Treatment Aspects: pharmacology, peri operative care & Infection prevention or safety measures [ BMWM]

1. TREATMENT ASPECTS: PHARMACOLOGY
AND PRE-POST OPERATIVE CARE
ASPECTS.
INFECTION CONTROL & STANDARD
SAFETY MEASURES.
BIO MEDICAL WASTE MANAGEMENT
DR. PALLAVI PATHANIA

3. TERMS AND DEFINITION
 DRUG
A drug defined as any substance or group of substance, which affect
living tissue.
Or
It is defined as any substance used to prevent, diagnose or treat
disease or to prevent pregnancy.
 PHARMACOLOGY
It is the study of the actions and effects of drugs on living systems
and their therapeutic use.

4. PHARMACOKINETICS
It deals with the absorption, distribution, metabolism and excretion of drugs.
TOXICOLOGY
It is the science of poisons. It includes the origin, chemical properties, toxic actions etc.
POSOLOGY
It is the science of dosage. It deals with the amount of drug necessary to produce a
desired physiological, therapeutic, or prophylactic effect.
MINIMUM DOSE
The minimum dose is considered the smallest dose of drug that that produce the
therapeutic effect.

5. MAXIMUM DOSE
The maximum dose is considered the large dose of drug that can be safely administered.
TOXIC DOSE
The toxic dose of a drug is considered the amount of drug that will produce noxious or harmful
effect.
LETHAL DOSE “LD50”
The lethal dose of a drug is the amount of substance that will cause death
SINGLE DOSE
It is the amount of that substance to be taken at one time.
DAILY DOSE
The daily dose of a drug is the amount of that substance to be taken in a 24 hour period.

6. MAINTAINCE DOSE
The maintenance dose of a drug is the amount of that substance taken to maintain
continue a desired therapeutic effect.

7. Greek Word
Pharmacon Logos
Drug Science
Science of drugs- dealing with the study of Desirable and Undesirable
effects.
PHARMACOLOGY

8. Pharmacology is the study of drugs and their actions on the
body

9. What is PHARMACOLOGY ?
Pharmacology
Pharmacokinetics Pharmacodynamics
What the body does to drug What the drug does to body
Pharmacotherapeutics Pharmacy
The study of the use of drugs Preparing suitable dosage forms
Toxicology

10. It is the science of:
• Identification
• Selection
• Preservation
• Standardization
• Compounding, and
• Dispensing of medicinal substances
PHARMACY

11. “ Drug is any substance or product that is used or is intended to be
used to modify physiological systems or pathological states for the
benefit of the recipient .”
DRUG

12. NOMNECLATURE
 CHEMICAL NAME: provided by chemist{ ingredients based}
 GENRIC NAME: manufacture name { company based}
 OFFICIAL NAME: FDA {food drug administration}
 TRADE NAME: brand name

13. Chemical Name 1,4 benzodiazepine analog
Generic Name Alprazolam
Official Name Alprazolam, USP
Brand Name Alprax®
DRUG NAMES

14. • Mineral
• Animal
• Plant
• Synthetic
• Micro-organisms
• Drugs produced by genetic
engineering
• Liquid paraffin, magnesium sulfate, etc
• Insulin, Thyroid, etc.
• Morphine, Quinine etc
• Aspirin, Sulfonamides, etc.
• Penicillin & other antibiotics.
• Human insulin, human growth, hormone etc.
THE NATURE AND SOURCES OF DRUGS

15. Chemistry
Animal Pharmacology
Animal Toxicity (Short / Long term)
Studies in Humans
Drug Authorities
Market
Synthesis & Purification
Formulation
DRUG DEVELOPMENT PROCESS

16. Tablets
Capsule
Injection
Infusion
Solution
Suspension
Cream
Aerosol
DRUG DOSAGE FORMS

17. ROUTES OF DRUG ADMINISTRATION
1. Oral
2. Sublingual
3. Rectal
Enteral Parenteral
(injectable)
1. Intravenous
2. Intramuscular
3. Subcutaneous
Topical
1. Intranasal
2. Inhalation
3. Intravaginal
How the drug is given

18. • The study of what the body does to the drug
• It is the study of absorption, distribution, metabolism and excretion
(ADME) of drugs
• “Fate of drug”
PHARMACOKINETICS

19. •Absorption
How the drug is moved into blood stream from the site of administration ?
• Distribution
How much drug is moved to various body tissues / organs ? Depends on blood flow through tissue
• Metabolism
How the drug is altered – broken down ?
• Excretion
How much of the drug is removed from the body ?
PHARMACOKINETICS

20. PHARMACOKINETICS : EFFECT OF DRUG ON BODY
THERAPUTIC EFFECT
LOCAL & SYSTEMIC EFFECT
ADVERSE EFFECT
SIDE EFFECT
OR OTHERS EFFECT

21. THERAPUTIC EFFECT
 It is the effect which is desired. Therapeutic effect r the
medication desired & intentional effect.
 These effects vary with the nature of the medication, the
length of time the client has received.
 These effects also vary with the client physical conditions &
interaction with the other day.

22. LOCAL & SYSTEMIC EFFECT
 Local effect “ of drugs r expected when they
applied topical region on the skin or mucous
membrane.
 Systemic effect “ must be absorbed in the blood
stream. They produced the systemic desired effect
in the various system of the parts of body.

23. ADVERSE EFFECTS
 ADVERSE EFFECTS “is any effect other than the
therapeutic effect. So e adverse effects r minor
while some r vary serious to health, for e.g. PCM=
liver toxicity
 SIDE EFFECTS “minor adverse effects. These r the
minor adverse effect which r absorbed due to
administration of drug. It can be treated by nsg
interventions. For e.g. amoxicillin= nausea,
vomiting.

24. ALLERGIC REACTION
 When the client body reacts towards drug of
recognized as a foreign body then the effects are
shown known as allergic effect.
 Effect on urinary system
 oliguria., anuria , hematuria, albumin urea

25. EFFECTS ON CVS
 Arrhythmia, HR=72b/m
 Rhythm= lub ,dup
 Hypotension
 Hypertension
 Effects on CNS system
 Tremors {involuntary movemnts}
 Insomnia
 Headache
 dizziness

26. EFFECTS ON GI
 Mucosal irritation, constipation, diarrhea.
 SYNERGIC EFFECTS” , “A combination of 2
drugs can some types cause an
effect that is greater than the sum
of the individual effect of each drug.


27.  Pharmacokinetics: The movement of drugs that is the appearance and disappearance in the body.
 Molecular pharmacology: Study of the intraction of drugs such as DNA, RNA, enzymes.

 Chemotherapy: Treatment that destroy microorganism, paracytes, or malignant cells.

 Toxicology: Study of the harmful effect of drugs and chemicals. A toxicologist is also interested in finding
proper antidotes to harmful effect of drugs.

