Puncture Wounds by Hypodermic Needles



                       A SAFETY TALK FOR

                      DISCUSSION LEADERS



This safety talk is designed for discussion leaders to use in

preparing safety meetings.



Set a specific time and date for your safety meeting.  Publicize

your meeting so everyone involved will be sure to attend.



Review this safety talk before the meeting and become familiar with

its content. Make notes about the points made in this talk that

pertain to your workplace.  You should be able to present the

material in your own words and lead the discussion without reading

it.



Seating space is not absolutely necessary, but arrangements should

be made so that those attending can easily see and hear the

presentation.



Collect whatever materials and props you will need ahead of time. 

Try to use equipment in your workplace to demonstrate your points.





                      DURING THE MEETING



Give the safety talk in your own words.  Use the printed talk

merely as a guide.



The purpose of a safety meeting is to initiate discussion of safety

problems and provide solutions to those problems.  Encourage

employees to discuss hazards or potential hazards the encounter on

the job. Ask them to suggest ways to improve safety in their area.



Don't let the meeting turn into a gripe session about unrelated

topics.  As discussion leader, its your job to make sure the topic

is safety.  Discussing other topics wastes time and can ruin the

effectiveness of your safety meeting.



At the end of the meeting, ask employees to sign a sheet on the

back of this talk as a record that they attended the safety

meeting.  Keep this talk on file for your records.













Puncture Wounds by Hypodermic Needles





NOTE TO DISCUSSION LEADER:

Before your meeting, you may want to visit each nursing unit nd

check for the following items:



ù A needle cutter that is working and has a lid which fastens

securely



ù A special container (not full) for disposal of used syringes



ù A special, labeled waste container for glass



The results of this inspection may interest your group. Point out

that nurses especially are responsible for seeing that these items

are used.



Consider these incidents:



ù A nurse carries some used needles in her pocket because she does

not want to go back to the nurses' station right away to dispose of

them. She reaches into her pocket and receives a serious puncture

wound because the cap came off one of the needles.



ù A hospital housekeeper is in a hurry and does not handle the

plastic refuse bag with care. He is stuck by a discarded needle,

which has punctured the bag.  When did either of these employees

last have a tetanus booster? Probably neither of them remembers.



Everyone who has worked in a hospital or nursing home and surely

every hospital supervisor has heard similar stories. We are here to

discuss the problem of puncture wounds, what to do if you receive

one and, most importantly, what you can do to prevent them.



Puncture wounds are different from lacerations because they bleed

only a little and the wounds often "seal over" and appear to be

healed. Therefore, puncture wounds are easy to disregard. However,

serious problems can result from puncture wounds. Let's discuss a

few of the diseases which can occur after being "stuck"

accidentally with a "dirty" needle.



ù Tetanus or "lockjaw." This disease is fatal and symptoms may not

appear until six weeks after the puncture wound is received.

Immunizations against tetanus should be kept up to date and should

be received as follows: initial series of two injections, four

weeks apart, followed by a booster in one year; and a routine

booster every eight to ten years and a booster injection following

an injury if the most recent booster is not within five years of

the injury. Remember, tetanus is rare, but when it does occur, it

is almost always fatal! No preventive measures are wasted.



ù Hepatitis. This is an infectious disease which causes

inflammation of the liver and can result in permanent liver damage

if the case is severe.



ù Syphilis. This venereal disease, usually transmitted only by

sexual contact, can be transmitted by needle if only a small amount

of time elapses between the "sticking" of the infected patient and

the "sticking" of the employee with the same needle. The "guilty"

organism, treponema pallidum, lives only briefly outside the

body. Operating room personnel are probably the most concerned with

contracting syphilis by way of a needle.



The following rules should prevent most puncture wounds:



ù Disposable needles, including those in IV sets, should be cut off

at the hubs immediately after use by a special needle cutter

equipped with a receptacle for used needles. Used needles should

never be carried in pockets and should not remain on med carts or

in med rooms long after use.



ù Needles "frozen" to syringes should be disposed of in the same

manner as dirty needles.



ù Needles should never be disposed of in a wastebasket; however,

housekeepers should be careful when emptying waste receptacles

because needles, broken glass or knife blades may be present.



ù Sharp instruments, such as knife blades, should be placed in

special containers immediately after use and then they should be

disposed of or taken to be sterilized.



ù Linens should be checked for needles before being taken to the

laundry, and laundry personnel should recheck and handle linens

carefully to avoid injury.



Broken glass should be swept up immediately. Never pick up broken

glass with your hands.



NOTE TO DISCUSSION LEADER:

Discuss at this time the observation you made at the various

nursing units.



If, in spite of the best precautions, you happen to be the victim

of a puncture wound, take immediate action:



ù Wash the wound and surrounding area with an iodophor solution.



ù Report the injury to your supervisor. An incident report form

should be completed in order to provide information that will be

helpful in preventing similar accidents.  You may want to get an

injection of gamma globulin, which provides some protection against

hepatitis, but is no guarantee.



ù Be alert for symptoms, especially those of hepatitis, such as

fatigue, nausea and sometimes vomiting, lack of appetite, swollen

glands and sore throat. Smokers with hepatitis may develop a

distaste for tobacco. Yellowing of the skin and eyes can be

present. Treatment of hepatitis involves several weeks of rest,

usually at home, taking vitamins and following a special diet.



ù Several weeks after the injury you may want to have a blood test

to assure that you have not contracted syphilis.



Puncture wounds have a way of happening to the most unsuspecting

people in hospitals. To insure that they aren't a problem and to

provide everyone with a safe working environment, we need to be

alert to all hazards that may result in puncture wounds, and then

take action to eliminate them. Puncture wounds are a

serious matter. Do your best not to get the "point!"

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Text Version