Staying safe at work (Proceedings)

Most people who work with animal do so because of an intense love for animals and desire to help them. We'll bet you're like that also. We're sure you'll find that there are may rewards for working in the veterinary community. Sometimes the rewards are very personal and sometimes they're shared with others, but they're the reason we're all here.

With every reward comes responsibility. One of your responsibilities is safety: the safety of yourself, your patients, and your co-workers. If you are hurt on the job, the injury goes well beyond the physical pain and disability you suffer. The hospital is affected financially and organizationally because the health care delivery team is incomplete and others have to work harder to cover the shortage. Finally, your patients and clients are affected by less than a full team providing their care.

Regardless of your position in the practice, as a staff member in a veterinary hospital, you are exposed to hazards in your day-to-day routine and often during the non-routine functions that always seem to occur. These hazards can be diseases, exposure to harmful chemicals or radiation, or simply the obvious physical dangers from the animals we serve. That's the bad news. The good news is that these hazards, when properly identified, can be controlled and your risk of injury minimized or even eliminated.

By participating in this training, you have taken the first step in controlling your risk of an accident or illness: you are becoming aware of potential problems. Some of the issues we'll discuss will seem very obvious to you, while others will seem more obscure. Remember that all the issues discussed in this manual are real possibilities for a veterinary health care worker. You may have very limited exposure to some of these challenges, but awareness of the hazards faced by other members of the team will only strengthen your understanding and the overall morale within your team.

The second step is to integrate the safety procedures you'll learn into the everyday habits of your job. As human beings, we operate from a set of "habits" for most of life's activities. We develop likes and dislikes on every level and safety is no different. Only you can improve the risk you face by incorporating the proper safety processes in your daily activities. Your safety should not be something you have to stop to think about...it should be automatic. The only way it becomes automatic is by practice.

Hazards that Affect All Staff Members

You should know where the Hospital Safety Manual is located and take time to become familiar with it. Memorize the "do's and don'ts" of the hospital and always follow the safety rules. No one can protect you from an injury or illness better than you can protect yourself!

One of the first rules of safety is to dress appropriately for the job at hand. In the veterinary profession ,that also includes footwear and jewelry. You can reduce the chances of getting injured from slips and falls by wearing shoes that cover your whole foot and have non-slip soles. Be especially cautious walking on uneven or wet floors. Never run inside the hospital or on uneven footing. Excessive jewelry and very loose-fitting clothing can present hazards if an animal struggles during restraint, so it's best to keep it to a minimum. This is definitely one of those times when less is more!

According to insurance statistics, back injuries account for one in every five workplace injuries to American workers. To minimize your chances of suffering one of these very painful injuries, remember the rules for lifting : keep your back straight and lift with your legs. Never bend over to lift an object. That rule applies to patients as well as inanimate objects such as boxes or supplies. If your practice doesn't have a motorized lift table, get help when lifting patients over 40 pounds. Remember to follow sound ergonomic principles when positioning or restraining patients, especially when working with horses or food animals.

Because veterinary workers perform such a variety of jobs in any given hour, it's pretty rare for us to acquire the types of ergonomic injuries common in other industries. However, it's important to note that the best defense against almost all ergonomic injuries is to change your posture and routine frequently.

Some injuries are caused by cluttered or dirty work areas. We also know that "clutter" contributes to the severity of accidents that otherwise would be minor. Cleanliness and organization are good business standards, especially in a healthcare facility. Always clean up spills as soon as they happen. You should always clean and return equipment to the proper storage place immediately after use. At least daily, remove all trash from your work area. Organize drawers, cabinets and counters so that items can be found easily and "clutter" is reduced.

Always store supplies and equipment properly. Store heavy supplies or equipment on the lower shelves to prevent unnecessary strains. Never use stairways or exit hallways as storage areas. Don't overload shelves or cabinets. Store liquids in containers with tight-fitting lids and always replace the lids when finished using the product. When possible, store chemicals on shelves that are at or below eye level. This will minimize the possibility of accidentally spilling the chemical on you when getting or replacing a container. Never climb into or on cabinets, shelves, chairs, buckets or similar items. Use an appropriate ladder or step to reach high locations.

