A medical syringe is a necessary attribute of every modern medical institution, from a huge hospital to a small point. But used syringes can be dangerous because they contain more than just leftovers. medicines but also biomaterials of sick people. Therefore, the procedure for handling used syringes is strictly regulated. normative documents in the health sector.
The basic guidelines that determine the procedure for handling waste from medical organizations are SanPiN (short for “Sanitary Rules and Norms”), the section “Sanitary and epidemiological requirements for organizations engaged in medical activities”, as well as the instruction “Rules for the collection, storage and disposal of waste from medical - preventive institutions.
All garbage that is generated and accumulated in polyclinics, hospitals, medical centers and FAPs is divided by regulatory documents into several classes - from A to D, according to the increasing level of possible danger to human life. So waste under the letter A is harmless, but category D includes especially dangerous, radioactive types of medical waste.
Syringes used for medical purposes are classified as hazard category B (dangerous) or C (very dangerous), since they come into direct contact with the biofluids of sick people:
- any used tool will fall under the letter B, since it may be the “carrier” of the infection;
- category B will include those used for patients with established severe diagnoses.
If the recommended safety precautions are not observed, first of all, the employees of medical institutions themselves may suffer. If not properly disposed of, medical waste of classes B and C can cause the spread of serious diseases.
Disposable and reusable syringes
Modern medical syringes can be disposable and reusable. Accordingly, a reusable instrument assumes that after a single use, the used needle must be discarded, and the body itself will be reused after sterilization. Such, for example, is a carpool reusable syringe for injections in dentistry.
Reusable instruments have a glass or metal body and end up in the waste either as a result of damage or after the expiration date.
Sometimes the working conditions do not allow doctors to carry out disinfection immediately on the spot - for example, during mass vaccination in schools, kindergartens, etc. Then the used syringes are stored in special containers, where they are stored until they arrive for disinfection.
Autoclaving and microwave treatment
Also, the processing of used syringes is carried out using special equipment:
- autoclave: the sterilization process is carried out with wet steam under pressure at a temperature of about 120 degrees Celsius;
- The microwave unit disinfects syringes at temperatures of about 140 degrees Celsius.
Temporary storage and transportation of used syringes
When all parts of used syringes are disinfected and placed in sealed containers or specially marked garbage bags, they can be stored for some time right in the medical facility, but in a room specially designated for these purposes.
Transportation of hazardous waste is carried out by special vehicles with a closed body. According to the rules, this machine is used only for transporting medical waste. After each flight, it is also thoroughly washed and disinfected.
Disposal of used needles and disposable syringes
- burial on;
- burning;
- recycling of materials - metal (needles) and polymers (cases).
It is also allowed to place medical waste in ordinary city garbage dumps, although, of course, this method of disposal is most criticized.
Thanks to modern equipment, needles after injections can be destroyed right in the hospital. To this end, many mobile installations- destructors, allowing, if necessary, to perform the process of burning needles independently.
These units are compact and easy to use.
Additional information on the video: the process of burning a needle from a syringe in a destructor.
Large volumes of syringes are burned in incinerators. Such an installation can be operated both in the health facility itself and at a separate enterprise engaged in the destruction of this class of waste.
Before being sent to a landfill or landfill, they are crushed to reduce the amount of garbage and to eliminate the possibility of reusing used medical material. Grinding is carried out in special crushers, grinders or mills for medical waste.
If in locality there are licensed enterprises that accept decontaminated medical waste for recycling, medical institutions can conclude agreements with them on the delivery of recyclable materials for recycling.
Syringe Disposal Safety
Due to the danger of used medical instruments, all actions with them require special care.
Medical staff involved in the disposal of disposable syringes and needles (who collects, disinfects, provides temporary storage or transportation) should:
- Obtain mandatory vaccination against hepatitis B (the corresponding entry is made in the medical book).
- Get special training.
- Have an emergency first aid kit on hand.
When working with used syringes, the instructions are prohibited:
- Pour them from one container to another.
- Place waste collectors near heating appliances.
- Perform any type of operation without gloves and overalls.
- Tamp waste with your hands.
- Put needle caps back on.
