3.1. Prevention infectious diseases

Guidelines MU 3.1.2313-08

"Requirements for decontamination, destruction and disposal
single use injection syringes

Date of introduction: from the moment of approval

2.12. Instructions for the collection, storage and delivery of scrap medical products for single use (approved by the Ministry of Health of the USSR on March 24, 1989).

3. General provisions

3.1. In order to prevent the spread of human infectious diseases and exclude the possibility of infection of medical personnel, it is necessary to carry out preventive measures provided for by sanitary rules in a timely manner and in full, incl. disinfection, destruction and disposal of single-use injection syringes.

3.2. Single-use injection syringes made of plastics used in medical institutions for injections (manipulations), after treatment and diagnostic procedures, are classified as medical waste potentially dangerous in relation to the spread of infectious diseases, and are medical waste of classes B and C.

3.3. Measures for the disinfection, destruction and disposal of single-use injection syringes should be carried out in accordance with the requirements of sanitary rules and other regulatory legal acts of the Russian Federation in all medical institutions, regardless of their profile.

3.4. Monitoring compliance with the measures for disinfection, destruction and disposal of single-use injection syringes, the quality of their disinfection is included in the production control program (plan) of the medical facility.

4. Requirements for the collection and disinfection of single-use injection syringes

4.1. Single-use injection syringes are medical devices that provide injection and diagnostic and treatment procedures. After use, syringes are hazardous (class B) or extremely hazardous (class C) healthcare facility waste due to contamination with infected or potentially infectious body fluids.

4.2. Single-use injection syringes are not subject to reuse for injections.

4.3. Collection, disinfection, temporary storage, transportation, destruction and disposal of used single-use injection syringes are carried out in accordance with the "Rules for the collection, storage and disposal of waste from medical institutions" (SanPiN 2.1.7.728-99).

4.4. For the disinfection of single-use injection syringes, chemical and physical methods are recommended.

4.4.1. Chemical method of disinfection.

4.4.1.1. For the disinfection of used single-use injection syringes by the chemical method, a disinfectant solution is preliminarily prepared, which is poured into two special labeled containers with lids: "Container for disinfecting needles" and "Container for disinfecting syringes". A needle remover can be used as a "Needle Decontamination Tank" when filled with a disinfectant solution. The needle remover is a hard, non-penetrating, disposable plastic container that has a lid with a specially shaped opening, suitable for removing needles from syringes of different diameters. The "Syringe Decontamination Tank" must be equipped with a perforated tray and yoke.

4.4.1.2. After the injection (manipulation), the medical worker, without covering the needle with a cap, performs separate disinfection of the used needle and syringe by a chemical disinfection method, for which he draws a disinfectant solution from the "Container for disinfecting syringes" into the syringe using a piston. Then the medical worker disconnects the needle from the syringe in one of the following ways, depending on the availability of special devices in the medical institution:

Removing the needle with a needle remover;

Cutting off the needle with a needle cutter with an integrated puncture-proof container for needles;

Destruction of the needle using a needle destructor - a device for burning needles by exposure to high temperature.

4.4.1.3. After disconnecting the needle, the body of the syringe with the plunger is placed in a container with a disinfectant solution, marked "for disinfecting syringes", and the required exposure time is maintained according to the instructions for use of the disinfectant used. Then, a disinfectant solution is released from the syringe body using a piston, after which the disinfected pistons and syringe bodies are placed in a bag fixed on a trolley rack or a single-use container with a color marking corresponding to the class of medical waste B or C. Capacity (bag, container) after filling to 3/4 of the volume, they are packaged, placed in a mini-container with a color marking corresponding to the class of medical waste, and stored in a temporary storage room for medical waste until the end of the working shift for the purpose of subsequent transportation to the place of destruction or disposal.

When the needle remover is filled 3/4 of the volume with needles and the required disinfection exposure time is observed, the solution is carefully drained, the container is closed with a lid, placed in a mini-container with a color marking corresponding to the class of medical waste, and stored in a room for temporary storage of medical waste until the end of the working time. shifts for the purpose of subsequent transportation to the place of neutralization or disposal.

4.4.1.4. If there are no devices for removing, cutting off or destroying needles (needle removers, needle cutters, needle destructors) in the medical institution, the needle should be separated from the syringe only after the syringe with the needle has been decontaminated. Disinfection is carried out by taking the disinfectant solution through the needle into the syringe and immersing the syringe with the needle into the "Containers for disinfecting syringes" with the disinfectant solution for the required exposure time.