The ingestion of pathogenic organisms or harmful chemicals is definitely present in most veterinary situations. That's why it's important that you only eat or drink in areas free of toxic and biologically harmful substances. This also applies to the preparation of foods and beverages: make sure your coffee pot and utensil area is well away from sources of possible contamination such as the lab or treatment/bathing tub. Check the cabinets above your drink or food to make sure it doesn't contain hazardous chemicals or supplies that could spill onto the area. Always store your food, drinks, condiments and snacks in a refrigerator free from biological or chemical hazards; vaccines, drugs and laboratory samples are all potential contamination sources and should not be in the same area as your food or drinks.

Never operate machinery or equipment without all the proper guards in place. Equipment like fans and cage dryers have moving parts that can severely hurt or even sever a finger. Long hair should be tied back or up to prevent it from getting caught in fans, or other moving parts. Avoid wearing excessively loose clothing or jewelry when working around machinery with moving parts.

If you must perform minor maintenance or user service of any electrical device, be sure to unplug it or disconnect the electrical power so that it can not be accidently energized until it is safe.

When using equipment like autoclaves, microwave ovens, cautery irons or other heating devices, be sure to understand the proper rules for safe operation. Burns, especially from steam, are painful and serious, and almost always can be prevented. Autoclaves also present a danger from the pressure that is used for proper sterilization. When opening the autoclave, first release the pressure with the "vent" device and keep your hands and face away from the steam. Let the steam rise completely before opening the door fully. Be careful when removing the packs because they are still hot. Always assume cautery devices and branding irons are hot and use the insulated handle whenever you handle them. Never place heated irons on any surface where they could overheat and start a fire, or where someone may accidentally touch them.

Electrical

Many procedures performed on a daily basis require the use of electricity. Although new equipment and buildings have many safety features built-in, you must be conscious of avoiding a situation which could cause a fire or physical harm to yourself, another person or a patient.

Do not remove light switch or electrical outlet covers. Always keep circuit breaker boxes closed and never block access by stacking supplies or equipment in front of them. Only persons trained to perform maintenance duties should repair electrical outlets, switches, fixtures or breakers.

If you must use a portable dryer or other electrical equipment in a wet area, make sure it is properly grounded and only plugged into a ground-fault circuit interruption (GFCI) type outlet.

Extension cords should only be used for temporary applications and should always be of the 3-conductor, grounded type. Never run extension cords through windows or doors which may close and damage the wires nor across aisles or floors where a tripping hazard may be created.

Surge suppressers should only be used to protect sensitive electronic equipment and should never be overloaded. Surge suppressers are not designed for things like heaters, autoclaves, coffee pots and may overheat to cause a fire.

Equipment with grounded plugs must never be used with adapters or non-grounded extension cords. Never alter or remove the ground terminals on plugs. Appliances or equipment with defective ground terminals or plugs should not be used until repaired.

Fire and Evacuation

The potential for dramatic loss of life (both human and animal) and the destruction of property make a hospital fire one of the most feared accidents imaginable. Fortunately, this danger can be significantly reduced by a few simple precautions.

Never use power adapters or surge suppressors as a substitute for permanent wiring. Overloaded or faulty electrical cords can overheat or short and start a fire, even when the equipment is turned off!

Always store flammable liquids properly; materials like gasoline, paint thinner and ether should never be stored inside the hospital except in an approved flammable storage cabinet. Some components of specialty dental and large animal acrylic repair kits are also very flammable. Very small amounts of these components are usually not a problem, but always ensure they are stored and used in an area with good ventilation and the containers have tight-fitting lids that are replaced immediately after use.

Flammable items, particularly newspapers, boxes, and cleaning chemicals must always be stored at least three feet away from an ignition source such as a water heater, furnace or stove. Always use extra care when using portable heaters. Never leave them unattended, and always make sure they are placed no closer than 3 feet from any wall, furniture or other flammable material.

