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Algorithm for the actions of a medical worker in case of cuts and injections
In order to avoid infection with parenteral viral hepatitis, HIV infection, the rules for working with pricking and cutting tools should be followed.
Option 2: Actions of a medical worker in an emergency (Decree of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of SP 18.104.22.16826-10“ Prevention of HIV infection ”).
- in case of cuts and injections, immediately remove gloves, wash hands with soap under running water, treat hands with 70% alcohol, grease the wound with 5% alcohol solution of iodine;
It is necessary to examine as soon as possible after contact the person who may be a potential source of infection for HIV and viral hepatitis B and C, and the person who has contacted him. HIV testing of the potential source of HIV infection and the contacting person is carried out by rapid testing for antibodies to HIV after an emergency with the obligatory sending of a sample from the same portion of blood for routine HIV testing in ELISA. Samples of the plasma (or serum) of the blood of a person who is a potential source of infection, and the contact person are transferred for storage for 12 months to the AIDS center of the subject of the Russian Federation.
Postexposure prophylaxis of HIV infection with antiretroviral drugs:
Registration of an emergency is carried out in accordance with the established requirements:
All healthcare facilities should be provided or, if necessary, have access to rapid HIV tests and antiretroviral drugs. The stock of antiretroviral drugs should be stored in any healthcare facility at the choice of the public health authorities of the constituent entities of the Russian Federation, but in such a way that examination and treatment can be organized within 2 hours after the emergency.
Dental Instrument Processing Sequences Used dental instruments and materials are decontaminated after each patient is admitted. If tools and materials are disposable, the safety of their disposal must be ensured. Before cotton swabs, plastic saliva ejectors, etc., are sent to the city landfill, they should be disinfected by immersing for 1 hour in a 1% solution of chloramine, or in a 6% solution of hydrogen peroxide, or in a 3% solution of bleach, or for 30 minutes in a solution of intrascept. The tips of drills, vacant lots, air and water guns, ultrasonic devices for removing dental deposits after each patient are twice treated with 70 ° alcohol and at the end of the shift they are treated with 3% chloramine for 60 minutes or with Intracept solution for 30 minutes. Instruments in contact with the patient’s mucous membrane and contaminated with biological fluids (dental hand tools, glasses, mirrors, burs) and gloves are immediately disinfected after use, then they undergo pre-sterilization treatment and sterilization. Disinfection is carried out by completely immersing the used tools for 30 minutes in a container with an inject solution (3% chloramine for 60 minutes or a 6% hydrogen peroxide solution for 60 minutes, or a 2% vircons solution for 10 minutes, or a solution can also be used sidex for 15 minutes, or 0.1% chlorsept solution for 60 minutes). The disinfectant solution is used six times, after which it changes. Further, the instruments undergo pre-sterilization treatment: the instruments are immersed in another container with an inject solution at t = 20–45 °, where each instrument is washed with a ruff for 15 s; rinse instruments with running water; rinse with distilled water; check the quality of cleaning: from blood - with an azapiran test (with a positive test, repeat all pre-sterilization treatment); from alkali - phenolphthalein breakdown (with a positive test repeat paragraphs 2 and 3); wipe the instruments with dry towels or dry them with hot air until moisture disappears. Glass, metal, silicone rubber products are sterilized without packaging (in open containers) or in paper packaging using the dry heat method (dry hot air). Sterilization mode: 60 min at t = 180 °. Polishers, working parts of dental scalers and burs are treated in the same way as tools. Dental mirrors are subjected to disinfection, then pre-sterilization treatment (paragraphs 2, 3 and 4), after which they are sterilized with glass beads at high temperature: stored in Petri dishes. Rubber gloves, cotton swabs, products made of polymers, textiles, latex are sterilized in biks by the autoclaving method in two modes: at t = 120 °, pressure 1 atm. for 45 min or at t = 132 °, pressure 2 atm. within 30 minutes The shelf life of sterility of instruments in sealed packaging (in a bix, in a kraft paper bag) is three days, after opening the bix the material in it is considered sterile during the working day. Features of the organization of patients with an increased risk of infection.
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