After the end of the disinfection exposure time, the needle is separated from the syringe with tweezers and placed in a solid package (non-piercing sealed single-use container) in accordance with the requirements of SanPiN 2.1.7.728-99 "Rules for the collection, storage and disposal of waste from medical institutions".

A disinfectant solution is released from the syringes using a piston, then they are placed in a bag fixed on a trolley rack, or a single-use container with a color marking corresponding to the class of medical waste B or C. The container (bag, container) after filling 3/4 of the volume packed, placed in a mini-container with a color marking corresponding to the class of medical waste, and stored in a temporary storage room for medical waste until the end of the working shift for the purpose of subsequent transportation to the place of destruction or disposal.

4.4.1.5. For disinfection of single-use injection syringes, disinfectants are used that have a certificate of state registration, a certificate of conformity and guidelines (instructions) for their use. The concentration of the disinfectant and the exposure time are determined in accordance with the guidelines (instructions) for its use, taking into account the regimen that is effective against pathogens of infectious diseases that the healthcare institution is focused on, and the regimens recommended for disinfecting medical devices for viral infections.

The disinfectant solution in the containers is changed at the end of the shift. The frequency of changing the solution in containers can be determined in accordance with the guidelines (instructions) for the use of a disinfectant.

The name, concentration, purpose and date of preparation should be indicated on the container for storing the disinfectant solution (for ready-to-use products approved for repeated use, indicate the start date of use).

4.4.2. Physical Methods disinfection.

4.4.2.1. The method of disinfection of single-use injection syringes with saturated water vapor in steam sterilizers (autoclaves) is used in accordance with the "Methodological guidelines for disinfection, pre-sterilization cleaning and sterilization of medical devices" dated December 30, 1998 No. MU-287-113 and "Instructions for the collection, storage and delivery of scrap medical devices single use", approved by the Ministry of Health of the USSR on September 24, 1989.

Using this method For disinfection, the bodies and pistons of syringes are placed in a special vapor-permeable disposable bag, resistant to high temperatures and intended for sterilization of medical devices. This bag is fixed on a rack-trolley inside a single-use bag designed for collecting waste with color and text marking corresponding to hazard class B and C, or put on a single-use container (container with a lid) with color and text marking corresponding to waste class B and C .

After filling the bag to 3/4 of its volume, it is sealed and delivered in a container (container) with a closed lid or in a bag designed to collect medical waste of the appropriate color marking, using a trolley rack to the place of disinfection.

After delivery to the place of disinfection, a vapor-permeable bag with syringes without needles is removed from a container (container) or an outer bag intended for collection, transportation and temporary storage of class B and C waste, placed in an autoclave and kept at a temperature of 121 ° C for 30 minutes.

Needle removers (canisters of needle cutters) with removed (cut off) non-disinfected needles after they are filled by 3/4 of the volume are closed with a lid and delivered using a trolley rack to the place of disinfection.

Needle removers (tanks of needle cutters) with needles are placed in an autoclave, having previously opened the covers of the needle removers (needle cutters) so that steam can penetrate into the container.

After the disinfection cycle, the needle removers (needle cutters) are tightly closed with lids (sealed). Syringes without needles, located in a vapor-permeable bag, are packed in a single-use outer bag designed to collect waste with color and text marking corresponding to hazard class B and C, sealed and delivered by means of a trolley rack to a temporary waste storage room (into a mini-container) until the end of the working shift for the purpose of subsequent transportation to the place of destruction or disposal.

4.4.2.2. The method of disinfection of single-use injection syringes in the UOMO-01/150 (UOMO-02/90) installation by exposure to microwave electromagnetic radiation and wet steam at a temperature of 100 ° C for 60 minutes is used in accordance with the methodological recommendations "Use of microwave electromagnetic radiation for the disinfection of infected medical waste", approved by the Federal State Health Institution "Federal Center for Hygiene and Epidemiology" of Rospotrebnadzor dated 06.05.06 No. 02.007-06.

When using this method of disinfection, after the needle is separated, the bodies and pistons of the syringes are placed in a single-use bag, fixed on a single-use container (container) or a trolley rack and intended for collecting waste with color and text marking corresponding to hazard class B and C. After filling the bag to 3/4 of its volume, it is sealed and delivered by means of a trolley rack directly to the place of disinfection.

Syringes in single-use bags are placed in a special polypropylene tank, which is attached to the UOMO-01/150 (UOMO-02/90) unit, with a polypropylene bag previously inserted into it. 2 liters of a special sensitizing solution are added to the polypropylene bag.

Needle removers (tanks of needle cutters) with removed (cut off) non-disinfected needles after they are filled by 3/4 of the volume are closed with lids and delivered by means of a trolley rack to the place of disinfection.