Become familiar with the location of the emergency exits in your facility. Make sure the emergency exits are always unlocked and free from obstructions when you are in the building. If you must work in a building when security warrants the doors be locked, make sure you have at least two clear exits form the building.

Learn the emergency warning system in your hospital. If the facility is equipped with an electronic alarm system, be sure you know how to activate it manually. In the absence of an electronic alarm system, a verbal alarm is very effective. You can use the telephone intercom feature to alert everyone that there is a fire in the building or in small buildings, simply yelling in a loud clear voice will get the message out!

Know your duties in the event of a fire. Remember, your first responsibility is to notify others about the fire and then to get out of the building safely if an evacuation is ordered. Leave the rescue duties to the professionals that are trained and equipped to handle this very dangerous task. If you do evacuate the building, immediately report to the designated assembly area for accountability. This is very important since others will assume you are still in the building if you are not present at the assembly area.

Know where the fire extinguishers are located and how to use them. Most veterinary hospitals are equipped with dry chemical type fire extinguishers. But, before you decide to use a fire extinguisher make sure the alarm has been sounded, everyone has left the building (or is in the process of leaving) and the fire department has been called.

Don't Become a Victim of Violence

Just as in any occupation, you are at risk of injury from accidents not directly related to your job. Vehicle accidents, personal assault, robbery, and even natural disasters have resulted in veterinary staff members being injured while on duty. Although no one can prevent every possible scenario, preparation can certainly help and sometimes will minimize the injury. When outside of the hospital building, be aware of your environment and do your best to avoid placing yourself in a situation that could go bad.

Always keep the "non-client" doors locked from the outside to prevent anyone from gaining unauthorized or undetected entry into the building.

If you work in a critical care or 24-hour practice, you should utilize the "barriers" that are usually available. Things like buzzers to control access from the front door, and one-way locks on the remaining doors (to let you out in case of an emergency, but keep the door locked from the outside) are essential in these environments, so don't defeat them.

In any business that keeps money or stores valuable items , there is a potential for robbery. If you ever find yourself in a situation where someone demands money, drugs or other material items while threatening your personal safety - DO NOT WITHHOLD THE THINGS THEY DEMAND. As soon as safely possible, let everyone else know of the situation. You should attempt to contact the police if it can be safely done without the person's knowledge, otherwise do it immediately after the person has left.

Cooperate with their demands and give them what they want, but do not go with the person. Resist physical assault or battery to the best of your abilities and preferably outside the building so that passers-by can see what's happening and render assistance or call the police.

Hazardous Chemicals

You may not think about it, but many products that you use every day can be hazardous. Every chemical, even common ones like cleaning supplies have the potential to cause you harm. Some chemicals contribute to health problems while others may be flammable and pose a fire threat. The most common chemicals in use in the veterinary profession are:

• cleaning and disinfecting agents;

• insecticides and pesticides;

• drugs and medications;

• sterilization agents; and

• radiology processing fluids.

Planning and training are the keys to safely handling any chemical. Every business, including your practice must follow the requirements of OSHA's Right To Know Law. This law requires you to be informed of all chemicals you may be exposed to while doing your job. The Right to Know Law also requires you to wear all safety equipment that is prescribed by the manufacturer when using any product containing a hazardous chemical. The safety equipment must be provided to you at no cost to you, but it is not optional - you must wear what is prescribed!

A key component of the Right to Know Law is the hazardous materials plan. This plan will describe the details of the practice's MSDS filing system, the secondary container labeling system, and the person responsible for ensuring all employees have received the necessary safety training. You have a right to review any of these materials, so ask your supervisor where your plan is located.

When you receive a product from the distributor, every bottle will be identified with a label containing directions and the appropriate warnings. You should always read, understand and follow all the directions and warnings printed on the label. Whenever possible, you should keep this label intact and readable. Becasue it is sometimes necessary to dilute a product or just transfer it to smaller bottles for ease of use; these smaller bottles are known as secondary containers. Always make sure to label secondary containers with the contents and include any appropriate safety warnings on the label. Your hospital should have a specified format so that all secondary container labels are easily recognized; be sure you understand that system.

