps that do not have any medicine left in the syringe/ampoule

Question 9

is the medical history important for sharps injuries

Answer 9

• you want to have the medical history of the patient available but you can’t guarantee that is is all true
• need to do blood tests anyway

Question 10

what is ARC

Answer 10

• response to sharps injury
• A = are you injured
• R = remove your gloves
• C = check the area carefully

Question 11

what must you do if you think you have sustained a sharps injury

Answer 11

• stop what you are doing
• take off your gloves
• get supervising clinical immediately and explain the situation
• investigate the ‘injury’ site, confirm there is NO injury before commencing with treatment
• dispose of used sharp and begin again with new sharp

Question 12

what form must be filled out if you sustain a sharps injury

Answer 12

• DATIX form

Question 13

who fills out the risk assessment

Answer 13

• not the student who has been injured

- information from the risk assessment must NOT be written in the case notes

Question 14

what happens after the risk assessment is complete

Answer 14

• phone occupational health

- risk assessment destroyed once occupational health has been phoned

Question 15

what is in the risk assessment form

Answer 15

• quite personal questions
• 10 questions
• if any of 4-10 are marked YES then source is deemed high risk

Question 16

when is occupational health phoned

Answer 16

• after risk assessment completed and patient outcome known

Question 17

where is the patients blood sample taken

Answer 17

• in house

Question 18

where is the students blood sample taken

Answer 18

• out of house or A&E

Question 19

what is the full management of an occupational exposure incident

Answer 19

• perform first aid
• is skin/tissue affected
  = yes - then encourage are not bleed, do not suck damaged skin, wash with warm water and non-antimicrobial soap, use saline if no water available
  = no - are eyes/ mouth affected = yes - rinse with copious water, use eye/mouth wash kits if available
• then report incident as per local procedures or investigation, this should be proportionate to the potential severity of the incident, ensure that any corrective action are undertaken
• ensure that the item that causes the injury is disposed of safely
• then risk asses, take patient blood sample, take student blood sample then fill out DATIX form

Question 20

what must you do if you wear contact lenses and your eyes are affected

Answer 20

• rinse/irrigate your eyes with water, then remove your lenses, then irrigate again

Question 21

what is written in DATIX form if student is injured

Answer 21

• students details must be added into the person affected section

Question 22

what is written in the DATIX form if patient is injured

Answer 22

• patients details entered into person affected
• student details added as witness
• student number added into summary of event

Question 23

what is the risk of acquisition of hep b

Answer 23

• 1 in 3 = 30%

Question 24

what is the incubation period and treatment for hep b

Answer 24

• incubation period is 3-6 months

- effective vaccine is available and essential

Question 25

what is the risk of acquisition of hep c

Answer 25

- 1 in 30 = 3%

Question 26

what is the incubation period and treatment of hep c

Answer 26

- incubation period is 20 years | - no vaccine available but there is a cure

Question 27

what is the risk of acquisition of HIV

Answer 27

- 1 in 300 = 0.3%

Question 28

what is the incubation period and treatment of HIV

Answer 28

- incubation period if 10 years | - no vaccine but there is good antivirals

Question 29

what happens if student receives a sharps injury

Answer 29

- student needs immediate access to medical advice - student offered post exposure prophylaxis (PEP) within the hour - any other medical treatment as advised by a registered medical practitioner - consider counselling

Question 30

summary of what to do after sharps injury

Answer 30

- stop procedure - inform the patient - make the sharp safe - first aid - clinician - risk assessment - occupational health - consent = bloods - paperwork - DATIX