Needle removers (capacities of needle cutters) with removed (cut off) non-disinfected needles are placed in the center of the tank above packages with disposable syringes without needles. Before placing the needle removers (canisters of needle cutters) with needles into the tank, a sensitizing solution is added to them so that the needles are completely immersed in the solution.

After the disinfection cycle has been completed, disposable syringes, needle removers (needle cutter containers) located in a polypropylene bag are packed in a single-use outer bag designed to collect waste with color and text markings corresponding to hazard class B and C, which is then sealed and delivered by means of a trolley rack to the premises for temporary storage of waste (in a mini-container) until the end of the working shift for the purpose of subsequent transportation to the place of destruction or disposal.

4.4.3. Medical workers who disinfect single-use injection syringes draw up a final act of disinfection for the entire batch of used syringes accumulated over a certain period and prepared for delivery to specialized organizations that have licenses to work (handle) with hazardous (medical) waste (app.) .

4.4.4. The quality control of disinfection of injection syringes for single use is carried out in accordance with the production control plan of the medical facility.

5. Requirements for temporary storage and transportation of used single-use injection syringes

5.1. Temporary storage (accumulation) of needles, pistons and cylinders of syringes collected in the departments of a medical institution, packed in a single sealed container, is carried out in mini-containers of the appropriate color marking, placed in a room specially designated for this purpose or in an open area, using labeled according to the hazard class of inter-vessel containers. open storage and contact of personnel with epidemiologically hazardous waste is not allowed.

5.2. Premises for temporary storage of waste should be equipped with exhaust ventilation and a sink for washing hands with hot and cold water. The interior lining of these rooms should exclude desorption and withstand repeated wet cleaning with the use of disinfectants.

5.3. If there are no conditions in the health facility for the use of decentralized methods of destruction of epidemiologically hazardous waste permitted in the established manner, the health facility concludes an agreement for the export of used single-use injection syringes with a specialized organization licensed to handle epidemiologically hazardous medical waste (collection, transportation , placement, destruction, disposal). Small HCFs may enter into waste disposal contracts with larger HCFs that have provisions for the collection and temporary storage of additional waste.

5.4. An agreement between a healthcare facility and a specialized organization for the removal of used single-use injection syringes must include a schedule for the removal of waste.

5.5. Transportation of reusable containers with used single-use injection syringes by specialized organizations is allowed only in closed bodies of special vehicles intended for the transportation of medical waste of class B and C, with its subsequent daily disinfection. In case of emergencies, if an open (without sealed packaging) waste is found inside containers or vehicles, transport is disinfected immediately.

Special vehicles must have sanitary passport. The use of this special vehicle for other purposes is not allowed.

6. Requirements for recycling (disposal) and destruction of used single-use injection syringes

6.1. Only disinfected single-use injection syringes are subject to secondary processing (disposal). During the recycling (disposal) of single-use injection syringes, thermal methods should be used to guarantee the complete epidemiological safety of the resulting secondary raw materials.

It is forbidden to manufacture medical devices, goods for children, products that come into contact with food products from the obtained secondary raw materials.

6.2. For the destruction of medical waste of hazard class B and C, incl. single-use injection syringes, thermal methods are recommended.

6.2.1. The priority is the method of high-temperature thermal destruction (burning) of medical waste in pyrolysis furnaces, which involves the afterburning of the resulting combustion products at a temperature of 1200 - 1300 ° C, which ensures the complete decomposition of dioxins.

The advantages of the method are its environmental and epidemiological safety, a significant reduction (by 5 - 10 times) in the volume and mass of waste being destroyed. The method is universal - any waste can be loaded into the plant without any preliminary sorting.

6.2.2. It is permissible to use combined technologies for the destruction of medical waste based on a combination of mechanical grinding of medical waste and thermal (chemical) methods of disinfection in special installations of domestic and foreign production, registered and permitted for use in the territory Russian Federation.

The disadvantages of these developed technologies is their non-universality - it is not recommended to destroy bioorganic and pathological-anatomical waste in these installations, medical waste requires additional sorting. The knives used in the installations do not withstand large objects and must be replaced periodically. During operation, additional consumption of disinfectants, forced ventilation equipment at their installation sites is required. At the same time, continuous loading of medical waste is not ensured, low productivity is noted, and the mass of waste does not decrease.

6.3. In the absence of locality organizations involved in the collection, destruction or disposal of used single-use injection syringes, as well as specialized facilities designed for the destruction of medical waste in healthcare facilities, it is preferable to disinfect used single-use injection syringes (class B and C waste) in a steam sterilizer specially designated for these purposes (autoclave) at a temperature of 132 ° C (20 min) in order to subject them to destruction (change appearance and loss of consumer properties). After the disinfection, waste from health facilities can be taken out and buried at landfills for municipal solid waste (MSW).

