Transcript Behavioral Emergencies - NAAE Communities of Practice

Chapter 6
Occupational Health and Safety
in Veterinary Hospitals
Copyright © 2010 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Learning Objectives
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Describe the role of OSHA in veterinary
practice safety
List the general requirements of the federal
laws related to workplace safety
Explain proper methods for lifting objects and
animals
List common workplace hazards in a
veterinary facility
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Learning Objectives
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Describe the requirements and the OSHA
“right to know” law
Explain the acronym MSDS and describe the
components of an MSDS
List the hazards associated with the use of
ethylene oxide, formalin, glutaraldehyde,
anesthetic gases, and compressed gases
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Learning Objectives
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Define the term zoonotic disease and list
common zoonotic diseases encountered in
the veterinary practice
List methods to minimize the hazards
associated with animal handling
Describe the proper handling of hazardous
and medical wastes
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Safety on the Job
Can Affect a Veterinary Practice
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Personal injury
Hazards
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Infectious diseases
 Harmful chemicals
 Radiation
 Animal-induced
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What is OSHA?
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Why is OSHA Important?
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Enforces federal laws
Helps ensure a safe workplace for American
workers
Employers have responsibilities
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Safety program
Safety training
OSHA Form 300A
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Employer Responsibility
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Employee Responsibilities
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Learn and follow safety rules
Read the OSHA poster
Comply with applicable standards
Wear or use personal protective equipment
Report hazardous conditions
Report job-related injury or illness
Seek treatment promptly
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General Workplace Hazard
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Attire
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Dress appropriately for job at hand
Minimal jewelry, if any
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General Workplace Hazard
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Lifting
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General Workplace Hazard
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Clutter
Lack of cleanliness
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General Workplace Hazard
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Ineffective organization
Improper storage
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General Workplace Hazard
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Break times
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Eating and drinking in designated area
Away from clinic areas
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General Workplace Hazard
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Machinery and equipment
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Proper operation
Proper use
Dangers in using
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General Workplace Hazard
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Electricity
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General Workplace Hazard
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Fire and evacuation
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Read and follow directions on your specific extinguisher.
Most portable fire extinguishers work according to the PASS
directions.
P: Pull the pin (some extinguishers require some motion such as
releasing a lock latch).
A: Aim low (point extinguisher horn or hose at base of fire).
S: Squeeze the handle (this releases extinguishing agent).
S: Sweep from side to side at base of fire until it appears to be out.
Watch fire area, and repeat use of extinguisher if needed.
Remember the word PASS
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General Workplace Hazard
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Violence
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Barriers
Personal safety includes the diligent use of locks and
barriers to deter unauthorized persons from entering
the facility.
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General Workplace Hazard
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Hazardous chemicals
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Most common chemicals used
• Cleaning and disinfecting agents
• Insecticides and pesticides
• Drugs and medications
• Sterilization agents
• Radiology processing fluids
“Right to Know” law
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Secondary Container Warning Label
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Figure shows an example of a secondary container
hazard working label.
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Material Safety Data Sheet
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An MSDS contains safety information that may not be
indicated on the product label.
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Precautions in Working
with Hazardous Chemicals
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Storage
Mixing and diluting
Spill clean-up
When making solutions from a concentrate,
always start with the correct amount of water
and then add the concentrate.
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Chemical Spill Clean-up
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Step 1: Keep people and pets away
Step 2: Increase ventilation
Step 3: Put on protective gloves, apron, and
protective eyewear if indicated
Step 4: Cover spill with absorbent materials
Step 5: Sweep saturated absorbent materials
into dustpan and deposit in plastic trash bag
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Chemical Spill Clean-up
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These are steps to clean up a dangerous chemical spill.
Step 1: Unnecessary people and pets could spread the spilled
material.
Step 2: Increase ventilation by opening a window or turning on
an exhaust fan; don’t use electric equipment and avoid turning
on or off electric switches when cleaning up spilled flammable
materials.
Step 3: Wear protective clothing if it is likely that your clothing
will become contaminated during clean-up.
Step 4: Absorbent materials include paper towels or cat litter;
they allow absorbent material to fully collect the liquid.
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Chemical Spill Clean-up
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Step 6: Seal trash bag, and dispose of it
Step 7: Wash contaminated area thoroughly
and allow area to air-dry. Wash with plain
water or a detergent (not a disinfectant) if
permissible by instructions in the MSDS.
Step 8: Remove protective equipment, and
dispose of single-use items
Step 9: Wash hands thoroughly and change
contaminated clothing
Step 10: Replace used materials in spill kit
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Ethylene Oxide
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Ethylene oxide (ETO)
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Gas sterilization
ETO is thought to be a human carcinogen, so
special precautions must be maintained.
Glutaraldehyde
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“Cold sterilization”
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Formalin
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Used for tissue preservation
When possible, use only biopsy jars filled with
formalin to prevent excessive exposure.
Human carcinogen
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Formalin is probably human carcinogen, so use special
precautions.
