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.

Handing off uncovered used sharps is a bad practice.

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