Every occupation has work hazards and same is true for doctors and nurses also. Doctors and nurses are prone to needle stick injury while working and there is always risk of getting blood borne infection like HIV, Hepatitis B and HIV

1. Safe Injection Practice
For Doctors and Nurses
Dr Ketan Ranpariya
(MBBS, PGDHM,PGDHIVM,HIVM)
HIV / AIDS CONSULTANAT
Mobile: 0 75 75 88 70 70
Dr Ketan Ranpariya

2. Disclaimer
• This information is for Awareness of Health Care
Personnel as part of “Safe Injection Practice”
Campaign 10 K.
• I do not have anything for financial disclosure. It’s
release for Public Health Interest
• Have a Safe and Healthy Injection Practice and keep
yourself and patient safe.
• Let’s Join Hand and Work Together to achieve
Harmless Injection Practice
Dr Ketan Ranpariya

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5. Unsafe Injections cause many
outbreaks
Dr Ketan Ranpariya

6. Unsafe Injections cause many
outbreaks
Dr Ketan Ranpariya

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9. True or False ?
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12. True or False ?
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15. True or False ?
Dr Ketan Ranpariya

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18. True or False ?
Dr Ketan Ranpariya

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21. These were
Dr Ketan Ranpariya

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23. Who are at risk of Unsafe Injection
Practice ?
Dr Ketan Ranpariya

24. Who are at risk of Unsafe Injection
Practice ?
1. Recipient
2. Health Care Worker
3. Community
Dr Ketan Ranpariya

25. Practices that can harm recipients
Dr Ketan Ranpariya

26. Practices that can harm recipients
• Giving an injection when there are safer
alternatives
Dr Ketan Ranpariya

27. Practices that can harm recipients
• Reusing a syringe or needle
Dr Ketan Ranpariya

28. Practices that can harm recipients
• Attempting to sterilize and reuse
disposable syringes
Dr Ketan Ranpariya

29. Practices that can harm recipients
• Improper Sterilization technique for glass
syringes.
Dr Ketan Ranpariya

30. Practices that can harm recipients
• Use only disinfectants on contaminated
syringes and needles to prepare them for
reuse.
Dr Ketan Ranpariya

31. Practices that can harm recipients
• Touching the needle
Dr Ketan Ranpariya

32. Practices that can harm recipients
• Loading syringes with multiple doses and
injecting multiple persons
Dr Ketan Ranpariya

33. Practices that can harm recipients
• Applying pressure to bleeding sites with
used material or a finger
Dr Ketan Ranpariya

34. Practices that can harm recipients
• Vaccinating infants in the buttocks
Dr Ketan Ranpariya

35. Practices that can harm recipients
• Leaving a needle in the vial to withdraw
additional doses
Dr Ketan Ranpariya

36. Practices that can harm
healthcare workers
Dr Ketan Ranpariya

37. Practices that can harm healthcare
workers
• Recapping contaminated or used needles
Dr Ketan Ranpariya

38. Practices that can harm healthcare
workers
• Placing needles on a surface or carrying
them any distance prior to disposal
Dr Ketan Ranpariya

39. Practices that can harm healthcare
workers
• Sharpening blunt or blocked needles for
reuse
Dr Ketan Ranpariya

40. Practices that can harm healthcare
workers
• Reaching into a mass of used syringes or
needles (for cleaning or sorting waste)
Dr Ketan Ranpariya

41. Practices that can harm the community
Dr Ketan Ranpariya

42. Practices that can harm the
community
• Leaving used syringes in areas where
children can play with them
Dr Ketan Ranpariya

43. Practices that can harm the
community
• Giving or selling used syringes to
vendors who will resell them
Dr Ketan Ranpariya

44. Practices that can harm the
community
• Leaving used syringes in areas accessible
to the public
Dr Ketan Ranpariya

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47. Characteristics of Unsafe Injections
(63 % of all Injections are Unsafe) – All India
Total
Total Unsafe
Wrong Habits
of Injection
Givers
54 %
Questionable
Sterility
24 %
Reuse 22 %
Dr Ketan Ranpariya

48. Wrong Habits of Injection Givers
( 54 % )
Dr Ketan Ranpariya

49. Wrong Habits of Injection Givers
• Giving an injection when there are safer
alternatives
Dr Ketan Ranpariya

50. Wrong Habits of Injection Givers ( 54% )
• Giving injection by just changing needle
Dr Ketan Ranpariya

51. Is it safe to Re Use Syringe with
NEW needle ???
Dr Ketan Ranpariya

52. Wrong Habits of Injection Givers ( 54% )
• Injection without proper hand washing
Dr Ketan Ranpariya

53. Wrong Habits of Injection Givers ( 54% )
• Permanent needle on multi dose vials
Dr Ketan Ranpariya

54. Wrong Habits of Injection Givers ( 54% )
• Improper cleaning of injection site
Dr Ketan Ranpariya

55. Wrong Habits of Injection Givers ( 54% )
• Cleaning needle with spirit
Dr Ketan Ranpariya

56. Wrong Habits of Injection Givers ( 54% )
• Checking needle sharpness with cotton
Dr Ketan Ranpariya

57. Wrong Habits of Injection Givers ( 54% )
• Touching needle with finger while
injecting
Dr Ketan Ranpariya

58. Wrong Habits of Injection Givers ( 54% )
• Pushing medicine fast
Dr Ketan Ranpariya

59. Wrong Habits of Injection Givers ( 54% )
• Using spirit cotton on after injection
Dr Ketan Ranpariya

60. Wrong Habits of Injection Givers ( 54% )
• Improper disposal of injection waste
Dr Ketan Ranpariya

61. Questionable Sterility ( 24% )
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62. Questionable Sterility ( 24% )
• sterilize and reuse disposable syringes
Dr Ketan Ranpariya

