BIO-MEDICAL WASTE MANAGEMENT FOR HCW.pdf · Pathological laboratories (irrespective of the size)...
Transcript of BIO-MEDICAL WASTE MANAGEMENT FOR HCW.pdf · Pathological laboratories (irrespective of the size)...
BIO-MEDICAL
WASTE
MANAGEMENT
BIO-MEDICAL WASTE
MANAGEMENT
What is Bio medical waste
Waste generated in the diagnosis, treatment or immunization of human beings or animals, in research or in the production or testing of biological products.
BIOMEDICAL WASTE RULES APPLY TO:-
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All who generate, collect, receive, store, transport, treat, dispose, or handle
bio medical waste :-
Hospitals,
Nursing homes
Clinics
Dispensaries,
Veterinary institutions
Animal houses
,
Pathological laboratories
(irrespective of the size)
Blood banks,
Clinical establishments
Research or educational institution
Health camps,
Medical or surgical camps,
Vaccination camps,
Blood donation camps,
First aid rooms of schools,
Forensic and research labs.
Ayush hospitals,
• First time the rules were framed in 1998.
• Later amendments were made in 2000, 2003
and 2011.
• Latest guidelines came into existence from 28th
March 2016.
• Amendments were further made in March
2018
WHY BMW
Rules
?
Hospital or Lab/
Infectious waste is not
dumped in open
ground …. potentially
hazardous to the
environment and
human beings
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• What are the hazards of the improper management of the biomedical waste generated in a hospital?
Needle prick injury
Mechanical vector transmitted diseases
Outbreak of other infectious diseases
Attract rag pickers and lead to reuse of contaminated items.
PROCESS FLOW OF BMW
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Generation Segregation
Storage Collection
Transportation Treatment &
Disposal
WASTE CATEGORISATION
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WASTE
Non Infectious 75-85%
Infectious 10- 15%
Hazardous 5- 15%
How to segregate waste .... in Non
Chlorinated Bags
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WASTE
PLASTIC Non
Plastic
GLASS
GENERAL SHARP M ETAL
Infectious Waste
BIO-MEDICAL WASTE
MANAGEMENT
BLACK BAG
Non-infectious waste (85%) generated in hospital can be collected.
• Paper, plastics
• Wrappers, Cardboards, Outer packaging
• Kitchen waste
• Unsoiled plaster cast
• Expired filling materials
• Tooth paste/ powder
• Cements temporary/ permanent
General waste
What goes in RED BAG
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Infectious Plastic and rubber waste such as
• Gloves
• I.V. tubing and I. V sets
• Catheters
• Urine bags
• Syringes (without needles and fixed needle syringes)
• Suction tips
• Vaccutainers with their needles cut and gloves.
• Disposable plastic glasses
• Used alginate impressions
• Rubber base impression materials
WHAT GOES IN
YELLOW BAG
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• Human/Animal tissue organs or body parts
• Animal carcasses
• Any non plastic soiled waste( contaminated with blood/ body fluids )
• Cotton dressings, bandages
• Linen beddings
• Soiled plaster casts, Soiled paper
• Periodontal packs
• Extracted teeth
Antibiotics and other drugs
Microbiology waste • Culture devices, stocks
or specimen of microorganisms
• Blood bags
WHAT GOES IN BLUE BAG?
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•Glassware – broken ,
Contaminated glass Medicine
Vials, ampoules etc
•(Glass sharps such as broken ampoules,injection vials
•Glass slides, coverslips
•Injection vials
•Broken test tubes/ Broken pipettes)
WHAT GOES IN WHITE PUNCTURE PROOF AND LEAK PROOF
CONTAINER
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White (Translucent) – Waste sharps
including metals – packed in puncture
proof containers
Needles, syringes with fixed needles
Scalpels, Blades, lancet
Suture needle, aluminum foil Intravenous canula LP needle Bone screws ( sharps)
Any contaminated sharp object causing
puncture/cuts
Handed over to Waste Agency… when
2/3
full.
• Destroy needle
Cut syringe tip
Decontaminate in bucket having 10%
bleach
CHEMICAL/LIQUID WASTE
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liquid waste: To be treated
with 1 to 2 % Hypochlorite
or to have an ETP.
Floor washing etc should be
pre-treated onsite using
10% Sodium Hypochlorite
or connected to ETP
AT SOURCE PRE TREATMENT
Pre-treatment By
Autoclave
Disinfection By
Hypochlorite
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STANDARDS FOR AUTOCLAVING OF BIO- MEDICAL WASTE (Pre-treatment..at source)
Chemical indicator strip….is to be
used with each batch of waste and
note change in color as an indication
of temperature and pressure achieved.
