How are disposable syringes disinfected? Disinfection of disposable syringes - handling rules Disinfectants for the treatment of syringes and needles
Disinfection of syringes is carried out in a medical institution in accordance with the sanitary and epidemiological standards of the Russian Federation. Syringes come into contact with body fluids, respectively, differ in the degree of danger. If the instrumentation was used to treat patients infected with an infection, it belongs to class "B". If the device has been in contact with a patient's body that is not infected with an infectious pathology, it belongs to class "B". Disinfection of disposable syringes requires strict adherence to standards.
General information about the handling of waste syringes
Each medical institution has an instruction that determines the employees responsible for the processing and disposal of syringes. The document contains a list of rules regarding handling, transportation and disposal. Disinfection of single-use needles and syringes is carried out under the supervision of the chief physician. The medical institution allocates containers for instruments in accordance with the hazard class, determines the ways of moving waste and unloading it to a temporary storage site.
The employee responsible for handling and disposal is instructed. The instruction is made by the head physician. The document indicates which containers are used for the transportation and storage of waste. Syringes are stored in sealed bags. The person responsible for sterilizing syringes must know how to properly collect them.
Disinfection and storage
The instructions drawn up by the chief physician indicate the sequence of actions of the staff if the integrity of the package is violated. The document contains information on what to do for an employee in case of skin damage with waste needles. Disposal of equipment must be carried out in accordance with the rules specified in the instructions. Disposal is carried out by an employee of a medical institution who has reached the age of eighteen, who has a sanitary book. If an employee has not been routinely vaccinated against hepatitis, he is not allowed to transport and dispose of syringes.
Employees responsible for sanitization and disposal, are constantly instructed in compliance with safety requirements. Personnel who are responsible for the storage and processing of disposable syringes according to SanPin have separate clothes and shoes. Laundry is carried out in the laundries of the medical institution. If personnel come into contact with syringes belonging to hazard class "B", a respirator must be worn. Tools that belong to the class "B" are disinfected by different methods. It is soaked in special solutions, sterilized with steam. It is possible to use microwave. Class B tools are placed in yellow bags. If there is a marking, it is usually yellow. The 1 liter bag contains 20 assembled syringes.
Containers with tight-fitting lids may be used for collection. Tools are placed in containers of 5 or 10 liters. Containers are filled to the top and closed. Marking for hazard class "B" is yellow. If possible, the staff uses needle removers, however, the tools can be stored assembled. The needles are not separated by hand. If they are removed, they are placed in special sealed containers. For tools belonging to class "B" (especially dangerous), red packages are distinguished, their marking is also red.
The staff undertakes to comply with the rules prescribed in the instructions "Requirements for the disinfection, destruction and disposal of syringes." Used tools must not be transferred to third-party containers, processed or disposed of in unforeseen ways. Once every 12 months, control is carried out. Experts take samples to identify harmful components in the air.
Transportation of waste syringes
First, the employee collects the used syringes, then sends them to the warehouse. After that, the devices are brought to the place where recycling is carried out. Syringes-waste is taken out in a special vehicle with a closed body. The export regulations indicate that employees fill the car with containers and packages with tools. Together with syringes, other honey waste is transported. When the tools are delivered and unloaded, the car is disinfected.
How is destruction carried out?
There are two schemes for the destruction of used tools: liquidation and disposal. Liquidation - storage of waste underground in a pre-allocated area. The method also involves placing in a warehouse after disinfection. Instrumentation, which is waste, is burned at high temperatures, the procedure is called autoclaving. In a specially designated area, the amount of resulting waste is reduced by applying pressure testing. If the syringe is class B, it is burned.
This method of disposal is carried out in different ways. Incinerators are often used. They have a significant drawback - they emit dioxins, carcinogenic substances that violate the environment. Dioxins release mercury compounds. These compounds disrupt the functions of the central nervous system, adversely affect internal organs. Carcinogenic substances released by dioxins enter the air and water. Burning syringes in plasma ovens is a safer method, suitable for destroying not only syringes but also needles. In this case, the device generates smoke passing through the slag layer.
Thanks to the lacquer layer, the toxins partially decompose, the smoke goes into the chamber, where a five-stage purification is carried out, only then the smoke enters the atmosphere. Used tools are burned by pyrolysis. First, the waste decomposes in an oxygen-free space, then it is burned and brought to safe values. Devices that combine the functions of a sterilizer and a chopper have gained popularity. Such autoclaves are used to process syringes of classes B and C. The tools are crushed and sent for sterilization. Hot steam is used for sterilization. After this procedure, the waste becomes completely purified. Those that belong to class "A" are taken out and placed underground.
Disinfection and disposal can be carried out in order to obtain recyclable materials. Recycling is a complex, painstaking process. The tools are pre-cleaned, then they are crushed, washed, dried, granulated, sent for recycling. Unlike recycling, disinfection is a reliable and more environmentally friendly way. When machines recycle syringes, not many toxins are released into the air. Disposal and disinfection are being improved. Despite the advantages, the methods have disadvantages. In order to properly dispose of, you need to sort the syringes, because the toolkit combines parts made from different kind plastic.
