Lab Fundamentals PDF

Labware Glassware Has many functions and come in many shapes and sizes It can be used in a specific test procedure or for preparing and storing reagents. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 Labware co...

Labware Glassware Has many functions and come in many shapes and sizes It can be used in a specific test procedure or for preparing and storing reagents. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 Labware cont. Recently, it has become common to use plastic containers as well as glass. Which is why the term “labware” was created, as it encompasses both plastic and glass. Most of today’s labware has been designed to be used only once and then discarded. This eliminates the possibility of using a container contaminated with residue from previous use 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 Labware cont. Types of general labware include: Bottles Beakers Flasks Test tubes Graduated cylinders Pipets 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Glassware Laboratory glassware can be made from many different types of glass. Flint glass: inexpensive, but low resistance to heat and chemicals. Disposable test tube are often made of flint glass. Borosilicate glass: non-reactive with most chemicals, and is resistant to both heat and cold shock. Can be heat sterilized. Commonly known as Pyrex or Kimax. Quartz glass: aka silica glass. Expensive. Used when glass must have excellent light transmission without distortion. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5 Plasticware Plastic containers are useful because they are lightweight and impact and corrosion-resistant. Three common plastics used to make labware are: Polyethylene & Polystyrene: both clear and inexpensive, but not heat resistant. Polypropylene: Usually milky or opaque appearance, heat resistant. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 6 Types and Functions of Labware Labware such as bottles beakers, test tubes, and certain flasks, are used to make noncritical measurements. Noncritical measurements are: measurements that are estimates or approximate. Noncritical glassware can be divided into two groups: Approximate glassware: which includes beakers and certain flasks. Measuring glassware: which includes graduated cylinders and serological pipettes. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 7 Types and Functions of Labware cont. Other labware is designed to strict standards to allow critical measurements. Critical measurements require precision and accuracy. This glassware is called Class A, or precise glassware. It’s calibrated and manufactured to the standards prescribed by the National Institute for Standards and Technology (NIST), and comes with a certificate of calibration. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 8 Types and Functions of Labware cont. Class A glassware includes: Volumetric flasks and volumetric pipettes. These flasks and pipettes are marked with capacity tolerance limits (error limits). ❖ Class A glassware is used for reconstituting controls and standards and preparing solutions. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 9 Bottles Reagent bottles are available in a variety of sizes and types. Plastic bottles should be used for all reagents that do not interact with plastic The reagent bottle should only be slightly larger than the volume of reagent. Brown plastic or glass bottles are used for storing light- sensitive reagents. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 10 Test Tubes Test tubes: Come in various shapes and sizes Can be plastic or glass Used in many different lab procedures Can be used as containers for blood, urine, plasma, and serum 10 January 2025 Confidential. All Rights Reserved. Cambria College. 11 Beakers Beakers are: Wide mouthed, straight-sided containers with a pouring spout formed from the rim. Used for estimating volumes of liquids, mixing solutions or holding liquids. Are labeled to indicate the approximate capacity of the markings. For example: A 250ml beaker marked +/- 5% indicates that when the beaker is filled to the 250ml mark, the actual volume would be between 237ml (-5%) and 263ml (+5%). 10 January 2025 Confidential. All Rights Reserved. Cambria College. 12 Graduated Cylinder Upright, straight-sided, with a flared base and a volume scale. More accurate than beakers and flasks Not commonly used for precise measurements Capacities range up from 5ml 10 January 2025 Confidential. All Rights Reserved. Cambria College. 13 Flasks Flasks are containers with an enlarged body and a narrow neck. Two common types of flasks are: Erlenmeyer and Volumetric 10 January 2025 Confidential. All Rights Reserved. Cambria College. 