Improper disposal of used syringes is a concern not only for sanitary doctors, but also for environmentalists. Indeed, the period of decomposition of steel needles and plastic cases in a natural way can be from several tens to several hundred years, causing harm to nature. Therefore, the most right decision is the recycling of syringes, which produces safe and high-quality raw materials suitable for further use in industry.
Why disinfect disposable syringes? Sanitary and hygienic treatment is carried out in order to eliminate pathogenic microorganisms, fungi and microbes that are dangerous to the health of medical staff and patients. All medical devices are subject to sterilization and disposal after their use in a patient, including a single use.
Sanitization steps
The main stages of sanitation of disposable syringes and other instruments are:
- proper disinfection;
- preparation for sterilization;
- sterilization.
a) Physical method
Disinfection includes physical or chemical method cleaning needles and syringes after use. The choice of rehabilitation method depends on the material of the product and the method of its use. Physical cleansing includes:
- boiling;
- dry steam treatment;
- steam treatment under pressure.
This method is environmentally acceptable, safe and reliable, so it is preferred under the right conditions. Before boiling, medical instruments are washed with running water from visible contamination and placed in water.
Dry steam treatment is carried out in an air sterilizer, in which products are placed without visible traces of organic contamination. Sanitation with wet steam under pressure is carried out in a special steam sterilizer without preliminary purification from organic contaminants.
b) Chemical method
Chemical disinfection of needles and syringes involves the use of disinfectants. Tools are immersed in the solution in glass, plastic or enameled containers with lids.
Flushing of needles and syringes prior to chemical sterilization is unacceptable. However, aldehyde-containing preparations require pre-cleaning of disposable syringes before sanitation. Processing of disposable items made of plastic and glass is carried out using chlorine-containing preparations. At the end of the procedure, the items are washed.
Processing of medical supplies (syringes, needles, etc.) is carried out in containers special purpose. There are two of them: for washing; for sterilization.
Destruction of sharp objects
Rules for the elimination of sharp objects:
- needles must not be broken to avoid injury;
- the needles are placed in a durable sealed container.
Deformation of sharp objects is carried out in a special sterilizer at elevated temperature for 30 minutes.
Important! Use medical gloves to apply the disinfectant. Remember that rubber gloves will not protect you from a needle injury, but will help clean it from local contamination with blood and other organic matter.
What items can be recycled
Disposal is subject to medical instruments (single-use needles, single-use syringes) that have been in contact with:
- with blood;
- with saliva and mucous membrane;
- with wound surface.
Decontamination is the process of processing medical devices in order to destroy pathogenic microorganisms. Disinfection consists of two stages: cleaning, disinfection. Cleaning always precedes the disinfection and sterilization process.
Disinfection destroys most of the pathogenic microorganisms, excluding bacterial spores. Sterilization destroys absolutely all biologically active forms of life, including bacterial spores.
The process is clearly shown in the video:
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Disinfection of needles, syringes has the main stages.
Prepare:
- a container with disinfectant for washing water;
- a container with disinfectant for needles;
- a container with a disinfectant solution for disinfecting syringes;
- gloves;
- tweezers;
- tray.
Technology.
1. Disinfection should be carried out immediately after injections in the same gloves.
2. Without disassembling the syringe, rinse the needles in the “Wash water” container.
3. Fill the needle channel with a disinfectant solution for needle disinfection, remove the needle from the cannula and place it in the same solution for 60 minutes.
4. Disassemble the syringe and completely immerse it in the syringe disinfectant solution for 60 minutes.
5. Record the date and time of the start of disinfection on the labels and sign.
6. After disinfection, put on gloves.
7. Use tweezers to remove all products from the solutions and rinse with running water.
8. Make marks on the labels about the end of disinfection.
9. Hand over prepared syringes and needles to a centralized sterilization department.
10. Dispose of used disinfectants into the sewer.
11. Remove gloves, wash hands.
Disinfection and disposal of disposable syringes and needles
Prepare:
- marked containers: for washing water;
- for disinfection of disposable needles;
- for disinfection of disposable syringes;
- for disinfection of disposable systems;
- cargo for immersion in disinfectant solution;
- gloves;
- disposable plastic bags;
- a cardboard box;
- scissors;
- tweezers;
- a syringe for flushing the needle from the system.