 Chemical Name: Is the chemical formula of the drug shows the structure of the drug.

 Generic Name / Official Name: Is a very less complicated name that is recognized as identifying the drug
for legal and scientific purposes. There is only one generic name for each drug.

 Brand Name / Trade Name / Proprietary Name: Is a private property of an individual drug manufacture.

28. • The study of what the drug does to the body
• It is the quantitative study of the biological and therapeutic effects of
drugs.
PHARMACODYNAMICS

29. USE OF DRUGS
 To maintain health
 To reserve a disease process
 To relieve symptoms
 To prevent disease
 To prevent pregnancy.

30.  PHARMAKOKINETICS: body action on drug
 PHARMACODYNAMICS: drug action on body.

31. FACTORS AFFECTING DRUG RESPONSE
 Pharmacological
 Dose & Route of administration
 Duration of treatment
 Time of administration
 Drug interaction
 Individual
 Age & Weight
 Gender
 Diet
 Tolerance
 -

32. INDICATION &
CONTRAINDICATION
 Indication:
A clinical circumstance indicating that the use of a particular
intervention would be appropriate
 Contraindication:
Any condition which renders a particular line of treatment improper
or undesirable.

33. What does the term adverse reaction refer to?
A. A life-threatening response to a drug
B. A drug-induced allergy
C. A harmful, noxious, unintended & undesirable response to a drug
D. An unpredictable response to a drug
ADVERSE DRUG REACTION

34. ADVERSE DRUG REACTIONS
 Side effect
 Toxicity – overdose
 Allergic reaction
 Physical dependence
 Carcinogenic effect

35. FORMS OF DRUGS
Solid

36. Solid dosage forms
1. Powders
2. Granules
3. Tablets
4. Capsules
5. Modified release dosage forms
(Tablet/Capsul)
6. Lozenges ( torches)
Semi-solid dosage forms
1. Ointments
2. Creams
3. Liniments
4. Suppository
5. Gel/ jelly
6. Paste
7. Poultices
8. Aerosols
9. Transdermal Drug delivery system
Liquid dosage formsNon–sterile
1. Syrup
2. Solution
3. Tincture
4. Suspension
5. Emulsion
6. Lotion
7. Elixir
8. Draughts
9. Enemas
10. Gargles
Sterile dosage forms
1. Injectables
2. Intravenous bolus dosage
3. Drops ( Eye & Ear)
11. Linctus
12. Lotions
13. Mixture

37. Solid form
 Caplet : shape like a capsule and coated for easy swallowing
 Capsule: powdered, liquid or oily drug enclosed in a gelatin shell
 Pills: tablet containing one or more drugs shaped into ovoid or oblong form
 Tablet: powdered dose compressed into hard disk.
 LOZENGES: flat, Round form containing drug, flavoring sugar, or dissolves in mouth.
 SUPPOSITORY: solid dose form mixed with gelatin for insertion in the body cavity,
melts at body temperature , releasing the drug for absorption
Suppositories

38. LIQUID FORM
 INJECTIONS: Liquid drugs in the ampoule or vial for IM, IV, SC , ID use
 DROPS: liquid drug for instillation in eyes, ears, nose
 SYURP: drug dissolved in conc. sugar solution
 SUSPENSION: finely divided drug particles in a liquid medium.
 LOTION: drug in liquid suspension used externally on the skin
 TINCTURE: water or alcohol drug solution
 EMULSION: mixture of two liquids uniformly dispersed throughout each other

39. SEMI SOLID FORM
 OINTMENT: preparation made for external use usually containing one or more drugs
 PASTE: thick and stiff preparation absorbed through skin more slowly than ointment
 CREAM: a non greasy semi solid prepration used on the skin.
Ointment
Pastes
Creams

40. PHARMACOLOGY

41. CLASSES OF DRUGS
 Analgesic
 Mild analgesics
 Non-steridol anti-inflammatory drug (NSAIDs)
 Antibiotics
 Antiviral
 Antifungal
 Anti tuberculin
 Antacids
 Antidepressants
 Antidiabitics

43. STORAGE AND CARE OF DRUGS
 All the drugs should be labeled properly, neatly and gently.
 The labeled should contain the name of drug, composition, strength and
dose
 There should be separate cupboard for storing drugs
 There should be separate cupboard for storing poisonous drugs & should
be under lock and key.
 There should be separate compartments for storing different forms of
drugs i.e. tablets, mixtures, lotions, injections, drops etc.
 All the drugs should be kept alphabetically.
 A record should be maintained for accounts of drugs.
 A separate record should be maintained for poisonous drugs to prevent
their theft and misuse.
 Emergency drugs should be kept in easy reach.
 .

44.  The expire date should be checked at regular intervals and replaced
from the central store.
 The drugs which get destroyed at room temperature e.g. vaccines,
antibiotics, serum etc should be stored in refrigerator.
 The oily medicine should be stored in water proof cover to prevent
soiling.
 Do not take the medicine from the bottle or container which have
illegible level.

45. FIVE R’S
Right
Medicine
Right
Dose
Right
Time
Right
Route
Right
patient

46. RIGHTS OF DRUG ADMINISTRATION
1. Right drug
2. Right dose
3. Right patient
4. Right route
5. Right preparations
6. Right times
7. Right handling
8. Right storage
9. Right expiry of date
10. Right discard
11. Right administration
12. Right explanation
13. Right documentation
14. Right order
15. Right patient chart
16. Right universal precaution

47. PRE & POST OPERATIVE CARE

48. PREOPERATIVE
PREPARATION AND
POSTOPERATIVE
CARE

49. INTRODUCTION
Patient education is a vital component of a surgical
experiences pre-operative patient education may be
offered through conversation , discussion.
The pre-operative nurse can assess the patient
knowledge and use this information in developing a plan
for an event full pre-operative course.
The use of audio-visual aids demonstration and
return demonstration.

50. Definitions.
 Preoperative nursing is a term used to
describe the nursing functions in the total
surgical experience of the patient, pre
operative, intra operative, and post
operative
(Lipincott Manual of Nursing
6thPractice
edition)

51. CLASSIFICATION OF SURGERY:
THE TYPE OF SURGICAL PROCEDURE ARE
CLASSIFIED ACCORDING TO
1] Seriousness
2] Urgency
3] Purpose

52. 1] Seriousness:
I] Major
II] Minor
I] Major surgery
Involves expensive reconstruction or alternation in
body parts . Poses great risk to well-being .
II] Minor
Involves minimal alternative in body parts often
designed to correct deformities involves minimal risk compared
with major procedure.
e.g. Cataract extraction, facial plastic surgery, tooth
extraction

53. 1) ELECTIVE
2)URGENT
3)EMERGENCY
1)ELECTIVE:-
It performed on basis of Clients choice, is not essential and
may not be necessary for health .
surgery , breast reconstruction

54. 2)URGENT:
Is necessary for client health, may
prevent additional problem from developing
(e.g. tissue destruction or impaired organ
function
e.g.:- excision of cancerous famour, removal
of gall bladder for stone
3}EMERGENCY:-
Must be done immediately for save life or
preserve function of body part.
e.g. Repair of perforated appendix, Repair of
traumatic amputation, Control of internal
hemorrhaging.