There is a lot of information on a product's label but that information is generally written for the average consumer who will have limited exposure using the product. When a product is used in a place like your veterinary practice, you may be exposed to that product more than the "average consumer" so your risk may be greater. The manufacturer of a product that contains a hazardous chemical will prepare a Material Safety Data Sheet (MSDS) for that product. The MSDS will give you additional precautions, instructions and advice for handling that product in the workplace. Your practice is required to keep an MSDS library for the chemicals that you use. Ask your supervisor where your hospital's MSDS library is located. Take the time to review the MSDSs for the products you use frequently

Always remember to replace the cap back on the bottle when using any chemical product. Working bottles of hazardous products should always have tight fitting, screw-on lids. You should endeavor to store chemical bottles in a closed cabinet; this will help prevent animals from injury if they escape. Ideally, the cabinet or shelf should be at or below eye level. This will minimize the chances of spilling the product in your face if the cap is not secure. Never store or use hazardous products near food, beverages or food preparation areas.

Be very cautious when mixing or diluting any chemical product. Try to keep the material from splashing on your hands, clothes or face. If it is likely that the product will splash on you, wear a pair of protective latex or nitrile gloves and some protective goggles or glasses. When making solutions from a concentrate, you should always start with the correct quantity of water then add the concentrate. Never add the water to the concentrate because the chemical may splash or react differently.

When two chemicals are mixed together the result is seldom a simple mixture. It is often a new, sometimes very different and very dangerous chemical. Never mix any chemicals unless directed to do so on the label or MSDS.

Minor spills of most chemicals can be cleaned up with paper towels or absorbent (like kitty litter) and disposed of in the trash; however, some very dangerous chemicals, like formaldehyde or ethylene oxide require special procedures. BEFORE you use a new chemical, review the MSDS and learn the procedures you must follow for cleaning up a spill.

Familiarize yourself with the locations of the eye wash stations in your practice. Test them regularly and know how to use them before you're in the position to need them!

Animal and Medical Hazards

We can't forget that the overriding purpose of a veterinary practice is the care and treatment of animals. But sometimes handling our patients can be a hazard in itself! Anyone who has worked with animals under stress or pain will relate personal accounts of injuries from patients. In fact, insurance statistics reveal that animal connected accidents are the most common injury of workers in veterinary related fields. Unfortunately, this hazard can't be eliminated so we have to do the next best thing– control it. Your best controls for this hazard are your training, knowledge and use of "restraint."

The very first safety rule when working around animals is to stay alert! Animals sometimes react to situations unexpectedly. Sudden noises, movements or even light can be the stimulus that would cause an animal to react, so if you are the person responsible for restraining the animal, keep your attention focused on the animal's reactions and not on the procedure. You must learn the proper restraint positions for each of the species of animals with which you work.

Remember that capture/restraint equipment is available if the animal is fractious or not cooperating; sometimes, just a piece of rope to hobble a leg or a piece of gauze for a hasty muzzle will make all the difference. And don't forget that chemical restraint is often better for both you and the animal instead of physical confrontation, but be sure to ask the veterinarian for approval before administering any medication to a patient.

Large animals like horses and cattle can severely injure or even kill you just by trying to escape the restraint. Never put your hand, leg or any other part of your body between the animal and the side of the enclosure or chute; use a hook or pole to pass ropes or belts through the chute. If you have to enter a stall, paddock or trailer with a large animal, stay on the side of the animal nearest the door, so that you can escape if the situation becomes hazardous. If you must capture a fractious animal from a cage or pen, make sure there is another person present that could assist you if you get in trouble.

If your job entails handling exotic or non-domestic animals, remember that they all have their own unique methods of defense. You should know and understand their possible reactions before you attempt to restrain or treat them.