Disinfection technology for syringes, systems and disposable needles
1. Disinfection is carried out at the end of the manipulation, in the same gloves.
2. Rinse the syringe with the needle in the wash water container.
3. Fill the needle channel with needle disinfectant.
4. Remove the needle from the cannula of the syringe and place it in the disinfectant for needles for 60 minutes.
5. Disassemble the syringe and lower it into the disinfectant solution for syringes for 60 minutes.
6. Make a note on the labels about the date and time of the start of disinfection.
7. After disinfection, put on gloves.
8. Get all products from solutions.
9. Make a mark on the end of disinfection.
10. Rinse syringes with running water.
11. Arrange the cylinders and plungers of syringes in different plastic bags.
12. Fill disposable bags to 3/4 of the volume, remove the air, tie and put in the second bag, tie.
13. Place the needles in the box without deforming them.
14. Mark packages and box - "Waste".
Disinfection technology for single use systems
1. Discharge the rest of the contents of the system into the rinsing water container.
2. Remove the needle from the system and rinse it with a syringe in a container for washing water.
3. Fill the needle channel with a needle disinfectant solution with a syringe and place the needle in the appropriate solution for 60 minutes.
4. Cut the system into pieces of 10 cm.
5. Immerse the sections with a load for 60 minutes in a suitable container to fill the cavities.
6. Mark the date and time of disinfection on the labels.
7. After the allotted time, put on gloves.
8. Remove parts of the system from the disinfectant solution with tweezers and place them in disposable bags, and the needles in a box.
9. Mark the disinfection end time on the labels.
10. Fill the bags to 3/4 of the volume, remove the air, tie and place in the second bag, tie.
11. Mark packages and box - "Waste".
12. Remove gloves, wash hands.
13. Hand over the needles on the account to the head nurse.
]. Prepare the first container- “Container for disinfecting syringes”, and fill 2/3 of the solution rum disinfectant.
2. Prepare a second container-
"Container for the disinfection of needles",
filled with disinfectant
solution for 2/3 volume._________
Performing a procedure
Hold the syringe in your hand
1. Immediately after the injection, without covering the needle with a cap, perform separate disinfection of the used needle and syringe.
2. Draw a disinfectant solution into the syringe from the "Capacity for disinfection syringe contamination.
3. Disconnect the needle from the syringe in another container "Container for the disinfection of needles" in one of the following ways: remove the needle using a needle remover:
| Stages | Notes |
| cutting off the needle with a needle cutter with an integrated non-piercing needle container; cutting off the needle using a needle destructor - a device for burning needles by exposure to high temperature. | 1) draw a disinfectant solution into the syringe from the “Container for disinfecting syringes”; 2) immerse the syringe with the needle unassembled into the same container. |
| 4. Place the body of the syringe with the piston into the "Container for disinfecting syringes"; | |
| 5. Disinfect both containers according to the instructions for use of the disinfectant. | Exposure time is maintained |
| 6. From the “Needle Decontamination Tank”, filled 3/4 of the volume with needles, carefully drain the solution, slightly opening the lid. Close the container with a lid until it clicks, place in a mini-container with a color marking "Class B Hazardous Waste" or "Class B Extremely Hazardous Waste". | Make sure the container is tightly closed. Observe the labeling of containers. |
| 7. In the “Syringe Decontamination Tank”, raise the tray and release the solution from the syringes using a piston, place the syringe in a bag mounted on a trolley rack or a single-use bag with a color marking “Class B hazardous waste” or “Extremely hazardous class B waste” ". | Make sure that there is no splashing of the solution. |
| 8. Fill with syringes a bag mounted on a trolley rack or a single-use bag with color marking for 3/4 of the volume | Observe the labeling of containers. Remember that the bag can safely collect waste up to 15 kg. |
| 9. Pack, place in a mini-container with color marking "Class B Hazardous Waste" or "Class B Extremely Hazardous Waste". | Use special zip ties to quickly and effectively seal the bag after it has been filled. |
| 10 Store mini-containers (tanks) in a room for temporary storage of medical waste until the end of the working shift. | Transportation of waste from collection sites to temporary storage sites on the territory of the department is carried out using a tank with a lightweight wheel support on two driving wheels, with a capacity of 20, 35, and 50 liters. |
2nd stage.Presteridization cleaning tools
The effectiveness of any sterilization method depends largely on the cleanliness of the objects to be sterilized. The presence of organic and inorganic contaminants (remnants of factory lubricants, drugs, urine, coagulated blood, etc.), which create a protective shell around microorganisms, sharply reduce the validity of both thermal and chemical sterilization.