55. PURPOSE:
1)Diagnostic :- Is surgical exploration that allow physician to
confirm diagnosis. May involve removal of tissue for further diagnostic
testing
e.g. Breast mass biopsy
2)Cosmetic :- Perform to improve personal appearances
e.g.Rhinoplasty to reshape nose 3)Constructive :- Restore
function lost or
reduced as result congenital abnormalities
e.g. Repair of cleft palate , closure of arterial septal defect in
heart
4)Palliative:- Relieves or reduces intensity of arterial symptoms
will not produce care.
e.g. colostomy, debridement of necrotic tissue

56. THE NURSING PROCESS IN THE PRE
OPERATIVE SURGICAL PHASE:
The surgical client may undergo test of procedures
to confirm or rule out alteration requiring surgery.
The client meets many health care personal including
surgeons, nurse, anesthesiologist, therapist all play a role in the
client care and recovery.
The nurse must effectively communication with the client
and family because the nurse client ralationship is the
foundation of care.
The nurse assess the client physical, emotional and
spiritual well being and cultural heritage, recognizes the degree
of surgical risk, coordinates diagnostic test, identifies nursing
diagnosis and nursing interventions and establishes outcome in
collaboration with the client and with family.

57. OF SURGICAL CLIENT IS
to establish the clients normal pre-
operative function to assist the nurse in
prevention and recognizing possible post
operative complications.

58.  MEDICAL HISTORY
 NUTRITION
 PAST HISTORY
 ALLERGIES
 HABITS
 FAMILY HISTORY
 AGE
 OBESITY
 FLUID AND ELECTROLYTE IMBALANCE
 PREGANACY

59. PHYSICAL EXAMINATION
 General assessment
 head to toe examination

60. DIAGNOSTIC SCREENING
 BLOOD INVESTIGATION
 RADIOLOGICAL INVESTIGATION
 ECG


61. IMPLEMENTATION : PRE-OPERATIVE NURSING
INTERVENTION PROVIDE THE CLIENT WITH A
COMPLETE UNDERSTANDING OF THE SURGICAL
INTERVENTION.
1) Informed consent:
Surgery cannot be legally or ethically performed until
client understand the need for a procedure the steps
involving, risk, expected resources and alternative treatment.
It is surgeons responsible to explain the procedure
and obtain the informed content.
After the consent form has been completed the nurse
ensure that the form is placed in the client medical record.

62. 2)Health Promotion:-
Health problem activity during the
pre-operative phase focus on health
maintenance, prevention or complication
and support of possible rehabilitation need
post operatively.

63. 3)Pre –operative teaching
The client education is an important
aspect of the client surgical experiences.
The nurse should provide client with
information about sensation typically
experienced after surgery.

64. 4)Deep breathing:
One goal of pre – operative nursing
care is to teach the patient how to promote
optimal lung expansion and resulting blood
oxygen after anesthesia.
Asset client to comfortable sitting
position on side of bed or in chair standing
position.
The nurse then demonstrates how to
take a deep slow breath and now exhale
slowly.

65. 5. INCENTIVE SPIRMETER
 Pre – operative the patient was a spirometer to
measure deep breath expiring maximum effort.
 The pre-operative measurement because the goal of
be achieve as soon as possible after the operation
Post operatively the patient is encouraged to use
the incentive spirometer about 10 to 12 time per
hours.
6. COUGHING:-
 If thoracic or abdominal incision is anticipated
nurse demonstrate now to splint the incision to
minimize pressure and control pain.
 The patient should put the palm of both hand
across the incision site acts as an effective
splint when coughing.

67. 1) Maintenances of normal fluid and
electrolyte balance
 The surgical client is vulnerable to fluid and
electrolyte imbalance as a result or in
adequate pre operative intake or excessive
fluids losses during surgery.
 A client traditionally took nothing by mouth
(NBM) after midnight on the morning of
surgery of keep stomach empty and thus
reduce the risk of vomiting and aspiration.
 The physician assess serum electrolyte
level.

68. 2)Promotional of rest and comfort :-
 Rest is essential for normal healing.
 Anxiety about the impending surgery can
easily interfere with ability to relax or
sleep.
 The nurse should attempts to make the
client environment quite and comfortable.

69. PRE PARATHION ON THE DAY OF SURGERY
THE NURSE COMPLETE A NUMBER OF ROUTINE
PROCEDURES BEFORE RELEASING THE CLIENT FOR
SURGERY .
 Hygiene:- basic hygiene measure provide additional
comfort before surgery e.g. bath, provide clean hospital
gown
 Removal of prostheses: the client must remorse all
presence. Including denture artificial limb raring aids or
contact lens
 Safeguarding valuables :-
If client has any valuables the nurse should give them to
family members of secure them for safekeeping
 Preparing the bowel and bladder :-
The client may required an enema or catheter the
morning of surgery to ensure that the colon is empty.

70.  Vital signs:-
The nurse measure a final pre operative
vital signs
If pre operative vital signs are abnormal
surgery need to be pond
 Documentation:
Before the client goes to surgery the nurse
choice the contents of the medical record
laboratory reports and consent from cy choice
list
 Administering preoperative medication
Typically the physician order operative
medication to be administered when the client
values for the operating room or at an earlier
prescribe time

71. INTRA OPERATIVE SURGICAL
PHASE
 The nurse conduct a focused pre
operative assessment to verify client is
ready for surgery and plan.

72. ACUTE CARE :-
 Physical preparation :
After safety securing the client on the
orating room table the nurse applies monitoring
devices to the client before surgery
Client reducing general and regional
anesthesia under go continues ECG monitoring
during surgery
Pulse oximetry will be used to monitor
oxygen saturation

73.  INTRODUCTION OF ANESTHESIA:-
Client undergoing surgical procedure reduces
one of four type or anesthesia, general, regional
local or conscious sedation
1) General anesthesia
It result in an immobile, acute, client does
not recall the surgical procedure
The client amnesia acts as a protective
measure from the unpleasant client of the
procedure
Surgical requiring general anesthesia
involve major procedure

74. 2)REGIONAL ANESTHESIA
 Regional anesthesia resulting of sensation in an area of
the body
 The method of induction influences the potion of
sensory path way that are anesthetized
 No loss of sensation of conciseness occures with
regional anesthesia
 Administration technique include nerve block and
spinal or epidural
3)LOCAL ANESTHESIA
 Local anesthesia involve loss of sensatinal at desired site
E.g. (growth on skin or the cornea of the eyes )

75.  POSITIONING THE CLIENT FOR SURGERY
 The choices or position is usually determine by surgical
approach
 Ideally the client position provide good asses to the
operative site and sustain adequate circulatory
respiratory function
 The client comfort and safety must be consider
 DOCUMENTATION OF INTRA OPERATIVE CARE
 During intra operative face the nursing staff countinues
pre operative plan e.g. strict asepsis must be follow
minimize the risk surgical wound infection.
 Full fluid infusion and monitoring of urinary output
are action the nurse takes to maintain fluid balance.