Noise is Noise

Dogs in a cage will inevitably bark, and barking dogs can be a health concern, especially in indoor kennels. Noise levels in dog wards can reach 110 decibels! Although relatively short duration exposure to these noise levels, like going into the kennel just to retrieve a patient, poses no serious damage to your hearing, chronic, or long-term exposure can contribute to hearing loss. When working in noisy areas for extended periods of time (e.g., cleaning of cages), you must wear personal hearing protectors. It doesn't matter what style or type of hearing protectors you use (ear plugs or muffs), as long as they are rated to filter the noise by at least 20 dB (the package will indicate the rating).

Zoonotic Diseases

Diseases that are common to both humans and animals are known as zoonotic diseases. Some diseases are difficult if not impossible to transmit from animals to humans while others are very easily spread. You can be exposed to the organisms that cause disease by several means: inhalation, contact with broken skin, oral, contact with your eyes and even through accidental inoculation by a needle.

Because you will probably contact some of these diseases in your job, particular attention to personal hygiene and sanitary work practices is essential. Good personal hygiene includes making sure your clothes don't become soiled by chemicals or biological material, and of course, regular hand washing. In general, you should wash your hands:

• after handling medications or lab samples,

• treating patients or cleaning cages,

• before as well as after you use the restroom, and

• before lunch or meal breaks and before you leave work at the end of your shift.

When treating patients with potentially infectious diseases (infectious to people or other animals) wear a protective apron, surgical mask, exam gloves, and if appropriate, eye protection. Thoroughly wash your hands with a disinfecting agent like chlorhexidine or povidone-iodine scrub at the completion of the treatment. Change your clothes if they have become contaminated.

In human medicine, the transfer of HIV (or the AIDS virus) and hepatitis-B between the patients and the workers is a real threat. Since all the current research indicates that our patients do not contract these two serious diseases, the risk of exposure to animal blood or other body fluids is less of a concern. Although the term "bloodborne pathogen" is usually reserved for human infectious agents, the principles of good clinical hygiene must still be followed. The best way to minimize this hazard is to take simple precautions like wearing protective equipment when indicated and practicing good personal hygiene.

A Dirty Mouth? Precautions for Dentistry Operations

Procedures like high speed or ultrasonic dental scaling will often aerosolize the pathogens, so personal protection is necessary. One of the most common pathogens in the mouths of animals is Pasteurella multocida and that organism has been linked to cardiac and pulmonary problems in humans and animals alike. Whenever you perform dental procedures, be sure to wear goggles, gloves and a surgical mask.

Radiology

The ability to "see inside the body" is a great tool in medicine. In most cases, the method of choice is diagnostic radiography (x-rays.) Short duration, infrequent exposure to radiation, such as having radiographs taken of yourself, is accepted as an insignificant variable in your overall health. However, long term exposure to low doses of radiation has been linked to genetic, cutaneous, glandular, and other disorders. High dose exposure can cause skin changes, cell damage, and gastrointestinal and bone marrow disorders that can be fatal. Fortunately, much is known about the properties of x-rays, and ways to protect ourselves. By following some very simple safety precautions, you can utilize radiography in your practice with complete confidence.

Although modern radiographic machines have many safeguards integrated in the design, there is still the possibility of injury if these tools are used incorrectly. When you are involved in the use of radiographic equipment, always wear the appropriate protective equipment - lead aprons and gloves are essential and required. Thyroid collars and lead glasses are recommended if they are available in your practice. And of course, NEVER place any part of your body in the primary beam (even gloved hands).

Before you use an x-ray machine, make sure you know the function of every individual knob or button. Always use the collimator to restrict the primary beam to a size smaller than the size of the cassette - in other words, "cone down" to the area to be radiographed so that scatter radiation is minimized. A properly collimated radiograph will have a small clear border around the entire film once developed.

Portable machines, like those used in large animal and mobile practices, can be particularly dangerous because of their multi-purpose abilities. These machines can be "aimed" in any direction, and because of their limited power they must utilize longer exposure times to produce diagnostic images. When using a portable machine, always make sure no one is in the path of the primary beam (even at a distance). Always utilize a cassette holding pole and NEVER hold a cassette with your hands while the exposure is made – even with gloves. And of course, remember to wear a lead apron and gloves when near the machine during exposure.