14 Erlenmeyer Flasks: Have flat bottom, and sloping sides that gradually narrow, with a bottle-like opening on top Opening can be plain to be stoppered with a cork or threaded for a screw on cap Range from 10 ml to 4000 ml in capacity Used to hold liquids, mix solutions, or measure non- critical values Ones that have increment markings are called graduated flasks. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 15 Volumetric Flask Pear-shaped flask used for making critical measurements. Range between 5 ml - 1000 ml capacity Manufactured to strict standards Guaranteed to contain a certain volume at a particular temperature. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 16  Centrifuges are instruments that spin samples at high speed, forcing the heavier particles to the bottom of the container ( usually a tube ). Centrifuges are most often used to separate serum from plasma. Sometimes urine is centrifuged to obtain urine sediment. Centrifuges Centrifuges vary in size, capacity and speed capability. The part of the centrifuge that holds the tubes and rotates during operation is called the rotor. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 17 Types of Centrifuges Fixed angle centrifuge – Slant (1200-1500) Horizontal centrifuge – Flat (up to 3000) Ultra centrifuge – High speed (10,000 – 100,000) Temperature centrifuge (37oC or 4OC) 10 January 2025 Confidential. All Rights Reserved. Cambria College. 18  Ensure that the centrifuge tubes are properly balanced Use according to manufacturer's recommendations Ensure that the safety lid is properly sealed and positively locked into place Proper Ensure that the rotor has completely stopped spinning before opening the Use of the lid Never attempt to stop a moving rotor with your hand or with a tool or object Centrifuge All personnel should follow standard precautions when performing centrifugation and other functions that may expose workers to splashed blood or body fluids. Using precautions, which may include wearing gloves, facial protection (face shields), gowns or lab coats and plastic aprons. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 19 Maintenance Procedure for Centrifuges Preventative maintenance will include ensuring that the rotor shaft is tight Clean and disinfect all centrifuges regularly according to the manufacturer’s recommendations. (ie: 2% Gluteraldehyde). Contact the manufacturer for guidance if the manual does not specify cleaning agents as some disinfectants (ie: 10% sodium hypochlorite) may damage the rotor and other centrifuge components. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 20 Balancing a Centrifuge Microscope A microscope is an instrument that can be used to observe small objects (cell or microorganisms). The image of an object is magnified through at least one lens in the microscope. This lens bends light towards the eye and makes an object appear larger than it actually is 10 January 2025 Confidential. All Rights Reserved. Cambria College. 22 Types of Microscopes Polarized Light Microscope If polarizing filters are incorporated into the light path of a compound light microscope, one before the specimen and one after the specimen they can be used to aid in the identification of specific tissue components. Numerous tissue elements, minerals and fibers are birefringent. Any object, which is birefringent, may be seen quite easily by the use of polarized light microscope Phase Contrast Microscope Used to produce high- contrast images of transparent specimens, such as living cell fiber, glass fragments By using an annulus and phase plate you are enhancing the change in wavelength when light passes through different mediums. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 23 Types of Microscopes cont. Fluorescent Microscope Using fluorochrome-containing dyes to specimens and high intensity light source (ex: tungsten- halogen or mercury lamps) in microscope. The wavelength of light emitted will excite the fluorochrome and cause it to appear brilliantly lit on an almost black background Darkfield Microscope One of the oldest techniques. By blocking the central area of the condenser lens, a hollow cone of light is formed. This is directed at an angle, which will just miss the lower lens of the objective. The formation of the image is dependent on the rays being diffracted from their original path. The diffracted rays produce an image, which appears brilliantly white on a black background 10 January 2025 Confidential. All Rights Reserved. Cambria College. 24 Types of Microscopes cont. Inverted Microscope Designed to examine something from their under surface rather than from their upper surface. Electron Microscope The lenses used in the electron microscope are magnetic coils. These magnetic coils are capable of focusing the electron beam on the sample such that the sample get illuminated. As the flow of current increases, the strength of the magnetic lens increases. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 25 Parts of a Light Microscope Guide to Pipetting The main function of lab pipettes is to extract, transport and dispense liquid samples. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 27 Guide to Pipetting cont. Air Displacement Pipette Air Displacement Pipette, used for standard pipetting applications, is highly accurate. How does an Air Displacement Pipette work? The piston moves to the appropriate position when the volume is set. When the operating button is pressed to the first stop, the piston expels the same volume of air as indicated on the volume setting. After immersing the tip into the liquid, the operating button is released. This creates a partial vacuum and the specified volume of liquid is aspirated into the tip. When the operating button is pressed to the first stop again, the air dispenses the liquid. To empty the tip completely the operating button is pressed to the second stop (blow out). 10 January 2025 Confidential. All Rights Reserved. Cambria College. 28  Air Displacement Pipette Positive Displacement Pipette Positive Displacement Pipette, is used for applications like PCR and other DNA amplification techniques. The micro-syringe tips used in positive displacement pipettes are disposable. This helps to avoid sample-to-sample cross- contamination (also known as sample carry-over), and contamination due to the aerosol effect. How does a positive displacement pipette work? The piston moves to the appropriate position when the volume is set. When the operating button is pressed to the stop, the piston descends to the tip opening. After the tip is immersed into the liquid, the operating button is released. The plunger is then raised and a partial vacuum is created. This causes the liquid to enter the tip. When the operating button is pressed again, the piston descends, expelling the liquid from the tip. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 30  Positive Displacement Pipette Cleaning Glassware It’s generally easier to clean glassware if you do it right away. When detergent is used, it’s usually one designed for lab glassware, such as Liquinox or Alconox. These detergents are preferable to any dishwashing detergent you might use on dishes at home. Much of the time, detergent and tap water are neither required nor desirable. You can rinse the glassware with proper solvent, and then finish up with a couple of rinses with distilled water, followed by final rinses with deionized water. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 How to wash out common lab Chemicals Water soluble solutions (e.g. sodium chloride or sucrose solutions) Rinse 3-4 times with deionized water then put the glassware away. Water insoluble solutions (e.g. solutions in hexane or chloroform) Rinse 2-3 times with ethanol or acetone, rinse 3-4 times with deionized water, then put the glassware away. In some situations, other solvents need to be used for the initial rinse. Strong acids (e.g. concentrated HCL or H₂SO₄) under the fume hood, carefully rinse the glassware with copious volumes of tap water. Rinse 3-4 times with deionized water, then put the glassware away. Strong bases (6M NaOH or concentrated NH₄OH) under the fume hood, carefully rinse the glassware with copious volumes of tap water. Rinse 3-4 times with deionized water, then put the glassware away. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 How to wash out common lab Chemicals cont… Weak acids (e.g. acetic acid solutions or dilutions of strong acids such as 0.1M or 1M HCL or H₂SO₄) Rinse 3-4 times with deionized water before putting the glassware away. Weak bases (e.g. 0.1M and 1M NaOH and NH₄OH) rinse thoroughly with tap water to remove the base, and then rinse 3-4 times with deionized water before putting the glassware away. Biohazardous (anything with tissue, blood etc.) Autoclave first to decontaminate and then wash glassware with detergent and water. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Washing special glassware Glassware used for organic chemistry: o Rinse the glassware with the appropriate solvent, use deionized water for water-soluble contents. Use ethanol for ethanol-soluble contents, followed by rinses in deionized water. Rinse with other solvents as needed, followed by ethantol and finally deionized water. If the glassware requires scrubbing, scrub with a brush using hot soapy water, rinse thoroughly with tap water, followed by rinses with deionized water. Burets: wash with hot soapy water, rinse thoroughly with tap water, and then rinse 3-4 times with deionized water. Be sure the final rinses sheet off of the glass. Burets need to be thoroughly clean to be used quantitative labwork. Pipets and volumetric flasks: in some cases, you may need to soak the glassware overnight in soapy water. Clean pipets and volumetric flasks using warm soapy water. The glassware may require scrubbing with a brush. Rinse with tap water followed by 3-4 rinses with deionized water. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5 Drying or not drying glassware Not drying: it is inadvisable to dry glassware with a paper towel or forced air since his can introduce fibres or impurities that can contaminate the solution. Normally you can allow glassware to air dry on the shelf. Otherwise, if you are adding water to the glassware, it is fine to leave it wet (unless it will affect the concentration of the final solution). If the solvent will be ether, you can rinse the glassware with ethanol or acetone to remove the water, and then rinse with the final solution to remove the alcohol or acetone. Rinsing with reagent: if water will affect the concentration of the final solution, triple rinse the glassware with the solution. Drying glassware: if glassware is to be used immediately after washing and must be dry, rinse it 2-3 times with acetone. This will remove any water and will evaporate quickly. While it’s not a great idea to blow air into glassware to dry it, sometimes you can apply a vacuum to evaporate the solvent 10 January 2025 Confidential. All Rights Reserved. Cambria College. 6 Glassware washing: Hand vs Machine Hand washing Hand washing as previously discussed requires an acid or base wash, rinse or soak which can be performed in plastic tubs. This method requires appropriate disposal of both acids and bases after washing is complete. Hot, soapy water can also clean soiled glassware. A final rinse in purified water or tap water usually completes the process. In most cases, hand-washing water will reach 120°F maximum, requiring sanitization or sterilization to be done in a autoclave. For drying, glassware can be hung on a drying rack, placed in an oven, or dried manually. This process is time consuming and sometimes requires a dedicated person to hand wash the glassware. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 7 Glassware washing: Hand vs Machine cont.. Automatic residential dishwashers Automatic residential dishwashers are another option sometimes employed when washing lab glassware. The initial investment is much less than an instrument designed for lab use and its features are not as durable or as flexible. The interior generally plastic or stainless steel designed to handle basic food, soil and beverages not chemicals and contaminants found in a laboratory. The baskets are designed for domestic plates, cups, bowls, glasses, pots and pans, rather than narrow neck glassware, culture tubes, beakers, and other specialized glassware used daily in the laboratory. Basket inserts for lab utensils are also not available. Expect manufacturer's warranty to be void when used for purposes other than residential settings. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 8 Glassware washing: Hand vs Machine cont.. Automatic Laboratory Glassware Washers Automatic laboratory glassware washers are designed to clean all types of lab soil, from light to heavy, and offer features and accessories for a broad range of lab glassware and contaminants. A washer with a high heat option is best for cleaning heavy and difficult to remove soil such as waxes, oil or agar. For more soluble soil, high heat is not required. If flasks, graduated cylinders and other narrow-neck glassware are to be washed, a spindle rack option should be considered. The interior of a lab washer must be designed to prevent damage to the washer from residual exposure to basic laboratory chemicals. Stainless steel chambers withstand traces of the every day chemicals used in a laboratory. Internal components, including the detergent cup, seals, pumps and other plastic and rubber components have been carefully chosen to withstand chemicals as well as the high heat conditions inside the washer. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 9 Glassware washing: Hand vs Machine cont.. Automatic Laboratory Glassware Washers cont… Another feature usually incorporated into a laboratory glassware washer is an optional purified water rinse. If pressurized purified water is not available, a separate pump may be required. Some washers include a separate pump to introduce purified water into the chamber, eliminating the need to buy it separately. HEPA filtered forced air drying, which traps dirt, lint and other particulate contaminants from the air should be considered if your research is sensitive to this type of contamination. Also, an RS232 port, to communicate wash conditions to a printer or computer, is available on some models if validation is required. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 10 Glassware washing: Hand vs Machine cont.. Automatic Laboratory Glassware Washers cont… Pipette inserts allow the effective washing of pipettes in various sizes. The attachment forces water and detergent deep inside the pipettes assuring cleanliness. Other inserts for specific types of glassware such as culture tubes, media plates, DNA sequencing plates, and BOD bottles are readily available. Automatic washer detergents formulated specifically for laboratory washers can meet specific needs. There are a wide variety of detergents — phosphate-free, chlorine-free, surfactant-free and non-ionic or ionic. These detergents leave no residue on the glassware so they are safe for sensitive applications such as tissue culture or instrumental analysis. Some laboratory washers automatically dispense liquid detergent and weak acid neutralizing rinse solutions. This eliminates the need to manually fill the detergent cup and rinse dispenser before each use. Using a built-in pump, the washer automatically meters the precise amount of detergent and acidic rinse solution into the washer at the appropriate cycle. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 11 Infection Control ▪ Infection Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com A condition that results when a microbe (microorganism) invades the body, multiplies, and causes injury or disease ▪ Microbes include bacteria, fungi, protozoa, viruses ▪ Pathogen: a microbe capable of causing disease ▪ Communicable infections ▪ Able to be spread from person to person ▪ CDC charged with investigation and control of disease Knowledge of infection control is important to protect yourself, patients, coworkers, and others from infection and to provide the best patient care. Infection (cont.) ▪ The global spread of disease Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Endemic: a disease that belongs to a particular area, people, or country and can be commonly found there ▪ Outbreak: a sudden increase in cases of a disease in an area beyond what is expected, or an infection in a new area. If an outbreak is not quickly controlled, it can lead to an epidemic ▪ Epidemic: when an outbreak of a disease spreads rapidly and affects many people within a community, population, or region, or the number infected in an area is significantly higher than normal ▪ Pandemic: when an epidemic of a disease has spread over multiple countries or continents and affects a large portion of the population See Table 3-1: Examples of Infectious Diseases with Global Reach Infection Control (cont.) ▪ Nosocomial and Healthcare-Associated Infections (HAIs) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Nosocomial infection: patient infection acquired in a hospital ▪ Healthcare-associated infection: patient infection acquired during healthcare delivery in any healthcare settings ▪ 1 in 31 hospital patients in the U.S. has at least one HAI ▪ More than a million/year, costing billions of dollars annually ▪ Causes: infected personnel, patients, visitors, food, drugs, or equipment Infection Control (cont.) ▪ Antibiotic-Resistant Infections Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Well-established antibiotic-resistant bacteria ▪ Clostridioides difficile ▪ MRSA ▪ Enterococcus ▪ Multidrug-resistant gram-negative bacteria ▪ Carbapenem-resistant Enterobacteriaceae (CRE): Escherichia coli and Klebsiella pneumonia ▪ Acinetobacter baumannii ▪ Pseudomonas aeruginosa Infection Control (cont.) ▪ Chain of Infection Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com 1. Infectious (causative) agent – Pathogenic microbe responsible for causing an infection 2. Reservoir – Source of infectious agent – Place where microbe can survive and grow or multiply – Includes: humans, animals, food, water, soil, equipment 3. Exit pathway – A way an infectious agent can leave a reservoir host – Secretions and exudates, tissue specimens, blood, feces, urine Infection Control (cont.) ▪ Chain of Infection (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com 4. Means of transmission – Airborne Have some fun – Contact finding biohazard – Direct (touching, kissing) exposure routes terms – Indirect (contaminated objects) In the Workbook – Droplet (coughing, sneezing) Knowledge Drill 3-2 – Vector (insect, arthropod, animal) – Vehicle (food, water, drugs) Infection Control (cont.) ▪ Chain of Infection(cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com 5. Entry pathway – How an infectious agent enters a susceptible host – Includes body orifices, mucous membranes, and breaks in skin 6. Susceptible host – Someone with a decreased ability to resist infection – Factors: age, health, immune status  Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com Test your knowledge of Key Points with WORKBOOK Knowledge Drill 3-1. Infection