76. THE NURSING PROCESSING IN POST
OPERATIVE CARE :
 The nurse thoroughly documents the
assessment including vital sciences,
level consciousness, condition of
dressing and drain, comfort level all
fluids status, and urinary output
measurement
 Client data can be enter flow sheet and
compute raised client record and written
progress notes

77. 1. RESPIRATION
 Certain anesthetic agent may cause
respiratory dispersion
 The nurse a specially alert for shallow, slow
breathing and weak cough
 The nurse asses air patency, respiratory rate
rhythm breath sound
 The acute care area nurse continues to asses
respiratory status and breath sound old clients
smokes and client with history respiratory
diseases are prone to developing complication
such as atelectasis or pneumonia

78. 2) CIRCULATION
 The client is risk for cardio vascular complication resulting of
actual or potential blood loss form surgical site. Side effect of
anesthesia, electrolyte imbalance and depression of normal
circulatory regulating mechanism
 Carefully assessment of heart rate and rhythm along with blood
pressure reveal’s the client cardio vascular status
 A common early circulatory problem is haemorrhage.
 Blood loss may occur externally through a drain or
incision or internally.
 Either type of haemorrhage resulting a fall in blood pressure
elevate heart and respiratory rate cool clubby pale skin and
restlessness
 The nurse maintain IV fluid infusion and many need to increase
IV replacement fluid vital sciences every 15 minutes oxygen need
to be continued medication may be consider
 Blood counts and coagulation studies are drawn send to laboratory.

79. 3)TEMPERATURE CONTROL
 Temperature regulation is important in the post
operative period
 Client are offend cool after surgery the
nurse proved warmed blanket in the
immediate post operative period

80. 4)MAINTAIN NEUROLOGICAL FUNCTION
 Orientation to environment is important in maintain
the clients mental status the nurse reorient the
clients experience that surgery is completed and
describe procedure by nursing measure
5)MAINTAIN
FLUIDS AND
ELECTROLYTE
BALANCE :-
 And important nursing responsibility is maintain
patency of IV infusion in the post operative period

81. 6)PROMOTING WOUND HEALING
7) ACHIEVING REST AND COMFORT

83. ANINFECTIONISADISEASESTATE THAT
RESULTS FROM THE PRESENCE OF
PATHOGENS (DISEASE PRODUCING
MICROORGANISMS) IN OR ON THE
BODY

85.  INCUBATIONPERIOD
 PRODROMALPERIOD
 FULLSTAGEOFILLNESS
 CONVALESCENTPERIOD

86.  NORMAL FLORAOFSKIN
 INFLAMMATORYRESPONSE
 IMMUNERESPONSE

87.  INTEGRITYOFSKIN&MUCUSMEMBRANE
 PHLEVELSOFG.I, G.U TRACTAND SKIN
 W.B.C. LEVEL
 AGE,SEX,RACEAND HEREDITARYFACTORS
 IMMUNIZATION STATUS
 LEVELOFFATIGUE,NUTRITIONALAND HEALTH STATUS
 STRESSLEVEL
 USEOFINVASIVEAND INDWELLING MEDICAL DEVICES

88. INFECTION
PREVENTION
INFECTION
CONTROL
PROGRAMME
ASEPTIC
TECHNIQUE
REPORT
ACCIDEN
T
EXPOSURE
STANDARD
PRECAUTIONS

89. MEDICALASEPSISORCLEANTECHNIQUE
INVOLVESPROCEDURES ANDPRACTICES
THAT REDUCE THE NUMBER AND
TRANSFEROFPATHOGENS.

90.  PRACTICE GOOD HAND HYGIENE
 DO NOT PLACE SOILED LINEN OR ANYOTHER
ITEMS ON FLOOR.
 AVOID HAVING PATIENT COUGH, SNEEZE, OR
BREATHE DIRECTLY ON OTHERS.
 DISPOSED OF SOILED OR USED ITEMS DIRECTLY
INTO APPROPRIATE CONTAINERS.
 FOLLOW STANDARD AND TRANSMISSION BASED
PRECAUTIONS BY THE AGENCY.

91.  PERFORMING HAND HYGIENE
 STERILIZING AND DISINFECTING
 USING PERSONAL PROTECTIVE MEASURES
 HANDLING AND DISPOSING OF SUPPLIES
 USING SPECIALIZED INFECTION CONTROL
PRECAUTIONS

92. EFFECTIVE
WASHING
ABSOLUTELY
ESSENTIAL
HAND
IS
IN
PREVENTING CROSS
INFECTION, AND AIMS TO
REMOVE DIRT &
MICRO-ORGANISMS FROM
THEHAND.

94. 1. STEAMMETHOD
2.DRYHEAT
3.BOILINGMETHOD
4.RADIATIONMETHOD
5.CHEMICALMETHOD

99.  USED EQUIPMENTMAYBEDISPOSED OFAFTER
USEOROFREUSABLEBAGGEDACCORDINGTO
AGENCYPOLICY, SENT TO CENTRALCLEANING
AREA.
 SINGLEUSEITEMSMUSTBEDISPOSED.
 CONTAMINATED ITEMSNEVERBEUSED FOR
ANOTHERPATIENT.

100. HISTORICALPERSPECTIVE:
 1970 :CATEGORYSPECIFIC ISOLATION
 1983 :DISEASE SPECIFICISOLATION
 1985 :BODY-SUBSTANCE PRECAUTIONS
 1987 :UNIVERSAL PRECAUTIONS
 2005 :REVISED CDC GUIDELINES FOR
ISOLATIONPRECAUTIONS

101. REVISED CDC GUIDELINES
 STANDARDPRECAUTIONS:
1. HAND HYGIENE
2. PERSONALPROTECTIVEMEASURES
3. PREVENTIONOFOCCUPATIONALEXPOSURE
4. MANAGEMENTOFBLOODANDBODYFLUID
SPILLAGES
5. MANAGEMENTOFEQUIPMENTUTILIZEDDURING
CARE
6. ENVIRONMENT CONTROL
7. SAFEDISPOSALOFWASTEINCLUDEINGSHARPS
8. LINEN