If you are involved in the exposure portion of radiography, you must have and utilize an individual dosimetry badge. This badge is worn on your collar outside your protective apron during radiographic procedures, not as protection, but as a measurement of any "incidental" radiation you may receive during the procedure. It's important to return the badge to the designated storage location (outside the x-ray area) when not in use. Unless you are taking radiographs, don't wear your badge outside because exposure to sunlight will result in false readings. Due to the relatively low numbers of radiographs taken in most practices, safer machines, and the use of good protective equipment, most workers receive very little, if any, occupational exposure to radiation.

Radiographic processing chemicals (the developer and fixer) can be very corrosive to materials and organic tissues, so use protective gloves and goggles when mixing or pouring the chemicals. For manual processing tanks, before use, stir the chemicals with care but avoid splashing them. After handling radiographic developing chemicals, always wash your hands. It's also important to avoid breathing the fumes of the processing chemicals, so make sure there is adequate ventilation in the dark room; generally an exhaust fan is necessary, so make sure it is used.

These chemicals can also react dangerously with other chemicals, so NEVER pour other chemicals into a sink or drain where developing chemicals are used. Some liquid drain openers, when mixed with developer and fixer, can produce toxic gases and others will produce an ectothermic (extremely high temperature) reaction that could damage pipes.

Anesthesia

Anesthesia is as common to veterinary medicine as antiseptic wound care. The National Institute of Occupational Safety & Health (NIOSH) estimates that over 250,000 U.S. workers are at risk from exposure to waste gasses which are not metabolized by the patient. Long term exposure to waste anesthetic gases (WAGs) has been linked to congenital abnormalities in children, spontaneous abortions, and even liver and kidney damage.

Although recent discoveries in the types of gasses used in veterinary medicine have produced safer agents for the patients and the workers, there is no chemical that is without risk, so we must still take precautions to protect ourselves even when using agents like isoflurane and sevoflurane. Therefore, OSHA has adopted a safe exposure limit for ALL halogenated anesthetic agents at 2 parts per million (ppm).

Using a proper scavenging system is the single most effective means of reducing your exposure to WAGs. There are three general methods of WAG removal for the veterinary practic: active scavenging, passive exhaust and absorption. Each has a place, but rarely does one method fit all circumstances. Regardless of the system your practice uses, make sure it is connected to the machine before use. If you use the absorption canisters, be sure to check them regularly (by weighing with a gram scale) because once they become saturated with gas, they are ineffective!

According to some research, as much as 90% of the anesthetic gas levels found in the room during a procedure can be attributed to leaks in the anesthesia machine, so always perform a leak check of the machine prior to use. Also make sure you use the correct size hoses and rebreathing bags for the patient. When intubated, inflate the tubes cuff before connecting the patient to the machine. Only should start the flow of anesthetic after connecting the patient to the machine. When the procedure is complete, stop the flow of anesthetic agent and use pure oxygen to "flush" the circuit through the scavenging system before disconnecting the patient.

When refilling the anesthetic machine vaporizer, move the machine to a well ventilated area. Use a pouring funnel and be careful to avoid overfilling the vaporizer or spilling the anesthetic. If you accidentally break a bottle of anesthetic, immediately evacuate all non-essential people from the area. Any windows in the building should be opened and all exhaust fans turned on. Quickly control the liquid with a generous amount of kitty litter and place a plastic bag over the spill to reduce evaporation. Pick up the absorbed liquid and kitty litter with a dust pan and place it inside a plastic garbage bag. Seal the bag tightly and dispose of it in an outside trash can. Leave the exhaust fans on and the windows open until you are sure the gas level has been reduced to a safe level.

Some procedures, like masking or tank induction, make collection of waste gasses more difficult, but not impossible. Be sure to use an appropriate flow rate and proper reservoir bag for the size of patient - DO NOT turn up the oxygen flow meter to maximum when masking a patient. Induction chambers should always be connected to the scavenging system or absorption canisters to reduce the levels of escaping gasses. Make sure the ventilation in the room is good and use local exhaust fans when available.

