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WATCH OUT: Preventing Needle Sticks in the Back of an Ambulance. Provena Regional EMS. Objectives. List the precautions required to minimize or eliminate the risk of accidental needle sticks in the pre-hospital setting. Outline the best practice of making good use of built in safeguards.
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WATCH OUT: Preventing Needle Sticks in the Back of an Ambulance Provena Regional EMS
Objectives • List the precautions required to minimize or eliminate the risk of accidental needle sticks in the pre-hospital setting. • Outline the best practice of making good use of built in safeguards. • Discuss the benefits and risks of using sharps with combative patients.
Problem • In 2008, six incidences of exposure to blood/body fluids reported by PRO • Two incidences due combative patients • Two incidences due to failure to use the built in safety features of the equipment • One incident due to using sharps in a moving unit • One incident due to blood dripping into a provider’s open wound
What is a sharp? • Needles on IV catheters • Needles on syringes for IV, IM and Sub Q injections • Needles on premixed IV drugs • IO needles • Per-trach blades
Sharps = Blood • First rule of EMS BSI • “If it is wet and its not yours. . • Don’t touch it!” • Infectious Material = Hazardous Material
Warning • The DOT Paramedic Curriculum warns that during IV and drug administration used needles present a significant risk to providers.
Remember • Proper handling of needles and other sharps before and after patient use can prevent accidental needle sticks.
To minimize or eliminate risk of needle stick • Minimize the tasks you perform in a moving ambulance. • Immediately dispose of used sharps in a sharps container. • Recap needles as a last resort. Make good use of built in safeguards such as retractable needles and needle guards.
Good Practice • Professional Advanced Providers (Intermediate and Paramedic) take responsibility for their own sharps. • Don’t delegate disposal to a partner.
Equipment is designed when used correctly to be safe and efficient.
With Combative Patients • Weigh the benefits of solutions given via IV/IM against the dangers of a combative patient.
Remember • Make good use of communication principles taught in CPI Nonviolent Crisis Intervention
Sometimes • It is wise to hold off on giving IV/IM till you get to the Emergency Department
Good Communications • Explain processes to the patient to scale down anxiety and limit accidental needle sticks.
Summary • Minimize the tasks performed with sharps in the back of a moving ambulance. • Immediately dispose of used sharps in a sharps container. • Make good use of built in safeguards such as retractable needles and needle guards
Take responsibility for the sharps you use. • Do not hand off uncovered sharps. • Weigh the risks and benefits of using sharps around agitated/combative patients.
Report • Upon completion of this presentation, please send notification to matthew.gant@provena.org