103.  AIRBORNEPRECAUTIONS
 DROPLETPRECAUTIONS
 CONTACTPRECAUTIONS

104. ISOLATION TECHNIQUE IS USED TO
PREVENT THE TRANSMISSION OF
INFECTION FROM INFECTED PATIENTS
TO OTHERS.

105. CATEGORY A:
THESEINFECTIONSARESPREADBYHANDS,CONTACT
WITHNON-STERILEEQUIPMENT,FAECES,BLOODAND
BODYFLUIDS.HIV,HAV,HBV,HCV,DIARRHEALVIRUSES
ANDENTEROVIRUSESCOMEUNDERTHISCATEGORY
- CUBICLEORPRIVATEROOMREQUIRED
- STAFFSSHOULDWEARAGOWNORAPRONAND
GLOVES
- WASHHANDSWHENLEAVINGTHECUBICLE

106. THISCATEGORYCOVERSINFECTIONSSPREAD
FROMTHERESPIRATORYTRACTVIADROPLET.
CHICKENPOX,MEASLESANDMUMPSARETHE
EXAMPLE.
- CUBICLEORSINGLEROOMISESSENTIAL
- MASKS,GLOVESANDAPRONSSHOULDBE
WORN
- VENTILATIONSYSTEMCONSISTINGOFATLEAST
EXTRACTORFAN.

107. THIS IS USED FOR DISEASES IN WHICH THERE IS INCREASE
SUSCEPTIBILITY TO INFECTION SUCH AS PATIENTS WITH
NEUTROPENIAON ANTI-CANCER
CHEMOTHERAPY AND SEVERELY IMMUNO
COMPROMISEDPATIENTS.THISCATEGORYCALLED AS
“REVERSEPROTECTIVEISOLATION”.
- HANDSMUSTBEWASHEDORDISINFECTEDBEFORE
ENTERINGTHEROOM
- STERILEGLOVES,MASKS,APRONMUSTBEDISCARDES
AFTERATTENDINGTHEPATIENT.

108. IT IS ONLY FOUND IN SPECIALIZED
UNITS FOR HIGHLY CONTAGIOUS
INFECTIONSSUCHASRABIESAND VIRAL
HEMORRHAGICFEVERS.
- CUBICLEISESSENTIAL
- GOWNS, MASKS AND EYE
GOGGLES MUSTBEWORN.

109.  IT IS ALSO KNOWN AS STERILE TECHNIQUE. IT
INCLUDES THE USE OF PROCEDURES TO KEEP
OBJECTSAND AREASFREEOFMICRO ORGANISMS
ANDTHEIRSPORES.
 SURGICAL ASEPSIS USED REGULARLY IN THE
OPERATING ROOM, LABOR AND DELIVERYAREAS
ANDCERTAINDIAGNOSTICTESTINGAREAS.

110.  ALLOWONLYASTERILEOBJECTTOTOUCHANOTHER
OBJECT.
 HOLDSTERILEOBJECTSABOVELEVELOFWRISTS.
 AVOIDTALKING,COUGHING,SNEEZINGORREACHING
OVERASTERILEFIELDOROBJECT.
 CONSIDEREDEDGEOFSTERILEFIELDTOBE
CONTAMINATED.
 AVOIDSPILLINGOFANYSOLUTIONONASTERILEFIELD
OROBJECT.

111. ASEPTICTECHNIQUEISMORESTRICTLYAPPLIEDIN
THEOPERATIONROOMBECAUSEOFTHEDIRECT AND
OFTEN EXTENSIVE DISRUPTION OF SKIN AND
UNDERLYING TISSUE. ASEPTIC TECHNIQUE HELPS TO
PREVENTORMINIMIZEPOSTOPERATIVEINFECTION.

112.  SURGICALSCRUB
 USE STERILE SURGICAL CLOTHING OR
PROTECTIVE MEASURES
 SURGICALDRAPES
 CAREFULATTENTIONONEQUIPMENTANDSUPPLIES.
 PROPERHANDLINGOFARTICLES.

113.  AVOIDTRAFFICSINOPERATINGROOM.
 MAINTAINPOSITIVEAIRFLOW
 AVOIDTOTOUCHCONTAMINATEDARTICLES.
 MAKESURESTERILEENVIRONMENT.

114. MEDICAL ASEPSIS SURGICAL ASEPSIS
DEFINITION PROTECT THE
PATIENTAND HIS
ENVIRONMENT FROM
SPREAD OF
INFECTIOUS
ORGANISMS.
ALL OF THE
PROCEDURES USED
TO STERILIZE ANDTO
KEEP STERILE ANY
OBJECTS
INTRODUCED TO
WOUND OR
PENETRATE THE SKIN
EMPHASIS CLEANLINESS
(FREEDOM FROM
MOST PATHOGENIC
ORGANISMS.
STERILITY (FREEDOM
FROM
MICROORGANISMS).
PURPOSE REDUCE THE
TRANSMISSION OF
PATHOGENIC
ORGANISMS FROM
PREVENT
INTRODUCTION OF
ANY ORGANISM INTO
AN OPEN WOUND OR
PATIENTTOANOTHER. INTO BODYCAVITY.

115. ISOLATION PATIENT WITH A
COMMUNICABLE
DISEASES ARE
SEPARATED FROM
THE REST OF
PATIENTS BY ROOM,
WARD OR UNIT.
PATIENT REQUIRING
SURGERYARETAKEN
TO O.T
ZONE A ZONE ABOUT THE
ISOLATION UNIT IS
ESTABLISHED AS
CONTAMINATED.
NOTHING GOES OUT OF
THE ZONE WITHOUT
BEING DISINFECTED OR
WRAPPED IN A CLEAN
COVER TO PERMIT
HANDLING IN A CLEAN
ZONE.
A ZONE ABOUT THE SITEOF
OPERATION OR WOUND IS
ESTABLISHED AS ASTERILE
FIELD. ONCE A STERILE
ARTICLE TOUCHES AN
UNSTERILE ARTICLE, IT IS
CONTAMINATED
(UNSTERILE). ONLY
STERILE ARTICLES ARE
BROUGHT INTO THE
STERILE FIELD.
HAND
WASHING
HANDS AND FOREARMS
ARE WASHED FOR 1 TO 2
MIN TO REMOVE
SURFACE
CONTAMINANTS AND
SOIL. HANDS ANDARMS
HANDS AND FOREARMS
ARE SCRUBBED FOR 10 MIN
TO REDUCE THE
BACTERIAL COUNT ON THE
SKIN SURFACE. HANDSAND
ARMS ARE DRIED WITHA

116. GOWNS CLEAN GOWNS
ARE WORN TO
PROTECT THE
WORKER. INSIDE
OF GOWN IS
CLEAN, OUTSIDE
OF GOWN IN
CONTACT WITH
THE PATIENTAND
HIS
ENVIRONMENT IS
CONTAMINATED.
STERILE GOWNS
ARE WORN TO
PROTECT THE
PATIENT FROM
THE WORKER.
OUTSIDE OF
GOWN THAT IS
CONTACT WITH
THE STERILE
FIELD MUST BE
KEPT STERILE.
STATUS OF
PATIENT
RESERVOIR OF
INFECTION
POTENTIAL HOST
(OTHER PEOPLE
AND
ENVIRONMENTARE
RESERVOIRS OF
INFECTION).

