Injection Waste Management
Slide No. 2
 Waste management is a process starting from the point of use of a device till its final disposal . It is not only an issue of technology but requires of lot of change in the way we think .Healthcare waste  is hazardous both to the healthcare professionals , patients and public at large .
Slide No. 3
Waste management for pediatrician happens at all levels from clinics , primary healthcare facilities and hospitals . It also incorporates wastes management at community level .
Slide No. 4
Sharps wastes which is predominantly needles generated at all levels needs to be secured in such a manner that it prevents unscrupulous elements from accessing it . This can be achieved by increasing awareness amongst healthcare professionals and the community about the potential hazards of sharps wastes . Minimising, segregating and disinfecting  this waste at the site of generation is of paramount importance .Destruction & mutilation of used devices is important to prevent their re-use .
Slide No. 5
Currently segregation of  needle waste is not well established in several health care facilities . In some cities , small towns & rural settings common wastes management facilities don't exist and the waste is dumped along with the municipal garbage . Very few  health facilities minimize , segregate disinfect and mutilate sharps wastes before disposing them of to authorized private vendors .Very few large hospitals have incinerators .
Slide  No. 6
Photographs of  sharps waste disposal in an injection clinic and small health facility .
Slide No. 7
Photographs of  sharps wastes disposal in urban area .
Slide No. 8
It is imperative that all sharps be minimized segregated , disinfected , transported and disposed off in an environment friendly manner and as per the healthcare waste management rules of Govt. of India .It is essential to see that bio-medical waste should not be mixed with other waste .
Slide No. 9
Of the total hospital waste generated 75 to 90 % is non-clinical waste and 10 to 25% is clinical waste which includes needles and sharps waste along with other things.
Slide No.  10
A few of the challenges of sharp waste management  are shown on this slide .
Slide No. 11
Needle waste represent only 1 % of the total healthcare waste , immunization related waste which is generated in remote peripheral institutions poses the largest challenge of all but as needles are potentially hazardous and can facilitate the transmission of Hep-B , C and HIV it needs to be handled with extreme care and caution .
Slide No. 12
Title Slide
Slide No. 13
Major considerations required in effecting proper sharps waste are enumerated on this slide .
Slide No. 14
Rational use of injections will minimize the volume of needles sharps generated at the healthcare facility .
Slide No. 15
Needles need to be segregated at source and healthcare professionals using needles are responsible for this. Awareness programs for healthcare profession along with providing appropriate containers and posters etc with instructions for use should be placed at the site of waste generation .
Slide No. 16
As per the healthcare waste disposable rules needles along with sharps need to be put in  a blue /white collection bag and container .
Slide No. 17
Sharps containers should be easily accessible and have to be blue/white colored and translucent , they should be puncture proof and leak proof .
Slide No. 18
The needles should not be recapped and mutilated by hand and also should not be removed with bare hands from the syringe . The needle and syringe both should be disinfected together . To facilitate minimization  ,segregation and to prevent reuse hub-cutters and needle syringe destroyers should be used at the point of use  .
Slide No. 19
The containers with needle waste should be picked-up and carried unsupported by its handle .It should not be thrown and dropped .All containers should have  the bio-hazard symbol and the vehicle used for transport should be authorized .
Slide No. 20
Sharps decontaminating units for syringe and needle are puncture proof containers made of plastics and should have a handle for easy carriage . They should be filled uptill 1/3 level with  1% hypochlorite solution .After the disinfection the needles and syringes should be transferred to another puncture-proof container for transportation . All these containers should be labeled “sharps only ”and have bio-hazards sign .
Slide No. 21
Pictorial of puncture proof sharps containers .
Slide No. 22
Safety boxes are point of use  disposable type sharps management system which can store 10 to 150 syringes with needles depending on the size . They should preferably be laminated on the outer surface to avoid leaching of any liquid . They should have a bio-hazard color coding with labels .
Slide No. 23
Pictorial of sharps containers .
Slide No. 24
In case of non- availability of commercially available sharps containers any plastic container with thick walls and narrow neck can be used . These should have a closeable mouth and should be clearly marked with warning . They should be transported as such without having to transfer the contents .
 Slide No. 25
 The principle to be applied for selecting puncture proof sharps container are enumerated on this slide .
Slide No . 26
Mutilation , destruction and shredding reduces the waste bulk . Needle syringes , another plastic disposable should be mutilated to prevent to reuse .Hubcutters and needle/syringe destroyers either mechanical or electrical are kept at the point of the use are recommended .
Slide No 27
Pictorial of needle destroyer / cutter / burner .
Slide No. 28
Pictorial of hubcutters and needle pullers .
Slide No. 29
The advantages of hubcutter and needle puller are enumerated on this slide .
Slide No. 30
The specifications for electrical needle cutter and burner are given on the slide .
Slide No. 31
Biomedical waste being hazardous needs to be pre-treated with disinfectants before final disposal . Disinfection at the point of use is preferred than at a different venue .The cheapest and most effective disinfectant is freshly prepared 1 % solution of sodium hypo chlorite .
Slide No. 32
The syringe and needle should be dropped in the sharps container and should be completed immersed in the disinfectant . Contact time should be of a minimum 50 minutes .When it is 2/3 full the needle and syringes should be transported for further disposal .
Slide No. 33
This slide show a flowchart for disposal of syringe needles and AD-syringes at small health units like clinics etc. as proposed by CPCB and  Govt. Of India .
Slide No. 34
Terminal disposable of different waste is enumerated on this slide .
Slide No. 35
This slide lays down simple guidelines for clinics and individual consultants in sharps waste management .
Slide No. 36 & 37
Do and Dont’s of sharps waste management are summarized on this slide .
Slide No. 38
Simple points to avoid needle stick injuries .