7. Requirements for organizations involved in transportation, disinfection, placement, recycling (disposal) and destruction of used single-use injection syringes

7.1. Transportation of medical waste (used single-use injection syringes) from medical institutions (organizations), disinfection, placement, recycling (utilization) and destruction are carried out by specialized organizations licensed to handle epidemiologically hazardous medical waste.

7.2. Specialized organizations Those carrying out this activity must have their own vehicles intended for the transportation of epidemiologically hazardous medical waste (classes B and C). Special vehicles must have a sanitary passport. Vehicles are disinfected daily.

7.3. The final stage of the activities of specialized organizations for the handling of used single-use injection syringes is their destruction (burning) or recycling (utilization) at specialized facilities owned by these organizations, or export under contracts with other enterprises and organizations specializing in destruction (burning) or recycling (disposal) of used single-use injection syringes.

7.4. All employees of specialized organizations are required to:

Undergo special training on the rules for handling epidemiologically hazardous medical waste;

Observe safety precautions when working with medical waste, the requirements for the operation of installations for the destruction (incineration) or recycling (disposal) of used single-use injection syringes;

Use personal protective equipment;

Be immunized against viral hepatitis B.

7.5. Specialized organizations licensed to deal with epidemiologically hazardous medical waste must be provided with the necessary technological equipment, consumables and disinfectants in sufficient quantities.

8. Requirements for the observance of safety precautions by the staff of health facilities during the collection, disinfection, temporary storage and transportation of injection syringes disposable

8.1. Medical workers who collect, decontaminate, temporarily store and transport used single-use injection syringes must have special safety training for these works, be able to use special equipment and disinfectants in accordance with the functional duties approved by the head of the healthcare institution. Personnel must be immunized against hepatitis B and have an appropriate entry in the medical book.

8.2. Persons under the age of 18 and who have not undergone preliminary training are not allowed to work related to the collection, disinfection, temporary storage and transportation of used single-use injection syringes.

8.3. Training of personnel on the rules for the safe handling of used single-use injection syringes is carried out by specialists responsible for organizing waste management in each health facility.

8.4. The specialist (deputy chief physician for technical issues, epidemiologist, chief nurse) responsible for organizing the management of medical waste is appointed by order of the head of the healthcare institution after passing a specialized training cycle.

8.5. Medical workers collecting, disinfecting, storing, transporting medical waste are strictly prohibited from:

Pour the collected single-use injection syringes from one container to another;

Place containers for collecting single-use injection syringes near electric heaters (both in places of formation and in temporary storage rooms);

Tamp the waste of single-use injection syringes with your hands;

Collect waste from single-use injection syringes without gloves and overalls.

8.6. The head of the healthcare facility is responsible for training staff in the safe handling of medical waste.

8.7. In the event that an employee is injured when handling used syringes, emergency preventive measures must be taken in accordance with the current instructive and methodological documents. All such cases are recorded in the injury reports indicating the date, time, place, nature of the injury, they describe in detail the situation, the use of personal protective equipment, compliance with safety regulations, indicate the persons who were at the site of the injury, as well as the applied skin treatment method, mucous membranes (app.).

8.8. At the workplace of personnel involved in the collection and transportation of waste, there should be a first aid kit (5% alcohol tincture iodine, 70° alcohol, potassium permanganate and water for dissolution, sterile wipes, bandages, plaster and bactericidal plaster).

8.9. Employees involved in the collection and transportation of medical waste must undergo preliminary medical examinations upon admission to work and periodic medical examinations in accordance with applicable regulations.

8.10. Personnel engaged in disinfection, collection and transportation of waste should be provided with overalls (gown, cap, shoes) and personal protective equipment (respirators, rubber gloves, sealed goggles, waterproof aprons, which are used in accordance with the instructions).

8.11. In the event of an accident during the use, disinfection, collection and transportation of single-use injection syringes, the following actions are necessary:

The medical worker immediately informs the head of the organization;

If the injection material gets on the mucous membranes of the eyes, they are washed with plenty of water;

In case of contact with the injection material, the skin is wiped twice with 70 ° m ethyl alcohol, and in case of damage to the skin, the wound is washed with water, treated with tincture of iodine and medical observation of the victim is established;

Contaminated surfaces and medical clothing are treated with disinfectant solutions;

Upon completion of the actions to eliminate the accident, the responsible person draws up an act in which he reflects the place, time, causes of the accident, measures to eliminate it;

The act is approved by the head of the organization.