Detergents used for pre-sterilization treatment
1. "Biolot" or a complex consisting of peroxide in
road with detergent. The washing solution allows
should be applied within a day before contamination (before the appearance of
pink coloration), but not more than six times. "Biolot"
used in manual washing at a concentration of 0.5%, with
machine - 0.3%.
2. Complex of hydrogen peroxide with detergent
contains 0.5% hydrogen peroxide solution and 0.5% pa
detergent solution (1:1), has a high detergent
activity, loosens various kinds of pollution,
does not affect the quality of glass, a number of metals, polymer
materials and is easy to rinse off.
A 0.5% hydrogen peroxide solution can be prepared from commercially available perhydrol. It contains 30-33% hydrogen peroxide. To prepare one liter of a 0.5% hydrogen peroxide solution, you need to take about 33 ml of perhydrol. As detergents apply "Progress", "Astra", "Lotus", "Ainu".
Table 20 Preparation of 0.5% hydrogen peroxide solution
Note. The solution is used for pre-sterilization cleaning of instruments with the addition of detergent at the rate of 5 grams per 1 liter of 0.5% hydrogen peroxide.
The washing solution can be used before contamination (until a pink color appears, which indicates that the solution is contaminated with blood, which reduces the effectiveness of cleaning). The unchanged solution can be heated 6 times to a temperature of 45-50 °C.
During heating, the concentration of hydrogen peroxide does not change significantly. In the washing solution, each medical item is washed for 0.5 minutes using a ruff or brush.
For disinfection of medical devices and combined processes of disinfection and pre-sterilization cleaning and sterilization, it is recommended to use modern disinfectants:
advance;
Alaminol;
Diseffect;
Mistral;
Samarovka;
Septabic;
Septustin and others.
Conducting pre-sterilization cleaning of instruments using the combined processes of disinfection and pre-sterilization cleaning and sterilization is carried out strictly according to guidelines to these funds.
Pre-sterilization treatment is carried out manually and mechanically.
Carrying out pre-sterilization cleaning of instruments manually
Target: removal of proteinaceous, fatty pollution, mechanical pollution, medicines.
Equipment: gown, mask, gloves. Cleaning solution 0.5% concentration, consisting of hydrogen peroxide and detergent, a container with a lid (electric sterilizer), a clock for 15 minutes (sand, electric), ruffs or gauze swabs, trays, a container with distilled water, a dry-heat cabinet, tools .
Required condition: specially trained junior medical personnel with a permit (certificate). It is carried out in the CSO, before cleaning, a color reaction is carried out for traces of disinfectants, confirming that after use the instruments have been disinfected.
| Stages | Rationale |
| Preparation for the procedure | |
| i. Wear a gown, mask, gloves. | Safe hospital environment, security |
| on the health of the staff. | |
| 2. Prepare and heat my- | Ensuring the effectiveness of |
| a 0.5% peroxide solution of water | solutions. |
| kind with detergent before | At a higher temperature |
| 50"S. | hydrogen peroxide loses its |
| cleansing (superficial | |
| active properties). | |
| Performing a procedure | |
| 1. Place the toolkit in | Ensuring the necessary contact |
| disassembled into a container with 0.5% | that tool with detergent solutions |
| cleaning solution for 15 minutes | ramie, maintaining the desired temperature |
| skipping the solution | solution rounds. |
| through the cavity, close the lid. |
| Stages | Rationale |
| 2 Treat each object with a ruff (gauze swab) in a washing solution for 30 seconds. (Pass the cleaning solution through the needles). Place instrumentation on grids or tray. | Removal of contaminants from the joints on the instruments, from gaps, cavities, gaps. |
| 3. Rinse under running water for 30 sec. each object, passing water through the cavities of the instrumentation. Place in tray. | Removal of chemicals from workpieces. |
| 4. Rinse each item in distilled water. | Removal of elements contained in running water, including salts. |
| End of procedure | |
| 5. Dry in a dry oven at a temperature of 85 ° C until the moisture disappears completely. | In a humid environment, the growth of microorganisms is sharply accelerated. |
Note. After the procedure, the quality of pre-sterilization cleaning is monitored for the presence of protein, fat contaminants, drugs, residual components of alkaline detergents by setting azo-pyramic, phenolphthalein and Sudan III tests (for fats).
