Intro to Lab Safety & Management

• Infection


  When a microorganism invades the body, multiplies, and causes illness/diseases, spreading bacterial, fungal or viral
• Pathogen


  A disease-causing microbe which could be classified as bacteria, fungi, protozoa, or virus
• Types of infection


  • Communicable infection (can spread from person-to-person)
  • Nosocomial infection (HAIs - usually caused by infected personnel, patients, visitors, drugs, or equipment while a patient is in the hospital or other healthcare facilities)
• Components of chain of infection

  • Infectious (causative agent)
  • Reservoir (source of the agent of infection or place where the microbe could grow, survive, and multiply)
  • Exit pathway (way wherein an infectious agent can leave the reservoir host)
  • Means of transmission (airborne, direct contact, indirect contact, droplets, vector, vehicle)
  • Entry pathway (way an infectious agent enters a host)
  • Susceptible host (someone prone to infection)
• Proper hand hygiene


  1. Routine hand washing (uses plain soap and water)

  2. Hand antisepsis (uses antimicrobial soap or alcohol-based hand sanitizer)
• Personal Protective Equipment (PPE)


  Includes gloves, gowns, lab coats, masks, face shields, goggles, and respirators
• Proper removal of gloves

  1. Grasp wrist part of one glove with opposite hand

  2. Pull glove inside and out and off hand

  3. Place recently removed glove in gloved hand

  4. Slip fingers of non-gloved hand under wrist of remaining glove

  5. Pull second glove inside out

  6. Drop gloves in proper receptacle
• Donning of PPE


  1. Put on gown first and fasten it

  2. Mask should cover nose and mouth

  3. Pull gloves over gown cuff
• Doffing of PPE


  1. Remove gloves first

  2. Pull gown from shoulders towards hand so it turns inside out

  3. Remove mask by only touching the string
• Infection control technique in nursery and neonatal ICU

  • Proper hand washing before putting on PPE
  • Phlebotomist should only bring necessary items
  • Blood collection tray left outside nursery
  • Remove gloves, wash hands, use new gloves between patients
• Bloodborne pathogens (BBP)


  Microorganisms in human blood that are infectious and can cause diseases like hepatitis B, hepatitis C, and HIV
• Exposure control plan for BBP exposure

  1. Caused by needlestick or sharp objects: Carefully remove sharp, wash site thoroughly with soap and water

  2. Exposure through mucous membrane: Flush with water or saline for at least 10 minutes, remove contact lenses, report incident to supervisor
• Biohazard


  Any material that could be harmful to one's health
• Biohazard exposure routes


  • Airborne (from splashes and aerosols during centrifuge and aliquot, patients with airborne diseases)
• Preventive measures for airborne biohazards

  • Observe proper handling practices
  • Wear PPE properly
  • Use safety shields
• Cleaning spills


  1. Wear gloves

  2. Use absorbent material

  3. Avoid spreading spills over wider area
• Non-reusable items contaminated by blood or other body fluids should be placed in biohazard waste containers for proper disposal
• Biosafety


  Preventing and protecting clinical laboratories from harmful incidents caused by laboratory specimens that are potential biohazards
• Biohazard exposure routes


  • Airborne
  • Ingestion
  • Non-intact skin
  • Percutaneous
  • Permucosal
• Electric shock response


  1. Remove the source of electricity

  2. Ask for medical assistance

  3. Start cardiopulmonary resuscitation (CPR) if necessary

  4. Keep the victim warm
• Regular fire drills should be conducted so employees know what to do in case of fire
• Employees should be familiar with the location of emergency exits and evacuation plans or routes
• The location of fire extinguishers and heavy blankets should be posted, and the staff should know how to use them

  
• Radiation safety factors


  • Time
  • Distance
  • Protection or shielding
• A radiation symbol must be posted in areas where radioactive materials are used and kept
• Radiation hazard can be encountered by the phlebotomist when collecting specimens from patients who have been injected with radioactive dyes or from the nuclear medicine department or simply when delivering specimens to the radioimmunoassay sections of the laboratory
• Chemicals are used as cleaning reagents, in adding preservatives in urine containers (24-hour), or in delivering specimens to the laboratory
• Chemical handling


  1. Always wear PPE when working with chemicals

  2. Properly use chemical clean-up materials in case of chemical spills
• Practices that should never be done

  • Storing chemicals above eye level
  • Adding water to acid
  • Mixing chemicals indiscriminately
  • Storing chemicals in unlabeled containers
  • Pouring chemicals into used or dirty containers
  • Using chemicals in ways other than their intended uses
• The healthcare worker should be informed where the safety showers and eyewash stations are located, in the event of chemical spill or splash in the eyes or body
• Response to chemical spill or splash

  1. Flush the affected part with water for at least 15 minutes

  2. Visit the emergency room (ER) for evaluation
• Shock


  A condition when there is not enough blood that circulates back to the heart, which results in inadequate supply of oxygen in the body
• Symptoms of shock


  • Pale, cold and clammy skin
  • Rapid and weak pulse
  • Increased and shallow breathing
  • Expressionless face with a blank stare
• Biosafety levels


  • BSL-1: Appropriate for agents that are not known to cause disease in normal healthy people
  • BSL-2: Moderate-risk agents that cause human disease (ingestion, percutaneous, mucous membrane exposure)
• Fire classes


  • Class A: Ordinary combustible materials
  • Class B: Flammable liquids and vapors
  • Class C: Live electrical equipment
  • Class D: Combustible and reactive metals
  • Class K: Cooking oil, grease, or fats with high temperature

  
• Toxicology


  The study of the nature and action of poisons
• Examples of threshold limit values and permissible exposure limits

  • Pesticides
  • Carbon disulfide
  • Phenol
  • Tetrachloride
  • Mercury
  • Saline
• Common irritants through contact

  • Ammonia
  • Alkaline dust & mist
  • HCL
  • HF
  • Halogens
  • Ozone
  • Phosgene
  • Nitrogen Dioxide
  • Phosphorus Fluoride
  • Arsenic Trichloride
• Common irritants through respiration

  • Sulfur dioxide
  • Acetic acid
  • Formaldehyde
  • Formic acid
  • Sulfuric acid
  • Halogens
• Never add water to acid, always add H2O to acid slowly