117. EACHHOSPITALNEEDSTODEVELOPAPROGRAMME
FOR THE IMPLEMENTATION OF GOOD INFECTION
CONTROL PRACTICES AND TO ENSURE THE
WELLBEING OF BOTH PATIENTS AND STAFFS BY
PREVENTINGANDCONTROLLINGH.A.I.

118.  MONITORHOSPITALASSOCIATEDINFECTIONS
 TRAININGOFSTAFFS
 INVESTIGATIONOFOUTBREAKS
 CONTROLLINGOUTBREAKSBYRECTIFICATIONOF
TECHNICALLAPSES.
 INSPECTIONOFWASTEDISPOSAL.
 MONITORHEALTHSTATUSOFTHESTAFFS.

119.  PROVIDEFUNDSAND RESOURCES
 ENSUREASAFEANDCLEANENVIRONMENT.
 SAFEFOODANDDRINKINGWATER.
 STERILESUPPLIESANDEQUIPMENT.
 ESTABLISHANINFECTIONCONTROLCOMMITTEE
ANDINFECTIONCONTROLTEAM.

120. 1.INFECTIONCONTROLCOMMITTEE:
REPRESENTATIVES OF MEDICAL, NURSING, ENGINEERING,
ADMINISTRATIVE, PHARMACY, CSSD AND MICROBIOLOGY
DEPARTMENTS ARETHE MEMBERS. THECOMMITTEE FORMULATESTHE
POLICIES FOR THE PREVENTION AND CONTROL OF INFECTION. ONE
MEMBEROFTHECOMMITTEEISELECTED CHAIRPERSONANDHASDIRECT
ACCESS TO THE HEAD OF THE HOSPITAL ADMINISTRATION. THE
INFECTION CONTROL OFFICER IS THE MEMBER SECRETARY. THE
COMMITTEEMEETSREGULARLYANDNOTLESSTHANTHREETIMESAYEAR.

121.  DIRECTOROFMEDICALSERVICES
 CONSULTANTMICROBIOLOGIST
 HEADOFTHEDEPARTMENT-SURGERY
 HEADOFTHEDEPARTMENT-MEDICAL
 ANESTHETIST
 HEADOFTHEDEPARTMENT-MAINTENANCE
 HEADOFTHEDEPARTMENT-HOUSEKEEPING
 NURSINGPERSONNELFROMVARIOUSDEPARTMENTS.

122.  THE TEAM IS FORMED FOR ASSISTING THE
INFECTION CONTROL COMMITTEE ON DAY
TO DAY ACTIVITIES. IT IS THE CORE OF THE
INFECTIONCONTROLCOMMITTEE.

123.  TO IMPLEMENT THE RECOMMENDATION
OF INFECTIONCONTROLCOMMITTEE.
 TO MONITOR THE SAFE PRACTICES OF PATIENTS
CARE.
 TOMONITORTHESTERILIZATIONPROCESS.
 TO PROTECT THE STAFFS AGAINST BLOOD
BORNE DISEASES.

124.  THEYVISITTHEO.PANDWARDSDAILY.
 VERIFYWHETHERTHEINFECTIONDATAIS COLLECTED
INALLHIGHRISKAREASINASEPARATEREGISTER.
 MAINTAINTHEREPORTOFINFECTIOUSCASES.
 THE TEAM MEMBERS INSPECT THE STERILIZATION
PROCEDURECONDUCTEDATVARIOUSAREASIN THE
HOSPITAL.
 THE OBSERVATIONS MADE BY THIS TEAM ARE
INFORMEDTOI.C.C

125.  THE INFECTION CONTROL OFFICER IS USUALLY A
MEDICAL MICROBIOLOGIST OR ANY OTHER
PHYSICIAN WITH AN INTEREST IN HOSPITAL
ASSOCIATEDINFECTIONS.

126.  SECRETARY OF INFECTION CONTROL COMMITTEE AND
RESPONSIBLE FOR RECORDING MINUTES AND ARRANGING
MEETINGS;
 CONSULTANTMEMBEROFICCANDLEADEROFICT;
 IDENTIFICATIONANDREPORTINGOFPATHOGENSAND THEIR
ANTIBIOTICSENSITIVITY;
 REGULAR ANALYSIS AND DISSEMINATION OF ANTIBIOTIC
RESISTANCE DATA, EMERGING PATHOGENS AND UNUSUAL
LABORATORYFINDINGS;
 INITIATING SURVEILLANCE OF HOSPITAL INFECTIONS AND
DETECTIONOFOUTBREAKS;
 INVESTIGATIONOFOUTBREAKS,AND
 TRAINING AND EDUCATION IN INFECTION CONTROL
PROCEDURESANDPRACTICE.

127.  A SENIOR NURSING SISTER SHOULD BE
APPOINTED FULL-TIME FOR THIS POSITION.
ADEQUATE FULL-TIME OR PART-TIME
NURSING STAFF SHOULD BE PROVIDED TO
SUPPORT THE PROGRAMME.

128.  TO LIAISE BETWEEN MICROBIOLOGY DEPARTMENT AND
CLINICALDEPARTMENTS FOR DETECTION AND CONTROLOF
HAI;
 TO COLLABORATE WITH THE ICO ON SURVEILLANCE OF
INFECTIONANDDETECTIONOFOUTBREAKS;
 TOCOLLECTSPECIMENSANDPRELIMINARYPROCESSING; THE
ICNS SHOULD BE TRAINED IN BASIC MICROBIOLOGIC
TECHNIQUES;
 TRAININGANDEDUCATIONUNDERTHESUPERVISIONOF ICO,
AND
 TO INCREASE AWARENESS AMONG PATIENTS AND VISITORS
ABOUTINFECTIONCONTROL.