The concept of pre-sterilization cleaning
and sterilization of medical instruments
Realizing the urgency of the problem of reducing labor intensity and improving the quality of disinfection, pre-sterilization cleaning and sterilization of medical instruments, as well as the particular importance of protecting the health of medical workers, the UZO-MEDEL installation is currently used, with the help of which these processes are mechanized. It is especially important to use them in infectious diseases hospitals, departments and AIDS prevention centers.
UZO-5-01 and UZO-10-01 units have the main advantages of using ultrasonic cleaners:
Minimal use of manual labor;
Reducing the risk of infection;
Significant reduction in labor intensity;
Improvement of the cleaning process, including in difficult
accessible areas of products;
Reduced processing time;
Increasing environmentally friendly processes;
Gentle exposure mode, which does not allow for
tool damage;
Possibility to carry out two stages in one process
processing: disinfection and pre-sterilization
cleaning, or three stages, including sterilization.
Also, a new economic, environmentally friendly way of disinfection and sterilization is a multi-purpose ozone sterilizer. It consists of an ozonizer “Orion? OP1-M + sterilization chamber.
Advantages of multipurpose ozone sterilizer:
Low temperature sterilization;
Environmentally friendly, safe sterile technology
lysis that does not require chemically resistant consumption
nyh reagents;
Low power consumption;
Ease of maintenance;
No pauses between sterilization cycles;
Automatic control of the sterilization process;
There is a special test program for checking the
rilization chamber for tightness. Sterilized
The cation cycle consists of the stage of air replacement
ha in the sterilization chamber of the ozone-air environment
doy, stages of sterilization and displacement of ozone-
stuffy environment, then filling the chamber is cleaned
air free from microflora.
Removal, processing and disposal of waste from 1 to 5 hazard class
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Depending on the hazard class, a medical institution disinfects and sterilizes medical instruments, confirmed by acts and relevant documentation. Already 5 years Russian Federation there are new sanitary and epidemiological rules and norms for medical waste, which include syringes.
According to the document, there are 5 hazard classes of medical waste. Syringes, as equipment in contact with body fluids, belong to class "B" - dangerous in an epidemic sense, or to class "C" - especially dangerous if they were used to treat infections that pose a serious threat to the population.
Requirements for recycling activities
Administration medical institutions approves the instructions, according to which the employees responsible for the processing and destruction of used disposable syringes are determined.
The instructions must include:
- The allocation of separate containers for the transportation of waste of various classes, since mixing them in one container is not allowed.
- Ways of moving used syringes to sterilizing devices, places of temporary storage and destruction
- Unloading and loading, use of mechanical equipment - carts, electric lifts, conveyors and other machines
- Briefing of persons responsible for the disinfection and disposal of used syringes.
The instruction is drawn up taking into account the current rules and regulations and is signed by the head physician of the medical institution.
Scheme for handling used syringes
The scheme of work with recycling material indicates:
- Composition, quality and quantity
- Containers for storage and removal of tools, hermetic bags, single-use and reusable containers.
- The procedure for collecting used instruments from treatment rooms, operating rooms and other departments.
- Methods for disinfecting syringes of different hazard classes, their export and disposal
- The procedure for personnel in case of violation of the tightness of the packaging and spillage of used tools, as well as in emergency situations - injury to fingers with used needles, etc.
- Regulations for training employees in safety rules when working with material to be disposed of.
Who can recycle
Persons from among the medical personnel who have reached the age of 18 are allowed to work with used syringes. All of them are required to undergo scheduled medical examinations and be vaccinated in accordance with the procedure for vaccinating medical staff. Persons who have not been immunized against serum hepatitis are not allowed to work on decontamination and transportation of used instruments.
The personnel responsible for the storage and removal of tools must be regularly instructed in compliance with safety measures. When working, medical workers should be equipped with overalls and shoes, which are stored in separate cabinets. Washing of overalls is carried out in the laundries of a medical institution; it is unacceptable to take it home.
