Biological hazards usually found in the operating room, place the healthcare workers into a high risk.

1. Biological Hazards
Presented by: Amen Ullah

2. Overview
o These are biological substances that poses threat to health of living
organisms (humans).
o Biologic hazards do exist in the environment, and every effort should be
made by health care providers to protect their patients and themselves.
o Standard precautions are a necessity (i.e., treating all body fluids and
materials as infectious).
o Appropriate protective equipment should be available.
o Surfaces such as door handles and computer keyboards have been found
to harbor active vancomycin-resistant Enterococcus (VRE), methicillin-
resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa
(PSAE) for prolonged periods.
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3.  Simple handwashing is becoming less effective in adequately
removing these microorganisms.
 Antiseptic gel hand hygiene is recommended.
 Cleaning contaminated surfaces such as computer keyboards
may be unreliable because these surfaces were not designed
for exposure to disinfectant solutions.
 Some chemicals and solutions can damage the equipment.
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4. Infectious waste
 Infectious medical waste is an environmental concern both
within and outside the health care facility.
 The EPA (Environmental Protection Agency) defines infectious
waste as waste containing pathogens with enough virulence
and quantity that exposure to them could result in an
infectious disease in a susceptible host.
 The disposal of potentially infectious waste generated in
health care facilities is regulated by governmental mandates…
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5. Factors that should be considered in deciding if something is
infectious waste include the following:
1. The presence of pathogenic organisms in sufficient numbers
to be capable of causing infection in living beings.
Many microorganisms are incapable of causing infection
2. The presence of a portal of entry into a susceptible host.
A cut, needlestick, puncture wound, or skin lesion provides a
portal of entry, but not all living beings are susceptible hosts
to infectious diseases.
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6. Conti…
 Potentially infectious waste is considered to be blood and blood products,
pathologic waste, microbiologic waste.
 Contaminated items includes those contaminated by blood, such as
sponges, drapes, gowns, and gloves.
 These items should be segregated from general waste, such as wrappers.
 Infectious waste is placed in leakproof containers or bags strong enough to
maintain integrity during transport, and these bags should be closed and
either labeled or color coded.
For example, red bags may be used to differentiate infectious waste.
Needles and sharps should be put in puncture-resistant containers.
 If the outside of the container is contaminated, double-bagging is
necessary for safe handling during transport to the disposal area.
 Waste can be steam sterilized or decontaminated with microwaves before
compaction and disposal in a landfill, or it can be incinerated.
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7. How Exposures Occur?
 Most common: needle sticks injuries
 Cuts from other contaminated sharps (scalpels,
broken glass, etc.)
 Splashes of blood into mucous membranes (for
example, the eye, nose, mouth) or broken skin (cut
or abraded) with contaminated blood
 Contamination where clothes soaked by blood
 Bites (which break the skin)
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8. Biohazards
 All patients are potential sources of infection.
 Risk of exposure my occur to skin, eye, mucous membrane, or
parenteral contact with blood or other potentially infectious
materials during the course of duty.
 Careful handling of and adequate protection from potentially
contaminated equipment also are important.
 Handwashing is a must after every patient contact or glove removal.
 Engineering controls include safety devices or equipment designed
to minimize or eliminate a biohazard.
 Likewise, restrictions or changes in work practices should ensure
the safety of all patients and personnel in the environment.
 For example, food must not be stored in the same refrigerator
as blood products or specimens. Eating and drinking are
prohibited.
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9. Punctures and Needlesticks
 A penetrating or a splash with fluid contaminated with blood or body
fluids must not be ignored.
 Bloodborne pathogens (HBV, HIV) can be transmitted through breaks in
the skin or contact with mucous membranes.
 The hepatitis B vaccine is recommended for all high-risk health care
workers.
If exposure to blood or body fluid occurs, the following procedures
should be performed.
1. Stop activity immediately
2. Squeeze the skin around the needlestick or cut.
3. Cleanse the puncture site or flush the eye with cool water. Flush cut or
puncture with alcohol or iodine preparation.
4. Report the inccident and seek medical attention promptly.
5. Follow the particular protocol established by the facility for follow-up.
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10.  If a needlestick is involved, most facilities will draw a baseline blood
sample from the patient and the injured caregiver.
 Periodic blood samples are drawn over a period of months to make
sure results remain clear.
 Caregivers who have been contaminated by a high-risk patient or a
patient known to have hepatitis B or to be positive for HIV should be
treated with the appropriate drugs and followed by the employee
health department
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11. Surgical Plume
 Plume (surgical smoke) is generated by the thermal destruction of tissue
or bone.
 Bloodborne pathogens, mutagens, carcinogens, and other toxic
substances can be aerosolized by lasers, electrosurgery, and powered
surgical instruments.
 Fifteen air exchanges, clean air duct filters, and positive room pressure
help minimize buildup of plume in the OR atmosphere.
 Masks capable of filtering particles at least as small as 0.1 mm (high
filtration) are recommended to prevent inhalation of plume particulate.
 Face shields, goggles, or eyeglasses with side shields should be worn to
protect the eyes.
 A smoke evacuator should be used to suction laser and electrosurgical
plumes.
 The evacuator has a filtration system that incorporates a prefilter to trap
particles, an ultralow penetrating air filter for particles in the 0.1-mm
range, and a charcoal filter to absorb odor and hydrocarbons.
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12. Surgical plume
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13.  The vacuum nozzle should be held close to the surgical site.
 OR personnel can change the filters in some evacuators,
whereas others require maintenance by a biomedical
technician.
 Filters are contaminated with biohazardous material and
should be disposed of in the same manner as items
contaminated with blood and body fluids.
 Gloves, masks, and protective eyewear should be worn when
changing filters because the connecting couplers have been
contaminated with plume and the material may be released
into the air when the connection is disengaged.
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Questions/Suggestions
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