Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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10. ADMINISTRATION OF DRUGS Establish a management protocol regarding extravasation of hazardous drugs. RECOMMENDATIONS 10.3.5.1 Workers must wear a protective gown and one (1) pair of gloves (see 4.1.7.7) when managing an extravasation of hazardous drugs. 10.3.5.2 Face protection (see 4.1.7.10) must be worn when there is a risk of splashing; limit the risk of facial exposure by working at a level lower than the face. 10.3.5.3 A disposable, absorbent, plastic-backed pad for the containers should be placed on the work table or under the patient’s arm when managing an extravasation of hazardous drugs. This pad will also absorb any contamination. 10.3.6 Intravenous Administration – direct injection (push) RATING: +++ Use an administration technique that limits exposure risks. RECOMMENDATIONS NOTE The recommendations applicable to the General Administration Measures Section (i.e., Section 10.3.4) should be complied with. 10.3.6.1 When applicable, workers administering the drugs should place a disposable, absorbent, plastic-backed pad on the work table or under the patient’s arm for the preparation containers (i.e., bag, syringe), when applicable, and particularly during administration via the peripheral route; this pad will also absorb any contamination. Avoiding pushing on the plunger, remove the protective cap from the syringe over the absorbent pad. 10.3.6.2 Insert the needleless device or the needle without removing the air. 10.3.6.3 Workers administering the drugs should use handling and administration techniques that minimize exposure risks: ‣ wrap the injection site with a sterile 10 x 10 cm gauze pad and inject the drug; ‣ withdraw a syringe from the primary tubing by wrapping the injection site with a sterile 10 x 10 cm gauze pad and gently withdrawing the tip; next, discard everything in a cytotoxic waste receptacle; ‣ if a needle is used, never remove it from the syringe; discard the syringe and the needle in a cytotoxic waste sharps container. ASHP, p. 1189 ♦ CS, p. 68 ♦ CSHP, Section 8.8 ♦ NIOSH, p. 14 ♦ ONS, p. 24 ♦ OSHA, Section Vc2 10.3.7 Intravenous Administration (infusion) RATING: +++ Use an administration technique that limits exposure risks. RECOMMENDATIONS NOTE The recommendations applicable to the General Administration Measures Section (i.e., Section 10.3.4), as well as the suggestions regarding the priming and air removal techniques (i.e., Section 10.3.3), should be complied with. 10-8 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
10. ADMINISTRATION OF DRUGS 10.3.7.1 Workers administering the drugs should use handling and administration techniques that minimize exposure risks: ‣ once drug administration is complete, rinse the primary tubing with the primary solution; ‣ never remove the tubing, needle or tip from the hazardous drug bag; discard everything in a cytotoxic waste receptacle. If a needle is used, discard it in a cytotoxic waste sharps container; ‣ use separate tubing for each bag of hazardous drug; ‣ it is preferable to leave the secondary tubing attached to a hazardous drug bag and to discard the primary tubing and all of the secondary tubing when the treatment has been completed; ‣ if this is not possible, rinse the secondary tubing connection site before disconnecting it from the primary tubing: using the retrograde technique, fill the secondary tubing containing the hazardous drug with the fluid from the primary tubing, in order to dilute the residual amount of hazardous drug (Figure 20); or Primary solution Drug bag Secondary tubing Primary tubing Toward the patient Area to be rinsed Disconnection site FIGURE 20 Rinsing the tubing using the retrograde technique PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 10-9
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Prevention Guide Safe Handling of H
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Prevention Guide Safe Handling of H
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This guide has been developed by th
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Table of Contents PREAMBLE ........
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List of Tables Table 1 Medication C
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PREAMBLE In September 2004, the Uni
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1. INTRODUCTION 1.1.1 Survey Regard
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1. INTRODUCTION 1.3 Guide Structure
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2. RISKS RELATED TO THE USE OF HAZA
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Pharmacy Care Wastes Support Receiv
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3. PREVENTION OBJECTIVES AND ACTION
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Page 39 and 40: 4. GENERAL PREVENTIVE MEASURES 4.1.
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Page 45 and 46: 4. GENERAL PREVENTIVE MEASURES Tabl
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Page 50 and 51: 5. RECEIVING AND TRANSPORT 5.3.2 De
Page 53 and 54: 6. UNPACKING AND STORAGE 6 UNPACKIN
Page 55 and 56: 6. UNPACKING AND STORAGE 6.3.3 Unpa
Page 57: 6. UNPACKING AND STORAGE 6.3.6 Spil
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Page 70 and 71: 8. DRUG PREPARATION The product nev
Page 72 and 73: 8. DRUG PREPARATION ‣ avoid sudde
Page 74 and 75: 8. DRUG PREPARATION or “Caution
Page 76 and 77: 8. DRUG PREPARATION 8.3.9 Preparing
Page 78 and 79: 8. DRUG PREPARATION Wearing both
Page 80 and 81: 9. TRANSPORT AND STORAGE FOLLOWING
Page 82 and 83: 10. ADMINISTRATION OF DRUGS Adminis
Page 84 and 85: 10. ADMINISTRATION OF DRUGS Nurses
Page 86 and 87: 10. ADMINISTRATION OF DRUGS Primary
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Page 92 and 93: 10. ADMINISTRATION OF DRUGS 10.3.10
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Page 96 and 97: 10. ADMINISTRATION OF DRUGS contain
Page 99 and 100: 11. PATIENT CARE 11 PATIENT CARE 11
Page 101 and 102: 11. PATIENT CARE arrive (see 13.3.1
Page 103: 11. PATIENT CARE Table 8. Hazardous
Page 106 and 107: 12. MANAGEMENT OF WASTE, ACCIDENTAL
Page 112 and 113: 13. HYGIENE AND SANITATION 13.2 Exp
Page 115: 14. LAUNDRY 14 LAUNDRY 14.1 Issues
Page 118 and 119: 15. MEDICAL, BIOLOGICAL AND ENVIRON
Page 120 and 121: 15. MEDICAL, BIOLOGICAL AND ENVIRON
Page 123 and 124: 16. REFERENCES 16 REFERENCES AHQ [1
Page 125: 16. REFERENCES Nygren O., Lundgren
Page 129 and 130: APPENDIX 1 - GLOSSARY APPENDIX 1- G
Page 131 and 132: APPENDIX 1 - GLOSSARY TERMS DEFINIT
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Page 136 and 137: APPENDIX 2 - LIST OF HAZARDOUS DRUG
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APPENDIX 2 - LIST OF HAZARDOUS DRUG
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APPENDIX 2 - LIST OF HAZARDOUS DRUG
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APPENDIX 3 - SURVEY REGARDING PRACT
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APPENDIX 4 - HAZARDOUS SPILL MANAGE
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APPENDIX 4 - HAZARDOUS SPILL MANAGE
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5. MEASUREMENT OF WORK SURFACE CONT
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