When working with spent material of class "B", personnel are required to protect the respiratory organs with masks.
Collection of used tools
Disinfection of medical instruments is applicable for devices that belong to Class B waste. For this, various methods are used - soaking in disinfectant solutions, sterilization with microwave rays, dry and wet steam. Then they are collected in puncture-proof durable bags of yellow color or provided with yellow marking, which corresponds to class "B". Liter packages contain 20 assembled syringes.
Collection scheme
You can use reusable waterproof containers with a tight-fitting lid for collection. There are containers for 5 and 10 liters, where 100 - 200 used syringes are placed. Containers are filled three-quarters or to the top, covered with a lid and sealed according to the color of the corresponding class.
The instrumentation is folded unassembled, or the needles are preliminarily separated from them using needle removers, needle destructors or needle cutters. Separating them manually is unacceptable. Needles are stored in sealed containers, and syringes in heat-resistant plastic bags.
Tools of hazard class "B" are folded into containers marked in red. It is forbidden to pour devices from one container to another, tamp them down and load needles into soft single-use packaging.
In places where disinfection and collection of used syringes are carried out, at least once a year, microbiological control of the quality of processing is carried out and air samples are taken for the content of volatile toxins.
Disinfection and all stages of collection and transportation of instruments are subject to documentation. The regulation is spelled out in the adopted SanPiN.
After collecting
After collection, used syringes and needles are sent to storage sites, from where they are then taken to a disposal site.
For export, special vehicles with a closed body are used. According to the export regulations, the car is filled with packages and containers with medical waste and transport them to the disposal site. After the procedure, the car is disinfected.
Disposal of tools
The problem of disposal of waste from medical institutions in Russia is very acute. Syringes make up about 2% of all waste to be disposed of. Hundreds of tons of disposable syringes are produced annually in large metropolitan areas.
Currently, there are two schemes for their destruction in the Russian Federation - liquidation and disposal.
Elimination methods include:
- Burial at a landfill, which is specially allocated for medical MSW
- Storage at the landfill after disinfection
- Incineration in high temperature furnaces
- Autoclaving
Landfills are being reduced solid waste, by the method of pressure testing on special installations. The first two methods are only acceptable for syringes and needles belonging to hazard class "B". Epidemiologically dangerous tools are to be burned.
Burning
Disposal in the form of incineration is carried out in several ways. The most common is with the help of incinerators - special furnaces with a high temperature regime. With all their advantages, incinerators are sources of dioxins - carcinogenic substances, pollute environment mercury compounds and neurotoxins that destroy nervous system. The ash from incinerators is also toxic and dangerous for toxins to enter aquifers.
A more environmentally friendly way is incineration in a plasma furnace. The principle of its action allows you to safely destroy syringes and needles. The smoke formed during combustion passes through the slag layer, where it is neutralized and partially dissolved. Then it enters a special chamber, where it undergoes a 5-stage purification, and then is released into the atmosphere. The plasma furnace operates on the territory of the capital's 1st Clinical Infectious Diseases Hospital.
Pyrolysis is a two-stage combustion, which provides for the preliminary decomposition of waste in an oxygen-free environment and their afterburning in a chamber to safe fractions.
Sterilization
In Russia, installations that combine two functions - a chopper and a sterilizer are gaining popularity. Used disposable syringes of hazard classes "B" and "C" are loaded into such an autoclave. They are crushed and sent to be sterilized with hot steam under high pressure. After the procedure, class A sterile waste is taken to the landfill and buried.
Utilization methods and disinfection involve the processing of polymeric materials into secondary raw materials. The algorithm of actions is quite long. The disassembled tools are first sent for pre-cleaning, then they are crushed, washed, dried, granulated and sent to the recycling plant. Utilization method and disinfection is environmentally friendly - in the process of processing it does not form harmful substances and economically justified. Today it is being improved to be massive. The biggest disadvantage of the disposal method is the need for sorting, since the body, piston and needle holder are made up of different types plastic polymers.
Today, scientists around the world are busy with the problem of creating biodegradable polymers. Such syringes after decontamination will decompose at landfills to safe fractions. As for the tools currently in use, it is necessary to be guided by the requirement for decontamination, destruction and disposal of syringes and other items.