Classification of medical waste
As indicated, syringes belong to classes "B" and "C". The rest of the waste has its own classification.
- Class A. This includes medical waste that has not come into contact with the patient's body fluids. Doctors' stationery is packed separately, food waste. High shade to the color of plastic containers is not provided, but it should not be yellow and red.
- Class B. In this case, the equipment poses an epidemiological hazard, but is not particularly dangerous. Devices that have interacted with biological fluids are placed in a yellow sealed polyethylene package. Class B includes surgical waste. They are stored in airtight soft or hard containers, marked with yellow. The volume of packaging depends on the amount of waste. Containers for storing syringes should be moisture resistant, tightly closed.
- Class B. This includes waste that has an increased threat of an epidemic. Instruments that have been in contact with a patient infected with a viral or infectious pathology are packed in a red container. If the materials are in environment, there is a possibility of an epidemic. Class B includes instruments that have been used to study microorganisms. Waste is placed in bright red containers or airtight plastic bags. The container must be very strong, protected from accidental opening.
- Class G. This includes drugs and devices with mercury that carry a toxic threat. Waste is collected in a secure package, stored for no more than 24 hours. The packaging of such waste has a special marking.
- Class D. These are radioactive materials. Hospitals typically hire carriers to transport this type of waste. Waste is packed in strong containers protected from involuntary opening.
Storage Features
Before placing the waste in storage, you need to pack it in a soft container. It should not be filled closely, it is allowed for 2/3. It is necessary to ensure the tightness of the packaging - pull it so that it does not come undone. The package is marked - the date of packaging, the name of the employee responsible for storage and disposal, the name of the health facility. Marking is applied with resistant paint, an alternative is gluing a tag.
Packages are changed once every 7 hours or more often, it all depends on which class the specific waste belongs to. The employee responsible for the storage and transportation of containers must comply with all safety regulations. If water gets on the packaging or it is inadvertently opened, the storage rules are considered violated. Containers are transported in accordance with the established export schedule. The rules for the placement of containers with waste are established by the management, based on the requirements of the current legislation. If there is a lot of medical waste, the area of \u200b\u200btemporary storage is increased. The room in which the containers are stored must be concreted. Medical waste is not stored in paper packaging.
Urns located outside the vault must meet certain requirements. The average volume of one urn is 10 liters, it is located near the entrance. If necessary, put a few pieces. When the territory is cleaned, plastic containers with a volume of up to 50 liters are used. For the convenience of unloading garbage, specialized carts are used. Waste with an increased risk of fire is stored in a separate container. The room must be covered with metal sheets.
The problem of waste disposal has always been relevant. Today it is possible to destroy used medical instruments without harm to health. However, if garbage is disposed of inappropriately, toxic substances will enter the soil, water bodies and air. Outdoor incineration is a more harmful disposal method. Smoke-cleaning ovens are used to destroy syringes. This method of waste disposal is considered high-quality and environmentally friendly.
Requirements for the disinfection, destruction and disposal of single-use injection syringes
Guidelines
MU 3.1.2313-08
mu-3.1.2313_08.pdf (469.34 KB) 3589 downloads
1 area of use
1.1. These guidelines (MU) are intended for all medical and preventive institutions (HCIs), organizations, enterprises, regardless of departmental affiliation and ownership, using single-use injection syringes in sterile factory packaging; engaged in the collection, transportation, disinfection, destruction and disposal of syringes, design and operation of installations for the processing of single-use injection syringes made of plastics; as well as for institutions that supervise the provision of medical care, immunoprophylaxis, compliance with the sanitary and anti-epidemic regime in medical facilities.
1.2. The guidelines set out the requirements aimed at organizing the work of a medical institution for the collection, storage, disinfection, destruction and disposal of single-use injection syringes, reducing the risk of infection of medical personnel in the performance of their duties, compliance with the basic safety rules when handling used injection syringes single use, as well as the procedure for emergency situations.
1.3. The requirements of the guidelines are aimed at protecting the health of medical personnel, personnel of organizations involved in the collection, transportation, disinfection, destruction and disposal of used single-use injection syringes, as well as ensuring environmental protection during medical and diagnostic manipulations in medical institutions.
3. General provisions
3.1. In order to prevent the spread infectious diseases of a person 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.
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 must be carried out in accordance with the requirements of sanitary rules and other regulatory legal acts 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 reuse not subject to injection.
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 disinfection method.
4.4.1.1. For the disinfection of used single-use injection syringes by the chemical method, a disinfectant solution is first 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. "Container for disinfection of syringes" must be equipped with a perforated tray and oppression.
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 color marking corresponding to the class medical waste B or C. The container (bag, container) after filling by ¾ of the volume is packed, 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 shift for the purpose of subsequent transportation to place of destruction or disposal.
When the needle remover is filled ¾ 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 shift from 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 "Capacity 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 by ¾ of the volume is packed, 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 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 of 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 USSR Ministry of Health 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 by ¾ 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 (tanks of needle cutters) with removed (cut off) non-disinfected needles, after filling them by ¾ 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 С for 60 minutes is used in accordance with guidelines"The use of microwave electromagnetic radiation for the disinfection of infected medical waste", approved by the Federal State 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 by ¾ 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 filling them by ¾ 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 those conducting disinfection of 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 (Appendix 1).