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Glutaraldehyde
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“Cold sterilization” methods
Disinfectants are designed to kill living organisms, so they must
be handled safely.
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Animal-Related Hazards
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Handling patients
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Restraint devices
Bathing, dipping, and spraying areas
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Personal protection equipment
Ventilation
Eye-wash station
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Animal-Related Hazard
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Noise
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Ear protection
Hearing protectors should always be used in noisy kennels.
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Zoonotic Diseases
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Common pathogens
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Viruses
• Rabies is a serious viral disease.
 Bacteria
• Bacterial pathogens include Borrelia burgdorferi (cause Lyme disease)
as well as Escherichia coli and Salmonella, Pasteurella, and
Pseudomonas species.
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Fungi
• Ringworm is caused by a fungus of the Microsporum species.
 Internal parasites
• Roundworms and hookworms are internal parasites.
 External parasites
• An example of an external parasite is the irritating and itchy mite that
causes sarcoptic mange.
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Protozoans
• Toxoplasmosis is an infestation by a protozoan.
Other zoonotic protozoans are Giardia and Coccidia.
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Non-Zoonotic Diseases
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Not serious concern to human health
Highly contagious
Examples
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Parvoviral enteritis in dogs
Panleukemia in cats
Personal protection equipment
Protective measures
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Precautions for Dentistry Operations
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Aerosolized microbes
Personal protection equipment
Microbes may become aerosolized by use of a high-speed and
ultrasonic scaler.
Always wear eye protection, a mask, and gloves when
performing dental prophylaxis procedures.
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Radiology Concerns
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Individual dosimeter badge
Personal protection equipment
Collimation
Processing chemicals
Never place your hand or any part of your body in the
primary beam when taking radiographs!
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Anesthesia Concerns
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Proper scavenging system
Check anesthesia machine before each use
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Workers are at risk of exposure to waste gases
not metabolized by patient.
 Proper scavenging system is the single most
effective means of reducing exposure to waste
anesthetic gases.
 Check your anesthesia machine for leaks before
each use.
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Anesthesia Machine Checklist
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Step 1: Assemble all
hoses, canisters,
valves, or tubes
according to the
manufacturer’s
instructions.
Step 2: Turn on the
oxygen supply to the
machine.
Figure shows Step 3:
Close the pressure
relief (pop-off) valve.
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Anesthesia Machine Checklist
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Step 4: Use your thumb
or palm to form a tight
seal on the Y piece (the
part of the hose that
attaches to the patient’s
endotracheal tube).
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Anesthesia Machine Checklist
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Step 5: Turn on the
oxygen until bag is
slightly over-inflated (or
when the pressure on
the manometer reaches
the 20 mark), then close
the valve.
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Anesthesia Machine Checklist
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Step 6: Observe the pressure in the
system on the manometer and
watch close for any decrease.
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If your machine is not equipped with
a manometer, observe the size of
the bag closely.
If the pressure remains constant,
the machine is leak-free.
If the pressure drops, there is a leak
(or leaks) in the system.
The faster the pressure drops, the
larger the leak(s).
If there is a leak, check and tighten
all connections, and replace any
damaged parts (machine may need
to be serviced by qualified
technician before use).
When machine is leak-free, reset
pressure relief valve to proper
position to use the machine
normally.
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Further Anesthesia Concerns
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Filling the vaporizer
Masking the patient
Delaying extubation
Pregnant personnel
As much as possible, delay extubation and allow patient to
recover while still connected to anesthesia machine (oxygen
only) and scavenging system.
Monitor recovering anesthesia patients “at arm’s length” to
minimize exposure to gases emitted during respiration.
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Working with Compressed Gasses
Storing tanks
 Moving tanks
 Small compressed-gas
cylinders must be secured
to prevent them from falling
over.
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One-Handed Needle Recapping
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Do not attempt to recap the needle after use unless physical
danger from sticks or lacerations cannot be avoided by any
other means.
When necessary to recap, follow “one-handed” method.
Step 1: Place cap on flat surface, such as countertop or floor.
Step 2: Using only one hand, hold syringe in fingertips with
needle pointing away from your body.
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One-Handed Needle Recapping
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Step 3: Place fingertips on flat surface so that needle
and syringe are parallel to and in line with the cap.
Step 4: Move hand forward until needle is inside cap.
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One-Handed Needle Recapping
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Final step: Use other hand to “seat” cap firmly.
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Non-Hazardous Medical Waste
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Sharps
Medical devices
Animal blood or tissues
Laboratory cultures
Bandages/sponges
Primate material
Animal waste
Refer to Table 6-1 Typical Medical Waste Definitions
(page 137) for definitions as to what constitutes
medical waste or normal trash.
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Hazardous Drugs
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All medicines are chemicals
Cytotoxic drugs
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Handling drugs
Biological safety cabinet
Handling patient’s body
Handling patient’s wastes
All medicines are chemicals; and chemicals can be
dangerous.
A biological safety cabinet (BSC) is required when
preparing cytotoxic drugs.
Discuss Case Presentation 6-3 (page 138).
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