129. THE MICROBIOLOGY LABORATORY HAS A PIVOTAL ROLE IN THE
CONTROL OF HOSPITAL ASSOCIATED INFECTIONS. THE
MICROBIOLOGIST IS USUALLYTHE INFECTION CONTROLOFFICER.
THEROLEOFTHEDEPARTMENTINTHEHAICONTROL PROGRAMME
INCLUDES:
 IDENTIFICATION OF PATHOGENS - THE LABORATORYSHOULD BE
CAPABLEOFIDENTIFYINGTHECOMMONBACTERIATOTHE SPECIES
LEVEL;
 PROVISIONOFADVICEONANTIMICROBIALTHERAPY;

130.  PROVISIONOFADVICEONSPECIMENCOLLECTIONAND
TRANSPORT;
 PROVISION OF INFORMATION ON ANTIMICROBIAL
SUSCEPTIBILITYOFCOMMONPATHOGENS
 PERIODIC REPORTING OF HOSPITAL INFECTION DATA
ANDANTIMICROBIALRESISTANCEPATTERN
 IDENTIFICATION OF SOURCES AND MODE
OF TRANSMISSIONOFINFECTION
 EPIDEMIOLOGICAL TYPING OF THE ISOLATES
FROM CASES,CARRIERSAND ENVIRONMENT;

131.  MICROBIOLOGICAL TESTING OF HOSPITAL
PERSONNELORENVIRONMENT
 PROVIDE SUPPORT
DISINFECTION IN
FOR STERILIZATION AND
THE FACILITY INCLUDING
BIOLOGICALMONITORINGOFSTERILIZATION.
 PROVIDEFACILITIESFORMICROBIOLOGICALTESTING OF
HOSPITALMATERIALSWHENCONSIDERED NECESSARY
 PROVIDE TRAINING FOR PERSONNEL INVOLVED IN
INFECTIONCONTROL

132.  ITISRECOMMENDEDTHATEACHHOSPITAL
DEVELOPS ITS OWN INFECTION CONTROL MANUAL
BASEDUPONEXISTINGDOCUMENTSBUT MODIFIED,
FORLOCALCIRCUMSTANCESANDRISKS.

133.  INONESTUDYITWASFOUNDTHATTHERE WERE
AROUND700 INJURIESPER1000 NURSING STAFF
PER WEEK OUT OF WHICH 60% WERE DUE TO
NEEDLES OCCURRED DURING RECAPPING OR
HANDLING BUT VERY FEW WERE DUE TO
DISCARDEDSHARPS. ITISALSOFOUNDTHAT THE
PRESENT AWARENESS AMONG HEALTH
PERSONNEL IS POOR REGARDING BIOMEDICAL
WASTE MANAGEMENT AND IMPARTING-
TRAINING DO IMPROVE THEIR ATTITUDE AND
PRACTICES.

136.  NURSES ARE ACCOUNTABLE FOR THEIR OWN ACTIVITY. ANY
NEEDLESTICKINJURYOR ACCIDENTALEXPOSURETO BLOOD
ORBODYFLUIDSMUSTBEREPORTEDIMMEDIATELY SOTHAT
APPROPRIATEDINTERVENTIONSCANBEUSED.
 WASHING THE EXPOSED AREA IMMEDIATELY WITH WARM
WATERANDSOAP.
 REPORTINGTHEINCIDENCE TO APPROPRIATEPERSONIN THE
AGENCY.
 CONSENTINGTOANINITIALBASELINEBLOODTEST.
 USEPOSTEXPOSUREPROPHYLAXISIFRECOMMENDED
 ATTENDING COUNSELING SESSION REGARDING SAFE
PRACTICES.

137.  POST-EXPOSURE PROPHYLAXIS SHOULD BE GIVEN WITHIN FOUR
HOURS.
- THE COMBINATION OF ANTIRETROVIRALDRUGS, ZIDOVUDINE
(AZT),LAMIVUDINE(3TC),ANDINDINAVIR.
› ABLOOD SAMPLE MUST BEOBTAINED FOR HIV TESTING FROM
THE HEALTH CARE WORKER AS SOON AS POSSIBLE AFTER
EXPOSURE,
› AT REGULAR INTERVALS TO DOCUMENT A POSSIBLE
SEROCONVERSION.
 COUNSELING, TESTING ANDTREATMENTMUST BEAVAILABLE24
HOURSADAY.
 FOLLOW-UPOFAN HIVEXPOSED FOR1 YEARFOR SEROLOGICAL
INVESTIGATIONS.

140.  THE MANAGEMENT OF WASTE ESPECIALLY HOSPITAL
WASTEPOSESTOBEAMAJORPROBLEMIN MOSTOF THE
COUNTRIES. PARTS OF THE WASTE FROM HEALTH CARE
FACILITIES IS REFERRED TO AS BIOMEDICAL OR BIO
HAZARDOUS. BIOMEDICALWASTECAN CAUSE RISKSTO
HUMAN HEALTH BY BEING POTENTIALLY INFECTIOUS.
SUCH WASTES REQUIRE PROPER HANDLING AND
DISPOSAL BECAUSE OF ENVIRONMENTAL AND
OCCUPATIONALCONCERNSASWELLASRISKSTO HUMAN
HEALTH.

141.  "BIO-MEDICAL WASTE" IS THE WASTE THAT IS
GENERATED FROM USE OF MEDICAL, SURGICAL
FACILITIES DURING THE DIAGNOSIS, TREATMENT OR
IMMUNIZATION OF HUMANS. PROPER DISPOSAL OF
HOSPITALIS OFPARAMOUNTIMPORTANCE BECAUSE
OF ITS INFECTIOUS AND HAZARDOUS
CHARACTERISTICS

143. 1. GENERALWASTE
2. PATHOLOGICALWASTE
3.INFECTIOUSWASTE
4. SHARPS
5. PHARMACEUTICALWASTE
6. CHEMICALWASTE
7.RADIOACTIVEWASTE

144.  UNSATISFACTORYBIO-WASTEREGULATION.
 LACKOFSEGREGATIONPRACTICES.
 WASTE BAGS NOT SECURELY TIED RESULTS
IN SCATTERINGOFBIOMEDICALWASTE.
 USAGE OF SAME
TRANSPORTATION OF
WHEEL
ALL
BARROW
FO
R CATEGORIES
OF
WASTE.
 NO MECHANISM FOR ENSURING WASTE
TREATMENTWITHINPRESCRIBEDTIMELIMIT.
 NO PROPER TRAINING OF EMPLOYEES
IN HAZARDOUSMATERIALSMANAGEMENT.

145.  INJURIESFROMSHARPSLEADINGTOINFECTIONTOA.LL
CATEGORIESOFHOSPITALPERSONNELANDWASTE
HANDLER.
 NOSOCOMIALINFECTIONSINPATIENTSFROMPOOR
INFECTIONCONTROLPRACTICESANDPOORWASTE
MANAGEMENT.
 RISKOFINFECTIONOUTSIDEHOSPITALFORWASTEHANDLERS
ANDSCAVENGERSANDATTIMEGENERALPUBLICLIVINGIN
THEVICINITYOFHOSPITALS.

146.  RISKASSOCIATEDWITHHAZARDOUSCHEMICALS,
DRUGSTOPERSONSHANDLINGWASTESATALLLEVELS.
 "DISPOSABLE"BEINGREPACKEDANDSOLDBY
UNSCRUPULOUSELEMENTSWITHOUTEVENBEING
WASHED.
 DRUGSWHICHHAVEBEENDISPOSEDOF,BEING
REPACKEDANDSOLDOFFTOUNSUSPECTINGBUYERS.
 RISKOFAIR,WATERANDSOILPOLLUTIONDIRECTLY
DUETOWASTE,ORDUETODEFECTIVEINCINERATION
EMISSIONSANDASH.