Since patients don't metabolize all the anesthetic gas they inhale during the procedure, some of the gas is released into the room air during respiration even after recovery. When monitoring patients during recovery, you should avoid close contact with their face and keep the number of recovering patients to an acceptable number for the size of the area and ventilation system. When practical, allow the patient to partially recover while still connected to the anesthetic machine (oxygen only) and scavenging system.

When changing the soda lime (carbon dioxide absorbent) in anesthetic machines, wear rubber or latex gloves. When the soda lime is wet, as is often the case from humidity in the system, it can be very caustic to tissues and some metals. Dispose of the used soda lime granules in a plastic trash bag as regular trash.

Sharps and Medical Waste

The most likely hazard from needles or sharp objects in a veterinary medical environment is from the physical trauma (and possible bacterial infection) that is caused by a puncture or laceration. To prevent these types of accidents, always keep sharps, needles, scalpel blades and other sharp instruments capped or sheathed until ready for use. Do not attempt to recap the needle after use unless the physical danger from sticks or lacerations cannot be avoided by any other means. When it is necessary to recap a needle, you should use the "one-handed" method . Although it takes a little practice to become "second nature," the one-handed method of recapping needles is the safest and most practical one for most veterinary situations.

Do not remove the needle from the syringe for disposal because this "unnecessary handling" often results in injuries. Whenever possible, the entire needle/syringe unit should be disposed of in the designated sharps containers immediately after use. Don't ry to over-fill a sharps container....when it's full, it's full! When the sharps container is full, seal and handle it according to your hospital's prescribed policy and replace it with a fresh one. Never open a sharps container that has already been sealed nor stick your fingers into one for any reason.

Destroying the needle prior to disposal is not recommended because it may aerosolize the contents of the needle and increase your exposure. Likewise, you should not collect sharps in a smaller container and transfer them to a larger container for disposal. Of course, never throw needles or sharps directly into regular trash containers, regardless of whether or not they are capped.

Pushing Drugs - The Pharmacy Operation

Medicines are designed to cure diseases and make patients better, but it's important to remember that all medicines are chemicals and chemicals can be dangerous. In the veterinary pharmacy, you can be exposed to all kinds of drugs just by handling them. Liquids can splash in your eyes when you pour them or they can release vapors that you can inhale. Handling, crushing or breaking tablets can leave powder residue on your hands that will be ingested next time you put your hands near your mouth or mucous membranes.

Some chemicals like the cytotoxic drugs (CD's) used to treat patients with cancer are so "potent" even minute exposures can cause harm. When preparing CD's, always wear powder-free chemotherapy gloves and a disposable gown that is not used for any other purpose. If the drugs are not mixed inside of a biological safety cabinet, then you may need to wear a respirator too; just be sure to follow the instructions on the MSDS, package insert and your practice's Chemotherapy Safety Plan.

During administration of CDs, it's not unreasonable to expect the unexpected, so it's very important to keep unnecessary people from the area and to wear protective equipment such as gloves, disposable aprons, surgical masks and eye glasses. You should avoid wearing contact lenses when preparing or administering CDs.

When handling or cleaning up after patients that have received chemotherapeutic treatments, remember that some drugs are excreted in bodily fluids so proper precautions are necessary. Always wear powder-free chemotherapy gloves and avoid contaminating your clothes when cleaning cages or picking up waste from chemotherapy patients. Make sure you dispose of all soiled materials from these patients as medical waste and launder non-disposable items separately from general laundry.

No matter what the drug, The biggest rule to remember when handling ANY medication is to practice good personal hygiene, especially a thorough hand washing!

Summary

We all face dangers in life every day but that doesn't mean we have to intentionally place ourselves in danger to get our job done. The successful person makes sure the reward for the action far outweighs the risk.

In this session, we've discussed your rights and responsibilities in a safety program, the hazards associated with your job from both a general and medical perspective and the actions you should take to protect yourself. But let's keep things in perspective: safety is not a special program or the cause of additional work. It's doing the job properly the first time and following the rules. Safety is not a reason to keep you from doing your job....it should be the reason you can continue to practice your career for a long time! Have fun, but be safe!