9. References

1. Order of the Ministry of Health of the USSR dated July 31, 1978 No. 720 "On improving medical care for patients with purulent surgical diseases and strengthening measures to combat nosocomial infection."

2. Order of the Ministry of Health of the USSR of 03.09.91 No. 254 "On the development of disinfection in the country" with amendments and additions (letter of the Ministry of Health of the Russian Federation 23-02/733 and GKSEN of 29.07.92 No. 01-20 / 104-11).

3. Order of the Ministry of Health of the Russian Federation dated November 26, 1997 No. 345 "On improving measures for the prevention of nosocomial infections in obstetric hospitals".

4. Order of the Ministry of Health of Russia dated November 10, 2002 No. 344 "On the state registration of disinfectants, disinsection and deratization agents for use in everyday life, in medical institutions and at other facilities to ensure the safety and health of people."

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Depending on the hazard class, a medical institution disinfects and sterilizes medical instruments, confirmed by acts and relevant documentation. For 5 years now, the Russian Federation has been implementing new sanitary and epidemiological rules and norms for medical waste, including syringes.

According to the document, there are 5 hazard classes of medical waste. Syringes, as equipment in contact with body fluids, belong to class "B" - dangerous in an epidemic sense, or to class "C" - especially dangerous if they were used to treat infections that represent serious threat for the population.

Requirements for recycling activities

The administration of medical institutions approves the instruction, according to which the employees responsible for the processing and destruction of used disposable syringes are determined.

The instructions must include:

• The allocation of separate containers for the transportation of waste of various classes, since mixing them in one container is not allowed.
• Ways of moving used syringes to sterilizing devices, places of temporary storage and destruction
• Unloading and loading, use of mechanical equipment - carts, electric lifts, conveyors and other machines
• Briefing of persons responsible for the disinfection and disposal of used syringes.

The instruction is drawn up taking into account the current rules and regulations and is signed by the chief physician medical institution.

Scheme for handling used syringes

The scheme of work with recycling material indicates:

• Composition, quality and quantity
• Containers for storage and removal of tools hermetic bags, single-use and reusable.
• The procedure for collecting used instruments from treatment rooms, operating rooms and other departments.
• Methods for disinfecting syringes of different hazard classes, their export and disposal
• The procedure for personnel in case of violation of the tightness of the packaging and spillage of used tools, as well as in emergency situations - injury to fingers with used needles, etc.
• Regulations for training employees in safety rules when working with material to be disposed of.

Who can recycle

Persons from among the medical personnel who have reached the age of 18 are allowed to work with used syringes. All of them are required to undergo scheduled medical examinations and be vaccinated in accordance with the procedure for vaccinating medical staff. Persons who have not been immunized against serum hepatitis are not allowed to work on decontamination and transportation of used instruments.

The personnel responsible for the storage and removal of tools must be regularly instructed in compliance with safety measures. At work medical workers must be equipped with overalls and shoes, which are stored in separate cabinets. Washing of overalls is carried out in the laundries of a medical institution; it is unacceptable to take it home.

When working with spent material of class "B", personnel are required to protect the respiratory organs with masks.

Collection of used tools

Disinfection of medical instruments is applicable for devices that belong to Class B waste. For this, various methods are used - soaking in disinfectant solutions, sterilization with microwave rays, dry and wet steam. Then they are collected in puncture-proof durable bags. yellow color or provided with a yellow marking, which corresponds to the class "B". Liter packages contain 20 assembled syringes.

Collection scheme

You can use reusable waterproof containers with a tight-fitting lid for collection. There are containers for 5 and 10 liters, where 100 - 200 used syringes are placed. Containers are filled three-quarters or to the top, covered with a lid and sealed according to the color of the corresponding class.

The instrumentation is folded unassembled, or the needles are preliminarily separated from them using needle removers, needle destructors or needle cutters. Separating them manually is unacceptable. Needles are stored in sealed containers, and syringes in heat-resistant plastic bags.

Tools of hazard class "B" are folded into containers marked in red. It is forbidden to pour devices from one container to another, tamp them down and load needles into soft single-use packaging.

In places where disinfection and collection of used syringes are carried out, at least once a year, microbiological control of the quality of processing is carried out and air samples are taken for the content of volatile toxins.

Disinfection and all stages of collection and transportation of instruments are subject to documentation. The regulation is spelled out in the adopted SanPiN.

After collecting

After collection, used syringes and needles are sent to storage sites, from where they are then taken to a disposal site.