63. Questionable Sterility ( 24% )
• Improper Sterilization technique for glass
syringes
Dr Ketan Ranpariya

64. Questionable Sterility ( 24% )
• Sub standard sterilization of disposable
syringes
Dr Ketan Ranpariya

65. Questionable Sterility ( 24% )
• Keeping used syringes for next injection
even for same patient
Dr Ketan Ranpariya

66. Reuse of syringes ( 22% )
Dr Ketan Ranpariya

67. Reuse of syringes ( 22% )
• Two types of reuse
– Downstream reuse – Where, after
discarding of the syringe by the
injection giver, someone else takes the
syringe for reuse
– Intentional reuse – Where the injection
giver intentionally brings about the
reuse of the syringe
Dr Ketan Ranpariya

68. Downstream Reuse
Although injection giver does not intentionally
reuse syringe, somewhere along the way the
syringe/needle gets picked for reuse
Medical waste is
disposed off
improperly due to
lack of sealable
sharps containers
and lack of
incineration
Dr Ketan Ranpariya

69. Downstream Reuse
Can be resold or simply reused:
Can’t tell if a syringe is new
• Evidence of “industry”
of reprocessing and
reselling; particularly
in India, Pakistan; also
reported in parts of
Africa
5-year-old girl smiles as she displays
her 'catch' to her mother - dozens of
used disposable syringes with the
needles intact!
Dr Ketan Ranpariya

70. Intentional Reuse
Reasons for the injection giver to purposefully
reuse injection equipment
– Lack of knowledge/education
• Misunderstanding of limits to “cleaning”
syringes
• Lack of awareness that using same syringe
with different needle across patient can spread
disease
• Ignorant that using same syringe multiple
times on single patient over a long period of
time can cause infections as affects
sterility
Dr Ketan Ranpariya

71. Intentional Reuse
Reasons for the injection giver to purposefully
reuse injection equipment
– Altruism - limited number of syringes; many
patients in need
Dr Ketan Ranpariya

72. Intentional Reuse
Reasons for the injection giver to purposefully
reuse injection equipment
– Economic reasons – reuse for financial gain
Dr Ketan Ranpariya

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75. Reuse prevention devices
Auto Disable syringes have been
mandated by WHO/UNICEF/UNFPA and GoI
in Immunization services
WHO recommends Reuse Prevention
feature enabled syringes as they offer the
highest level of safety to the recipients.
Dr Ketan Ranpariya

76. Re Use Prevention (RUP) Syringes
4 locking petals in the
plunger rod lock in place in
the barrel when a full dose is
delivered.
Dr Ketan Ranpariya

77. Re Use Prevention (RUP) Syringes
If the user attempts to pull
the plunger rod out of the
lock, the plunger rod will
break.
Dr Ketan Ranpariya

78. Re Use Prevention (RUP) Syringes
RUP syringes meet ISO
7886-4 requirements for
passive reuse prevention.
Dr Ketan Ranpariya

79. Re Use Prevention (RUP) Syringes
The reuse prevention
mechanism does not
require any additional
steps beyond delivery of a
dose
Dr Ketan Ranpariya

80. Re Use Prevention (RUP) Syringes
Dr Ketan Ranpariya

81. Benefits of using RUP Syringes
Since RUP syringes get locked after
injection, this syringe will not be available
for repacking, thereby ensuring fresh
syringe each time when we open a pack.
Dr Ketan Ranpariya

82. Benefits of using RUP Syringes
RUP syringes ensure proper disposal of
syringes since it is getting locked after
injection & breakable plunger
Dr Ketan Ranpariya

83. Benefits of using RUP Syringes
It prevents both intentional & downstream
reuse
Dr Ketan Ranpariya

84. Bio Medical Waste Management Rules
Dr Ketan Ranpariya

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86. Sharp containers
Dr Ketan Ranpariya

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88. ESNC an Innovative Game Changer
Dr Ketan Ranpariya

89. FAB- BD Emerald™ Needle
Collector
• Small size – Portable (Easy to Carry)-
– Bedside needle containment
– Prevent recapping of needle
– Prevent NSI (Employee welfare)
Dr Ketan Ranpariya

90. FAB- BD Emerald™ Needle
Collector
• Slide door- Closed containment of
Needles
– Prevent exposure of sharps
– Infection prevention - Ease of operation
Dr Ketan Ranpariya

91. FAB- BD Emerald™ Needle
Collector
• Made of Polypropylene –
• Non Chlorinated Plastic
– No PVC
– Incinerable if BMWM rules allows
Dr Ketan Ranpariya

92. Share Your Knowledge
Dr Ketan Ranpariya

93. Thank You !!!
Dr Ketan Ranpariya

94. To Participate in
“Safe Injection Practice” Campaign 10 K
You can contact us on
: 0 70 48 70 41 41
: www.facebook.com/HIVCLINICSURAT
: doctorforhiv@gmail.com
: www.hivaidssurat.com
Dr Ketan Ranpariya