What to do if the sharps container is knocked over and stabbed

The nurse in the medical examination department accidentally knocked over the sharps box and the needle stuck on the examinee. Apart from drawing blood and tracking the examinee, what measures should be taken?

If a patient is injured, it must be a medical adverse event. The first thing to do is blood tests, do a comprehensive blood test if the hospital conditions permit including hepatitis B, hepatitis A, hepatitis C, hepatitis E, tuberculosis, syphilis, AIDS and other infectious diseases, to confirm whether the stabbed patient is infected with infectious diseases.


 

Secondly, the tracking and prevention of blood-borne pathogens.
This is easy to think of as a sensor controller, but there are two issues to consider:
①Is it necessary to monitor blood-borne pathogens for all examiners or relevant examiners in the sharps box?
The physical examination items of the medical examiners may not all have the eight screening immunization items (hepatitis B, hepatitis C, syphilis, HIV). One of the problems of the disease, and the incubation period of the disease also needs to be considered. It can be tracked and dealt with according to the source of unexplained exposure. Do you agree?

②Whether or not to carry out large-scale screening of patients, there is still another question to consider, the problem of HIV prevention drugs?
In fact, this question can be turned into if the medical staff is exposed to unknown reasons, do you use preventive medicine for them?

With medication, there is a risk of liver and kidney damage; without medication, there is a risk of infection.

Both have pros and cons. If the exposure source cannot be traced, it can only be treated as an unknown exposure source. As for whether HIV needs preventive medication, it needs to be assessed by the local HIV occupational exposure expert group.
In addition to the evaluation by the expert group, I think it is necessary to make it clear to the patients that they have the right to know the situation. They have the right to decide whether to use it or not. Otherwise, they will not cooperate or not cooperate, and the preventive effect will be reduced.

Therefore, after the notification is clear, whether to use it is decided by the patient's signature.

Third, pay attention to the infection of the needle eye wound.
In addition to the spread of blood-borne diseases, it is also necessary to consider the physical condition of the patient, whether it belongs to a high-risk group, and pay attention to whether the patient will have needle-mouth infection. If you feel unwell, seek medical attention in time.

Fourth, the relief of psychological pressure.
It can be seen from the texts discussed by the teachers in the group that we, as professionals, are all nervous, and the client must be under psychological pressure. Whether it is the nurse in charge of drawing blood or the patient who was stabbed, don’t ignore the psychology of both. Comfort, this can rely on the power of their own hospital psychologists.

Fifth, it is an adverse event.
If a patient is injured, it must be an adverse event and needs to be reported. Why is it overturned? Analyze the reasons, the impact of placement and height? Is the quality of the product qualified? Is the process reasonable?

How to place the sharps box location and height:
Place the sharps box in a convenient, highly visible location. The study showed that the optimal placement height of the sharps box was (91.52±7.51) cm, and the effective distance for handling sharps was (37.97±6.03) cm. If the sharps box is placed too high, the visibility is poor, and the sharps cannot be accurately put in, and there is a risk of stabbing. If the sharps box is placed too low, especially on the ground or the bottom of the work vehicle, it is necessary to bend over to operate, and the line of sight is easily obstructed. Blocking, increasing the probability of damage. At the same time, the sharps box should be placed in a position that is convenient for medical personnel to operate, such as the side of the treatment table (it is also placed on the treatment table in foreign countries, but the premise is to ensure that the sharps box is clean) to reduce the transfer path of sharps.

Sixth, medical waste spillage.
The sharps box was knocked over, resulting in the spillage of medical waste. It is necessary to deal with it according to the procedures established by the hospital, whether it is necessary to respond to the emergency plan for the prevention and control of medical waste loss, leakage and diffusion.


 


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