For export, special vehicles with a closed body are used. According to the export regulations, the car is filled with bags and containers with medical waste and transports them to the disposal site. After the procedure, the car is disinfected.

Disposal of tools

The problem of disposal of waste from medical institutions in Russia is very acute. Syringes make up about 2% of all waste to be disposed of. Hundreds of tons of disposable syringes are produced annually in large metropolitan areas.

Currently, there are two schemes for their destruction in the Russian Federation - liquidation and disposal.

Elimination methods include:

1. Burial at a landfill, which is specially allocated for medical MSW
2. Storage at the landfill after disinfection
3. Incineration in high temperature furnaces
4. Autoclaving

At landfills, the volume of solid waste is reduced by pressure testing at special installations. The first two methods are only acceptable for syringes and needles belonging to hazard class "B". Epidemiologically dangerous tools are to be burned.

Burning

Disposal in the form of incineration is carried out in several ways. The most common is with the help of incinerators - special furnaces with a high temperature regime. With all their advantages, incinerators are sources of dioxins - carcinogenic substances, pollute the environment with mercury compounds and neurotoxins that destroy nervous system. The ash from incinerators is also toxic and dangerous for toxins to enter aquifers.

A more environmentally friendly way is incineration in a plasma furnace. The principle of its action allows you to safely destroy syringes and needles. The smoke formed during combustion passes through the slag layer, where it is neutralized and partially dissolved. Then it enters a special chamber, where it undergoes a 5-stage purification, and then is released into the atmosphere. The plasma furnace operates on the territory of the capital's 1st Clinical Infectious Diseases Hospital.

Pyrolysis is a two-stage combustion, which provides for the preliminary decomposition of waste in an oxygen-free environment and their afterburning in a chamber to safe fractions.

Sterilization

In Russia, installations that combine two functions - a chopper and a sterilizer are gaining popularity. Used disposable syringes of hazard classes "B" and "C" are loaded into such an autoclave. They are crushed and sent to sterilize with hot steam under high pressure. After the procedure, class A sterile waste is taken to the landfill and buried.

Utilization methods and disinfection involve the processing of polymeric materials into secondary raw materials. The algorithm of actions is quite long. The disassembled tools are first sent for pre-cleaning, then they are crushed, washed, dried, granulated and sent to the recycling plant. The recycling method and disinfection is environmentally friendly - no harmful substances are formed during the processing and economically justified. Today it is being improved to be massive. The biggest disadvantage of the disposal method is the need for sorting, since the body, piston and needle holder are made up of different types plastic polymers.

Today, scientists around the world are busy with the problem of creating biodegradable polymers. Such syringes after decontamination will decompose at landfills to safe fractions. As for the tools currently in use, it is necessary to be guided by the requirement for decontamination, destruction and disposal of syringes and other items.

This methodological material is intended for all structural units of hospitals and polyclinics that use single-use injection syringes in sterile factory packaging; engaged in disinfection, collection, transportation of syringes.

IN methodological material set out the requirements aimed at organizing work on the collection, storage, disinfection and disposal of single-use injection syringes, reducing the risk of infection of medical personnel in the performance of their duties, the implementation of basic safety rules when handling used single-use injection syringes, as well as the procedure in emergency situations.

The requirements are aimed at protecting the health of medical personnel, personnel of organizations involved in the collection, transportation, disinfection of used single-use injection syringes, as well as ensuring protection environment when carrying out medical and diagnostic manipulations in medical institutions.

General provisions

Attention!

In order to prevent the spread of human infectious diseases and exclude the possibility of infection of medical personnel, it is necessary to carry out preventive measures provided for by sanitary rules in a timely manner and in full, including disinfection, destruction and disposal of single-use injection syringes.

Single-use injection syringes made of plastics used in medical institutions for injections (manipulations), after treatment and diagnostic procedures, are classified as medical waste potentially dangerous in relation to the spread of infectious diseases, and are medical waste of classes B and C.

Measures for the disinfection, destruction and disposal of single-use injection syringes must be carried out in accordance with the requirements of sanitary rules and other regulatory legal acts of the Russian Federation.

Monitoring compliance with the measures for disinfection, destruction and disposal of single-use injection syringes, the quality of their disinfection is included in the production control program (plan) of the medical facility.

Requirements for the collection and disinfection of single-use injection syringes

Single-use injection syringes are medical devices that provide injection and diagnostic and treatment procedures.

After use, syringes are hazardous (class B) or extremely hazardous (class C) healthcare facility waste due to contamination with infected or potentially infectious body fluids.

Single use injection syringes reuse not subject to injection.