Control (cont.) Infection Control (cont.) ▪ Breaking the Chain of Infection Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Hand hygiene ▪ Nutrition, rest, stress reduction A phlebotomist, ▪ Immunization whose duties involve ▪ Decontamination of surfaces and instruments contact with many ▪ Disposal of sharps and infectious waste patients, must be fully aware of the infection ▪ Use of gloves, gowns, masks, and respirators process and take ▪ Needle safety devices precautions to prevent ▪ Infection control programs the spread of infection. ▪ Insect and rodent control ▪ Isolation procedures Infection Control (cont.) ▪ Infection Control Programs Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ To protect patients, employees, visitors, and others ▪ To break chain of infection ▪ Monitor and collect data on all infections occurring in institution ▪ Institute special precautions in the event of outbreaks ▪ Components ▪ Employee screening ▪ Employee immunization ▪ Evaluation and treatment ▪ Surveillance Infection Control (cont.) ▪ Infection Control Practices Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Hand hygiene ▪ Use of alcohol-based antiseptic hand cleaners ▪ Handwashing ▪ Personal protective equipment (PPE) ▪ Gloves ▪ Gowns ▪ Lab coats Test your knowledge ▪ Masks, face shields, and goggles of proper hand ▪ Respirators washing procedure with WORKBOOK Skills Drill 3-3. Infection Control (cont.) Glove Removal Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com Glove use does not replace the need for hand hygiene Sanitize hands immediately after glove removal and before going to another patient, back to the lab, or performing other duties  Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com Figure 3-2 N95 respirator. Infection Control (cont.) © Jasni/Shutterstock. Infection Control (cont.) ▪ Order for Donning PPE ▪ Order for Removing PPE Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com 1. Gown 1. Gloves 2. Mask or respirator 2. Goggles or face shield 3. Goggles or face shield 3. Gown 4. Gloves 4. Mask (touch only strings) Wash hands after removing PPE! Lab coats worn as PPE must not be worn on break, in the cafeteria or other nonpatient areas, or outside the hospital. © Jones & Bartlett Learning. Infection Control (cont.) ▪ Asepsis: condition of being free of contamination or germs that can cause disease Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Aseptic: free of disease-causing microbes ▪ Aseptic technique: practice used to reduce the chance of microbial contamination ▪ Aseptic technique for blood collection personnel ▪ Proper hand hygiene ▪ Keep supplies within easy reach to avoid dropping them ▪ Open packages in a way to avoid contamination ▪ Prompt and safe disposal of contaminated equipment ▪ Prompt cleanup of infectious material ▪ Wear gloves for blood collection and other PPE when indicated Infection Control (cont.) ▪ NICU Infection Control Technique Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Wash hands and put on clean gloves ▪ Gather only those items necessary to perform specimen collection ▪ Leave blood collection tray or cart outside the nursery ▪ Remove gloves, decontaminate hands, and put on new gloves between patients Infection Control (cont.) ▪ Isolation Procedures: Overview Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Keep patients with communicable infections separate from others ▪ Prevent spread of infection ▪ Protect patients with compromised immune system ▪ Isolation requires doctor’s order Scrubs/pants that touch the floor can pick up ▪ Infected patient is confined to infectious material. private room CLSI laboratory safety guidelines: pants worn by laboratory personnel should be 1 to 1½ inches off the floor to prevent contamination. Infection Control (cont.) ▪ Isolation Procedures Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Protective/reverse isolation ▪ For patients highly susceptible to infections ▪ Universal precautions (UP) ▪ Blood and body fluids of all people are potentially infectious ▪ Body substance isolation ▪ Goes beyond UP: gloves for contacting moist body substances Infection Control (cont.) ▪ Guideline for Isolation Procedures Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Standard precautions ▪ Used for all patients ▪ Number one strategy for control of nosocomial infection ▪ Covers blood, all body fluids, skin breaks, mucous membranes ▪ Update added: Respiratory Hygiene/Cough Etiquette ▪ Transmission-based precautions ▪ Used for patients known/suspected to have certain infections ▪ Three types: ▪ 1. Airborne ▪ 2. Droplet ▪ 3. Contact Safety ▪ Biosafety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Biohazard ▪ Any material or substance (potentially) harmful to health ▪ Identified by a biohazard symbol Figure 3-11 The biohazard symbol. © Wolters Kluwer. Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Biohazard exposure routes ▪ Airborne ▪ Ingestion ▪ Nonintact skin ▪ Percutaneous (through the skin) ▪ Permucosal (through mucous membranes) Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Bloodborne pathogens ▪ Hepatitis B virus (HBV) and hepatitis D virus ▪ Best defense is HBV vaccination ▪ HBV exposure hazards: 1. Present in blood and other body fluids 2. Can survive up to a week on objects 3. Transmitted via needlesticks, sexual contact ▪ Symptoms: flu-like, fatigue, loss of appetite, mild fever, muscle/joint/abdominal pain, nausea, vomiting Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Bloodborne pathogens (cont.) ▪ Hepatitis C virus (HCV) ▪ HCV exposure hazards 1. Present in blood and serum; sometimes saliva 2. Infection primarily occurs after large or multiple exposures 3. Transmitted via needlesticks, sexual contact ▪ Symptoms: flu-like, fatigue, loss of appetite, mild fever, muscle/joint/abdominal pain, nausea, vomiting Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Bloodborne pathogens (cont.) ▪ Human immunodeficiency virus (HIV) ▪ HIV exposure hazards 1. Present in blood, semen, saliva, tears, urine, CSF, amniotic fluid, breast milk, cervical secretions, and tissue 2. Risk to HCWs is primarily through exposure to blood ▪ Symptoms: progression through mild to severe flu-like symptoms, hairy leukoplakia, white lesion on tongue, Kaposi sarcoma, neurological symptoms, dementia Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ OSHA Blood-Borne Pathogens (BBP) Standard ▪ Enforced by federal law ▪ Intended to reduce/eliminate BBP exposure ▪ Requires: ▪ Engineering and work practice controls to prevent exposure incidents ▪ Availability and use of PPE ▪ Special training ▪ Medical surveillance ▪ HBV vaccination availability for all at-risk personnel Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Needlestick Safety and Prevention Act ▪ Required OSHA to revise BBP standard in four key areas: 1. Revision and updating of the exposure control plan 2. Solicitation of employee input in selecting engineering and work practice controls 3. Modification of engineering definition 4. New record-keeping requirement, including the requirement to keep a sharps injury log Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Exposure control plan ▪ Must be written ▪ Must be reviewed and updated at least annually ▪ Nonmanagerial employees with risk of exposure must be involved in: ▪ Identification ▪ Review ▪ Selection Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ BBP exposure routes ▪ Skin pierced by contaminated needle or sharp object ▪ Blood or other body fluid splashes in eyes, nose, or mouth ▪ Blood or other body fluid contacts cut, scratch, or abrasion ▪ A human bite breaks the skin Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Exposure incident procedure ▪ Needlestick or other sharps injury: ▪ Carefully remove shards of glass or other objects ▪ Wash site with soap and water at least 30 seconds ▪ Mucous membrane exposure: ▪ Flush site with water or sterile saline at least 10 minutes ▪ Use eyewash station if available to flush a splash to eyes ▪ Remove contact lenses ASAP and disinfect them ▪ Report incident to immediate supervisor ▪ Report directly to provider for evaluation, treatment, counseling Safety (cont.) ▪ Biosafety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Surface decontamination (required by OSHA) ▪ All surfaces in specimen collection and processing areas ▪ 1:10 bleach solution or other EPA-approved solution ▪ Cleanup of body fluid spills ▪ EPA-approved chemical solutions and kits ▪ Gloves must be worn ▪ Absorb material without spreading it over wider area ▪ Biohazard waste disposal ▪ All nonreusable items contaminated with blood/body fluids go in biohazard waste containers Personal Wellness Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ It is NOT just about what you eat—it requires a holistic approach, one that meets the physical, emotional, social, spiritual, and economic needs. Figure 3-24 Holistic food pyramid. © Wolters Kluwer. Personal Wellness (cont.) ▪ Proper Nutrition Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Plant-based diet rich in variety of vegetables, fruits, and legumes ▪ Avoid processed, starchy staple foods ▪ Balance of carbohydrate, fat, protein, vitamins, minerals, fiber ▪ Rest and Exercise ▪ Lack of rest and sleep can lead to fatigue and other medical problems ▪ Stay fit to be healthier and live longer ▪ Focus on strength, flexibility, and endurance Personal Wellness (cont.) ▪ Personal Hygiene Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Shower/bathe regularly, use deodorant, but no heavily scented lotions or colognes ▪ Brush teeth and use mouthwash several times per day ▪ Hair clean and neat and fingernails clean, short, neatly trimmed ▪ Back Protection ▪ Use proper lifting techniques Personal Wellness (cont.) ▪ Stress Management Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Chronic stress may weaken the immune system and be associated with hypertension, ulcers, migraines, and nervous breakdowns Healthcare workers are at risk for back injury because of activities they are required to do (e.g., lift and move patients) and because of the stressful environment often associated with health care today.  