147.  KEEPING IN VIEW INAPPROPRIATE BIO-MEDICAL
WASTE MANAGEMENT, THE MINISTRY OF
ENVIRONMENT AND FORESTS NOTIFIED THE “BIO-
MEDICAL WASTE (MANAGEMENT AND HANDLING)
RULES, 1998” IN JULY 1998. IN ACCORDANCE WITH
THESE RULES (RULE 4), IT IS THE DUTY OF EVERY
“OCCUPIER” I.E. A PERSON WHO HAS THE CONTROL
OVER THE INSTITUTION AND OR ITS PREMISES, TO
TAKEALLSTEPSTOENSURETHATWASTE GENERATEDIS
HANDLED WITHOUT ANY ADVERSE EFFECT TO
HUMANHEALTHANDENVIRONMENT.

149. OPTION TREATMENT&
DISPOSAL
WASTECATEGORY
CAT.NO.1 INCINERATION/DEEPBURIAL HUMAN ANATOMICAL WASTE
(HUMAN TISSUES, ORGANS,
BODYPARTS)
CAT.NO.2 INCINERATION/DEEPBURIAL ANIMAL WASTE ANIMAL
TISSUES,ORGANS,BODY PARTS
CARCASSES, BLEEDING PARTS,
FLUID, BLOOD AND
EXPERIMENTALANIMALS USED
INRESEARCH,WASTE
GENERATED BY VETERINARY
HOSPITALS/
COLLEGES,DISCHARGEFROM
HOSPITALS,ANIMALHOUSES)

150. CAT.NO.3 A LOCAL AUTOCLAVING/
WAVING/INCINERATION
MICRO MICROBIOLOGY&BIOTECHNOLOGY
WASTE (WASTES FROM LABORATORY
CULTURES, STOCKS OR SPECIMENSOF
MICRO-ORGANISMS LIVE OR
ATTENUATED VACCINES, HUMAN AND
ANIMAL CELL CULTURE USED IN
RESEARCH AND INFECTIOUS AGENTS
FROM RESEARCH AND
INDUSTRIAL LABORATORIES, WASTES
FROM PRODUCTION OF BIOLOGICAL,
TOXINS, DISHES AND DEVICES USED
FORTRANSFEROFCULTURES)
CAT.NO.4 DISINFECTIONS
TREATMENT
ANDMUTILATIONSHREDDING
(CHEMICAL WASTE SHARPS (NEEDLES,
SYRINGES, SCALPELS BLADES,
/AUTOCLAVING/MICRO WAVING GLASS ETC. THAT MAY CAUSE
PUNCTURE AND CUTS. THIS
INCLUDES BOTH USED &UNUSED
SHARPS)
CAT.NO.5 INCINERATION / DESTRUCTION & DISCARDED MEDICINES AND
DRUGS DISPOSAL IN SECURED CYTO TOXIC DRUGS (WASTES
LANDFILLS COMPRISING OF OUTDATED,
CONTAMINATED AND
DISCARDEDMEDICINES)

151. CAT.NO.6 INCINERATION
AUTOCLAVING/MICRO
WAVING
, SOLID WASTE (ITEMS
CONTAMINATED WITH
BLOODANDBODYFLUIDS
INCLUDIN
G
DRESSINGS,
COTTON,
SOILED
PLASTER CASTS,
LIN
E BEDDINGS,
OTHER
MATERIAL
CONTAMINATED
WITHBLOOD)
CAT.NO.7 DISINFECTIONS BY SOLID WASTE (WASTE
CHEMICAL TREATMENT GENERATED FROM
AUTOCLAVING/MICRO DISPOSABLEITEMSOTHER
WAVING& MUTILATION THANTHEWASTESHARPS
SHREDDING. SUCH AS TUBING,
CATHETERS,INTRAVENOUS
SETSETC.)

152. CAT.NO.8 DISINFECTIONS BY LIQUID WASTE (WASTE
CHEMICAL TREATMENT GENERATED FROM
AND DISCHARGE INTO LABORATORY&WASHING,
DRAIN CLEANING , HOUSE-
KEEPING AND
DISINFECTINGACTIVITIES)
CAT.NO.9 DISPOSAL IN MUNICIPAL INCINERATION ASH
(ASH LANDFILL
FROM INCINERATION OFANY
BIO-MEDICAL
WASTE)
CAT.NO.10 CHEMICAL TREATMENT & CHEMICAL WASTE
DISCHARGE INTO DRAIN (CHEMICALS USED IN FOR
LIQUID & SECURED PRODUCTION OF
LANDFILLFORSOLIDS BIOLOGICAL,CHEMICALS,
USED IN DISINFECT ION,
ASINSECTICIDES,ETC)

153.  CHEMICALSTREATMENTUSINGATLEAST1%
HYPOCHLORITESOLUTIONORANYOTHER
EQUIVALENTCHEMICALREAGENT.ITMUSTBE
ENSUREDTHATCHEMICALTREATMENTENSURES
DISINFECTIONS

155. COLOUR CODING TYPE
OF CONTAINERS
WASTE CATEGORY TREATMENT
OPTIONS AS PER
SCHEDULE 1
YELLOW PLASTIC BAG 1,2,3,6 INCINERATION/DEEP
BURIAL
RED DISINFECTED
CONTAINER/ PLASTIC
BAG
3,6,7
BLUE/ WHITE
TRANSLUCENT
PLASTIC
BAG/PUNCTURE
PROOF CONTAINER
4,7
AUTOCLAVING/MICRO
WAVING/ CHEMICAL
TREATMENT
AUTOCLAVING/MICRO
WAVING/ CHEMICAL
TREATMENT AND
DESTRUCTION/SHRED
DING
BLACK PLASTICBAG 5,9,10 (SOLID) DISPOSAL IN
SECUREDLANDFILL

157.  CHEMICALDISINFECTION
 DEEPBURIAL
 INCINERATION
 AUTOCLAVING
 MICROWAVE.

158.  WITH IN HOSPITAL, WASTE ROUTES MUST BE
DESIGNATED TO AVOID THE PASSAGES OF WASTE
THROUGH PATIENT CARE AREAS. DEDICATED
WHEELEDCONTAINERS,TROLLEYSORCARTS SHOULD
BEUSED TO TRANSPORT.SEPARATETIME SHOULD BE
EARMARKEDFORTRANSPORTATIONOF BIOMEDICAL
WASTE.

159.  AIRPOLLUTION
 WATERPOLLUTION
 LANDPOLLUTION
 HAZARDSFROMINFECTIOUSWASTEAND SHARPS
 HAZARDSFROMCHEMICALANDPHARMACEUTICALWASTE
 HAZARDSFROMGENOTOXICWASTE
 HAZARDSFROMRADIOACTIVEWASTE
 PUBLICSENSITIVITY