Source: https://moluch.ru/conf/med/archive/154/7536/

The procedure for disposing of disposable instruments

For many medical organizations disposal of disposable instruments - serious problem . The institution needs to find a company that provides waste disposal services.

After all, it is strictly forbidden to simply throw away used needles, syringes, and other disposable medical instruments. The procedure for the disposal of medical instruments is quite complicated, so that health institutions begin to deal with it themselves.

It is much more convenient for them to find an enterprise that is ready to provide them with the necessary service.

How medical waste should be disposed of is prescribed in the SanPiN rules.

They indicate how the collection of used instruments is carried out depending on their type, transportation to the place of destruction and the method of disposal.

Various types of tools are being processed. And the requirements for their transportation and destruction are different.

Collection and recycling of waste is carried out strictly according to the rules. Depending on the type of instruments, they may be prescribed to be treated with disinfectants, and only then packed and transported to the place of destruction.

Also, used accessories must be stored and transported in special waterproof containers that are highly durable and cannot be pierced with a needle or any other sharp object.

Spent syringes are placed in a container immediately after their use. When a sufficient amount of used tool is collected in the container, it is closed, sealed and marked.

The container is marked - class B, which corresponds to the level of "hazardous waste".

Filled containers are also disposable. They are destroyed along with their contents.

How disposable instruments and containers are disposed of where was it placed? Autoclaving is used to destroy plastic products.

At temperatures above 140 °C, the plastic softens and the product turns into a normal mass of plastic. In order to completely destroy the sharp and piercing parts of the tools, they are placed in a special crusher that crushes them.

Thanks to this method of waste processing, the complete destruction of disposable medical equipment occurs. In addition, thanks to the shredding of objects, the volume of waste can be reduced by 60 - 80%.

According to the requirements of medical institutions, it can be carried out disposal of disposable instruments, not only used, but also sterile.

Since unused instruments do not pose a risk of infection to humans and animals, they can be disposed of in other ways than by autoclaving.

Their burial or removal to specialized landfills is allowed.

Use the services of reliable companies

It is very important for medical institutions to use the services of waste disposal companies that can provide them with qualified services. The destruction of syringes, needles and other instruments is a difficult and responsible job.

Therefore, it should be dealt with only by organizations that not only know the algorithm for the destruction of such waste, but also have the opportunity to recycle it.

If the used instrument is not destroyed in accordance with the rules, this will damage the reputation of the medical institution, because it will put the population at risk of infection with dangerous viruses.

Therefore, in order not to break the law and not put people and the environment at risk, clinics should find an organization that has affordable prices for the disposal of medical instruments for a medical institution.

Source: https://medi.ru/info/7592/

DIAinstruction: safe disposal of medical waste at home

This article will focus on the SAFE USE of pen and syringe needles, as well as lancets and infusion set cannulas, at home, at work and while traveling.

How to dispose of used sharps, which are in abundance in the daily life of a person with diabetes?

The easiest way is to throw it in the trash and forget it.

BUT: when throwing away, it is important to make sure that no one can get hurt with needles (at risk are your loved ones, children, employees of garbage disposal companies, housekeeper, janitors) - this is dangerous not only with cuts or injuries, but also with infection, in if the user has diseases such as viral hepatitis B, C or HIV.

To avoid accidental cuts/damages, needles and other sharp objects must be placed in special CONTAINERS after use - they are made of puncture-resistant plastic with a tight-fitting lid. In some countries, these containers are available from pharmacies, medical supply stores, or online.

In the absence of such containers, you can use a suitable container for detergent or other household chemicals made of durable plastic. Label the container stating that it contains sharps. Always place the container in the middle of the trash bag.

Safe disposal of used needles/syringes/lancets/cannulas is needed everywhere - at home, at work, at school, while traveling and in other in public places such as hotels, parks and restaurants.

Never leave needles and other sharps (outside the sharps disposal container) in the open or in public trash cans, and never flush them down the toilet!

And finally - 8 simple rules To prevent injuries from sharp objects:

1. Do not throw used needles in the trash.
2. Keep sharps containers out of the reach of children.
3. Do not throw used sharp objects down the toilet.
4. Do not use glass or plastic bottles, cardboard boxes or cans to make containers.
5. There is no need to "fill to the brim" the container - when it is two-thirds full, it's time to throw it away.
6. Do not wait. Place your sharps in a container immediately after use.
7. Do not bend or break the needle.
8. Do not use other people's needles;

Solid waste is classified as hazardous if:

• they are the cause / one of the reasons for the increase in mortality, the frequency of severe and irreversible diseases, including those leading to disability;
• represent a potential hazard to humans or the environment in case of violation of the disposal technology.

