Most of the time we come across patients suffering from HIV, HCV, HBV and many more. In our dental set up what all are the standard protocol to treat those patients.
I am lab scientist but I guess this could help; use the Hierarchy of Controls but the golden rule use the Standard Precautions (Universal Precaution). Treat everything as infectious. The infection can also be from the provider to the patient.
Please find the following CDC links below:
http://www.cdc.gov/niosh/docs/wp-solutions/2010-139/pdfs/2010-139.pdf
http://www.cdc.gov/niosh/topics/women/bloodborne.html
http://www.cdc.gov/niosh/topics/bbp/genres.html
http://webcache.googleusercontent.com/search?q=cache:lwNNW8vNGJkJ:www.in.gov/isdh/files/BBP_American_Red_Cross_Fact_Sheet_xps(1).pdf+&cd=9&hl=en&ct=clnk&gl=us
Good answers. I would add that blood safety depends more on what we do than on what we know. At least this was found to be the case in some dental clinics in South Africa. I suspect there are frequently dire public health situations in Nepal.
A little more than halfway down is a section on "other invasive procedures". or just search on "dental" (and see Mehtar S, Shisana O, Mosala T, et al. ‘Infection control practices in public dental care services: findings from one South African Province’, J Hosp Infect, 2007, 66: 65-70. p. 69)
https://sites.google.com/site/davidgisselquist/chapter9
Hello ,maybe this can help you :
http://www.cdc.gov/HAI/organisms/hiv/hiv.html
prevention is better than cure. strictly adhere to universal safety precautions
HIV has post exposure prophylaxis. Zidivudine,lamovudine and Indinavir are used.You can get the drugs from any ICTC (integrated conseling and testing center). They will guide them because they require counseling and testing for HIV also.
For Hepatitis B iHepatitis B immunoglobulins should be given to neutralise the virus. Interferons and lamuvudine can be used. still they may have malignant potential and may get hepatocellular carcinoma at later life
For Hepatitis C NO vaccine is available and interferons and ribavirine is used but efficacy is doubtful. HCV also has malignant potential like HBV
UNIVERSAL SAFETY PRECAUTIONS MUST BE FOLLOWED STRICTLY
PLEASE CAMPAIGN AMONG YOUR COLLEAGUES
Universal safety precautions
Hand wash
protective gear(gloves,masks,goggles)
sterilisation of instruments and disinfection
Disposal of infectious waste,sharps (biohazard) in Safe manner
Vaccine against Hepatitis B
The golden rule is to consider and hence treat all patients as potential carriers. Wear gloves, face masks and avoid sterss.
you should treat every patient as carrier and protect yourself and other patients accordingly
1st-- z kit for known patients with strict precautions as to use of sharp instruments like needle and elevators
after completion of procedure on patients the working area should be disinfected with 2% gluteraldehyde and all used instruments should be soaked in glutaraldehyde for 6- 8 hours and then they should be autoclaved
we should not forget suction tubes or the drain pipes
one should worry about HIV and Hepatitis b virus and should not forget about hepatitis C as their cases are on the rise
generally we do tests for HIV and HBV and not for HCV
prevention is best but one should also have knowledge about PEP post exposure prophyllaxis for hiv
Follow universal Barrier Protection procedure to prevent infection transmission. Get yourself vaccinated for HBV & evaluate anti-HBs antibody titre (should be more that 10 iu) to assess your protection potential. If a patient has any indication of infection, immediately refer to nearest Govt facility for testing and counselling.
You should follow CDC Guidelines and Reccomendations for Infection Control in Dental-Health Care Settings. In the following page you can find the regulatory framework for desinfectants and sterilants, and the immunizations recommended for heath-care personnel.
http://www.cdc.gov/oralhealth/infectioncontrol/guidelines/
It's important to receive DT vaccination (DTPa once in a lifetime) every ten years and hepatitis B vaccination with antibody titters over 10 IU/ml (also once in a lifetime, you don't need to be over 10 IU/ml all the time).
It's also important to follow SHEA recommendations after an occupational accident with HIV patients. I attach theese recommendations and 2001 CDC recommendations for occupational exposures to HIV, HBV and HCV.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm
You should use one time a steril devices. The metallic devices should be decontaminated, sterilized before use. One steril kit should be used for each patient.
You should respect the who precautionnal hygiene measure.
Dear Deepak,
should follow WHO guidelines srictly sterlisation should be maintained and disposable sterile kit should be used for each patient.
These links may be help you:
1) Managing the care of patients infected with bloodborne ...
www.ncbi.nlm.nih.gov/pubmed/12699050
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de LG DePaola - 2003 - Cité 27 fois - Autres articles
Managing the care of patients infected with bloodborne diseases. ... (1)Department of Oral Medicine and Diagnostic Sciences, Dental School, University of ...
2) CE 90 - Guidelines for Infection Contol in Dental Health ...
www.dentalcare.com/media/en-US/.../ce90/ce90.pdf
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de SK Dickinson - Cité 2 fois - Autres articles
the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens .... for disease transmission during the delivery of dental care, all dental ...
3) [PDF]Department of Dental Hygiene Policy on Bloodborne ...
www.bridgevalley.edu/.../Dental.../Policy%20on%20...
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The BridgeValley Department of Dental Hygiene clinic facility is considered a ... bloodborne disease that may be identified during the provision of dental care.
4) Bloodborne Pathogen/Hazard Information | Herman Ostrow ...
dentistry.usc.edu › ... › Dental Hygiene
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Bloodborne Pathogen & Infection Control Training ... Patients of the Dental Hygiene Clinic are informed of bloodborne pathogen policies at their initial ...
Strict Blood-borne pathogens protocols/SOP to be put in place, these should include but not limited to; Prevention/emergency (PEP), disposal, decontamination and sterilization (plus sterility testing of the equipment). Follow your counties OS&H guidelines if there are any.
This should be attended to using holistic approach. 1. Preventive approach. Infection control guidelines such as those of WHO and CDC should be adopted as suggested above including training of personnel on risk reduction techniques, optimal use of PPE and waste disposal. 2.Analytical approach. Routine counselling and testing unit for these pathogens should form part of the procedure to identify the infected subjects and post-test counselling should be available also to optimize care. For intance, 5-in-1 multi-panel kit screening for HBV markers can be adopted for HBV screening to scientifically confirm high risk of infectivity. 3. Appropriate policy for post-exposure prophylaxis (PEP) should be in place in case of occupational exposure. Finally, periodical policy review based on your findings should be encouraged and adopted.
By following the general precaution guidelines and good sterilization and disinfection methods.
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