Frequency: To use more than one
strip with every batch and bag,record
the same.
Spore testing at least once in every
week
Medical waste shall not be
properly treated considered
unless the
as
time, temperature and
pressure indicators indicate that the
time, temperature and
were reached during the
process - AUTOCLAVE
required
pressure
autoclave
AGAIN
PROCEDURE : The
autoclave should be
dedicated for the purposes of
disinfecting and treating bio-
medical waste.
When operating a gravity
flow autoclave, medical
waste shall be subjected to: A
temperature of not less than
121° C and pressure of 15
pounds per square inch (psi)
for an autoclave residence
time of at least 20 minutes. 30
% of hypochlorite solution to be used
• Calcium hypochlorite ( 70% available chlorine) - 140 gram/ 20 liters of water
• Sodium hypochlorite ( 5 % available chlorines)– 2 liters/ 20 liters of water
• 10% solution is prepared by adding 100gm of bleaching powder in 1 liter of water
TRANSPORTATION
• Within hospital:- By designated wheeled containers and trolleys
• Outside the hospital:- By the authorized vehicle as specified by the Govt.
• Bags for transportation must be labelled ( date, weight, ward number, department and duty in charge signature)
Transport
Transport by wheeled trolleys/containers /carts only in vehicles authorized for the purpose
They should be
Easy to load and unload
No sharp edges
Easy to clean
Disinfect daily
PERSONNEL PROTECTIVE EQUIPMENTS
• Gloves
• Masks and Goggles
• Boots
VACCINATION
• HEPATITIS B VACCINE
• TETANUS TOXOID
MANAGEMENT OF SPILLS
• COVER THE SPILLS WITH PAPER TOWEL/ BLOTTING PAPER/ NEWSPAPER.
• ADD 10% SODIUM HYPOCHLORITE SOLUTION ON AND AROUND THE SPILL FROM PERIPHERY TO CENTER.
• COVER IT FOR AROUND 30 MINUTES.
• REMOVE PAPER WITH GLOVED HANDS AND DISCARD IT IN YELLOW BAG.
• FINALLY THE FLOOR IS CLEANED WITH DETERGENT AND WATER IN A USUAL WAY.
ACCIDENTAL EXPOSURE
• CONTACT CMO
• Use of Hand sanitizers/ Tap water with soap/ Disinfectants
HIV : 3 infections per 1,000 sticks with a HIV +ve Needle
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Hepatitis C: 18 persons per 1,000 needle-sticks
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HEPATITIS B IS most infectious (30%)
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BIO-MEDICAL WASTE
MANAGEMENT
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DISINFECTION OF MATTRESSES , BLANKETS AND PILLOWS
• COVER THE MATTRESSES WITH WATERPROOF MATERIAL- PLASTIC/ REXENE.
• WASHING CAN BE DONE MANUALLY.
• NATURAL DISINFECTION CAN ALSO BE DONE (SUNLIGHT- UV RAYS).
• SYNTHETIC BLANKETS ARE PREFERRED. • WOOLEN BLANKETS ARE DECONTAMINATED BY EXPOSING TO
FORMALDEHYDE VAPOURS OR AUTOCLAVING.
PERSONAL PROTECTION
1. Dressing-
Waterproof apron-to protect against splashes
2. Gloves
3. Masks
4. Protective glasses , eye shields
5. Foot wear- washable footwear , knee length (gum boots)
6. Immunization : Hepatitis B , Tetanus injection
THE SEQUENCE OF DONNING Personnel Protective Equipment (PPE)
• Wear shoes covers with trousers tucked • Hand hygiene • Gown • Cap • Face mask ( fit for size) • Goggles or face shield • Gloves • After use discard in appropriate waste disposal bags–
to be autoclaved / chemically disinfected before final disposal
The sequence of removing PPE
• Remove gloves and discard in disposable bags
• Remove goggles and discard as above
• Remove gown and discard in waste disposal bags
• Use alcohol based hand rub/ or wash hands with soap and water
• Remove face mask by grasping elastic or tie strips behind ears (don’t touch front of mask)
cont…
• Remove cap ( head cover) and discard
• Remove shoe covers
• Do hand washing again
• Leave the room
• Once outside the room do hand washing again with soap and water
Health hazards of BMW Type of waste Health hazard
Human / Animal waste/ Soiled waste
HIV,HBV,HCV, Haemorrhagic fevers, cholera, salmonellosis, shigellosis, rabies, leptospirosis, anthrax,TB, pneumonia, septicemia
Sharps HIV, HBV, HCV, Injuries
Cytotoxic/ radioactive waste
Cancer, genetic mutation, birth defect
Chemical waste Poisonings, dermatitis, conjunctivitis, bronchitis