Distinguish liquidation and utilization methods of processing of medical waste. Liquidations include:

• burial at a special site;
• storage at MSW landfills after preliminary disinfection;
• burning.

Disposal methods mean the use of medical waste as a secondary raw material. In particular, recycling methods are applied to products made of polymeric materials and metal.

Disposal of disposable syringes and needles

Before the syringes are released from the needles using a needle remover, destructor or needle cutter. Used syringes and needles are subject to separate chemical or physical disinfection. During chemical disinfection, syringes and needles are treated with disinfectant solutions.

Physical disinfection of needles and syringes is performed by a single autoclaving or microwave treatment. Before processing, the waste is placed in special bags or containers. Autoclaving is carried out for half an hour at a steam temperature of 121 °C. For the final destruction of needles and syringes after autoclaving, a crusher or mill is used.

Processing after use with microwave radiation is the most advanced method of disinfection. Compared to autoclaving, it is less energy intensive, and the disinfection mode is controlled automatically. In addition, during processing, the temperature of exposure to waste is about 140 ° C. Irradiation is carried out for an hour, after which the waste is subject to grinding and further disposal.

Self-disrupting (self-locking) syringes are collected in safe disposable non-puncture containers, which are subject to decontamination by autoclaving or microwave radiation. After disinfection, the container must be disposed of along with all contents.

For temporary storage within the institution, sealed containers or bags with used syringes must be sealed, labeled according to the hazard class and placed in a specially equipped room.

For transportation of waste outside the LPO, special vehicles with a closed body are used. After the flight, it is disinfected and cannot be used for any other purpose.

Safety requirements

When working with hazardous medical waste, personnel should wear special and replacement shoes, which are stored separately from everyday clothing. Hands must be protected with rubber gloves. For disassembly and washing of reusable containers, it is necessary to wear a rubber apron. All requirements for the processing, disinfection and disposal of disposable syringes, including dental - carpool, are prescribed in regulatory documents, SanPiN and guidelines.

It is strictly forbidden to eat or smoke in the area where waste is processed.

Why disinfect disposable syringes? Sanitary and hygienic treatment is carried out in order to eliminate pathogenic microorganisms, fungi and microbes that are dangerous to the health of medical staff and patients. All medical devices are subject to sterilization and disposal after their use in a patient, including a single use.

Sanitization steps

The main stages of sanitation of disposable syringes and other instruments are:

1. proper disinfection;
2. preparation for sterilization;
3. sterilization.

a) Physical method

Disinfection includes the physical or chemical method of cleaning needles and syringes after use. The choice of rehabilitation method depends on the material of the product and the method of its use. Physical cleansing includes:

• boiling;
• dry steam treatment;
• steam treatment under pressure.

This method is environmentally acceptable, safe and reliable, so it is preferred under the right conditions. Before boiling, medical instruments are washed running water from visible contamination and placed in water.

Dry steam treatment is carried out in an air sterilizer, in which products are placed without visible traces of organic contamination. Sanitation with wet steam under pressure is carried out in a special steam sterilizer without preliminary purification from organic contaminants.

b) Chemical method

Chemical disinfection of needles and syringes involves the use of disinfectants. Tools are immersed in the solution in glass, plastic or enameled containers with lids.

Flushing of needles and syringes prior to chemical sterilization is unacceptable. However, aldehyde-containing preparations require pre-cleaning of disposable syringes before sanitation. Processing of disposable items made of plastic and glass is carried out using chlorine-containing preparations. At the end of the procedure, the items are washed.

Processing of medical supplies (syringes, needles, etc.) is carried out in containers special purpose. There are two of them: for washing; for sterilization.

Destruction of sharp objects

Rules for the elimination of sharp objects:

• needles must not be broken to avoid injury;
• the needles are placed in a durable sealed container.

Deformation of sharp objects is carried out in a special sterilizer at elevated temperature for 30 minutes.

Important! Use medical gloves to apply the disinfectant. Remember that rubber gloves will not protect you from a needle injury, but will help clean it from local contamination with blood and other organic matter.

What items can be recycled

Disposal is subject to medical instruments (single-use needles, single-use syringes) that have been in contact with:

1. with blood;
2. with saliva and mucous membrane;
3. with wound surface.

Decontamination is the process of processing medical devices in order to destroy pathogenic microorganisms. Disinfection consists of two stages: cleaning, disinfection. Cleaning always precedes the disinfection and sterilization process.

Disinfection destroys most of the pathogenic microorganisms, excluding bacterial spores. Sterilization destroys absolutely all biologically active forms of life, including bacterial spores.

The process is clearly shown in the video:

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