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.
4.5. Without preliminary decontamination in a medical facility, collection, temporary storage and transportation of medical waste generated during injections is allowed, if all the necessary epidemiological safety requirements are met in the process of their collection, temporary storage, transportation to the place of neutralization with the obligatory use of thermal methods of destruction (burning).
In this case, syringes with needles immediately after their use are placed in disposable sealed non-piercing containers with color and text markings corresponding to waste class B and C, registered and authorized for use in the prescribed manner. The design of containers for collecting waste should ensure their sealing and the impossibility of opening them during transportation. After filling the containers by ¾ of their volume, they are sealed, placed for temporary storage in a specially designated room for the storage of medical waste, and then transported for the purpose of subsequent destruction by thermal methods (burning) by specialized vehicles of an organization (firm) that has a license to work (handle) with hazardous (medical) waste.
4.6. The method of collecting medical waste generated during immunization without preliminary disinfection specified in paragraph 4.5 can be used when vaccinating children and educational institutions, during the work of mobile vaccination teams. In this case, disposable sealed containers with color and text marking corresponding to waste class B and C are sealed at the end of the working day or when they are ¾ full, placed in a mini-container with a tight-fitting lid, specially designed for transporting hazardous medical waste. A mini-container with waste generated after immunization in children's and educational institutions, during the work of mobile vaccination teams, is transported to the medical facility by vehicles specially allocated for this purpose of this institution for subsequent destruction by thermal methods along with other waste from the facility. After transportation, the mini-container(s) are subjected to washing and disinfection.
4.7. Single-use packaging for waste collection (bags, containers, sealed containers for collecting needles and syringes) used in medical facilities must meet the medical and technical requirements for these products and have a registration certificate authorizing its use in medical practice in accordance with SanPiN 2.1 .7.728-99.
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, including 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 С, 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 on the territory of the 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 С (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 implementing 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;
to collect waste of 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 (Appendix 2).
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
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 rehabilitation disposable syringes and other tools are:
- proper disinfection;
- preparation for sterilization;
- 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:
- with blood;
- with saliva and mucous membrane;
- 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:
Syringe Kalashnikov pistol for injection
Syringe pen for insulin with a removable needle - how to choose?
Medical syringes: sizes and other characteristics
Disinfection treatment of syringes and needles according to sanitary standards is carried out in heat-resistant plastic bags and non-puncture special containers using microwave radiation or autoclaving. During autoclaving, medical waste is treated with steam for half an hour at 121°C. The quality of disinfection is controlled by biological or litmus indicators.
In order to completely destroy the syringes and needles melted during the autoclaving process, their remains are placed in a mill or crusher.
Microwave irradiation of medical waste is the most reliable and versatile method of disinfection. It is less energy-intensive, its control system is automated, and the environment is not exposed to environmental hazards. Syringes and needles are treated with microwave radiation for an hour, after which they are crushed, compressed and disposed of without the formation of toxic gases, smoke and other waste.
Disposal of syringes and needles
Safe and convenient disposal of auto-disable syringes and disposable injection needles is done using a water-resistant, puncture-proof container. It is installed on a stable surface and processed medical waste is lowered inside, filling the container to ¾ of its volume (or completely). After the container is completely filled, the container is hermetically sealed with a lid, a seal is applied with a marking corresponding to the waste class, and transferred to a temporary storage room closed to unauthorized persons. The containers are then decontaminated and destroyed.
One liter safety container can hold twenty syringes and needles, while a five to ten liter container can hold 100 to 200 syringes and needles.
In addition to safe containers, a separation method is also used - with a special needle cutter, needles are removed from used syringes and placed in a sealed container that is integrated into the needle cutter. The syringes themselves are placed in heat-resistant plastic bags, which, together with containers, are transported by special vehicles with a closed body, and then disposed of. After disposal, the transport is disinfected. When collecting, processing, packaging and disposing of waste, medical workers must wear overalls and rubber gloves, and also comply with all sanitary norms and safety rules.
For the past five years, completely new epidemiological and sanitary norms and rules have been in force on the territory of our country regarding the disposal of such medical waste as needles and syringes.
It is worth noting that syringes and needles are class B, as they are in direct contact with liquids. human body. In this regard, the disposal of needles and syringes in Moscow and the Moscow region should be carried out in places specially equipped for this and with strict observance of all safety measures.
The management of medical institutions determines responsible persons who are responsible for collecting used syringes and needles for them and storing them. Particular attention is paid to syringes and needles of class B, that is, those that have been in direct contact with infected patients and can cause the spread of infection.
Preparation for disposal
Before disposal, used needles and syringes are sorted into different containers depending on the waste class. Class B and C waste may not be stored together under any circumstances. Before storage, the waste material is disinfected. Only after it, needles and syringes are sent for storage and subsequent removal for disposal. Employees may carry out transportation and disposal work only if the following conditions are met:
- Age over 18 years.
- The presence of vaccinations.
- Passed medical examination.
- Immunized against serum hepatitis.
- Have received appropriate training.