General Laboratory Safety Rules 10 January 2025 Confidential. All Rights Reserved. Cambria College. 1 General Laboratory Rules and Safety No food or drink of any type Open toes are not allowed in the laboratory Long hair must be pulled back off of face All sharps must go in the sharps container Place all biohazard waste & chemical waste in the proper containers Wear all personal protective equipment (PPE) 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 Standard Precautions Standard Precautions are designed to reduce the risk of transmission of infectious diseases. Standard Precautions are also known as Routine Precautions and formally known as Universal Precautions. Standard Precautions should be used whenever there is a risk of an exposure to any body fluid, as they can carry organisms (germs) that could cause infection if they enter non-intact skin or mucous membranes. Standard Precautions are to be used in conjunction with transmission-based precautions also known as additional precautions. These include contact precautions, droplet precautions and air-borne precautions. Standard Precautions are most often practiced in acute care, long term care, ambulatory care, medical clinics, and home care settings but can be used by anyone in a situation where there are body fluids present that may be capable of transmitting infection. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 Standard Precautions cont. Body fluids include: Blood, saliva, fluids from coughing or sneezing and other secretions and excretions except sweat regardless of whether or not they contain visible blood. Non-intact skin and mucous membranes include: Eyes, nose, mouth, open wounds, scrapes, and also severe dry skin and dermatitis. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Hand Washing Hands should be washed after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Wash hands immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of organisms to other persons or environmental surfaces. It may be necessary to wash hands between procedures on the same person to prevent cross- contamination of different body sites. Use plain (non anti-microbial) soap for routine handwashing. Waterless antiseptic agents containing 60-70% alcohol are effective unless hands are visibly soiled. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5 Hand Washing cont. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 6 Hand washing cont. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 7 Gloves Wear gloves (clean, non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and potentially contaminated items. Put on clean gloves just before touching any mucous membranes or non-intact skin. Gloves should also be changed between procedures on the same the same person to prevent cross-contamination. Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before working with another person and/or moving to another room. Wash hands immediately after removing gloves to avoid transfer of organisms to other persons and/or environments. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 8 Mask, Eye Protection, Face Shield and Gowns Wear mask, eye protection, face shield and gowns to protect clothing and mucous membranes such as eyes, nose, and mouth during procedures and care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 9 Handling Sharps Handle all sharps as minimally as possible. Do not re-cap needles. Place used needles and other sharps in a specially designed container. If you are exposed to blood or body fluids through a needlestick injury, an opening in the skin or through a human bite, report it the college’s on-site first aid attendant immediately. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 10 Cleaning and Disinfection of Equipment and Environmental Surfaces Handle used care equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of organisms to other persons and environments. Ensure that reusable equipment is not used for the care of another person until it has been appropriately cleaned and/or disinfected. Single-use items should be discarded. Ensure that adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces and other frequently touched surfaces, are being followed. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 11 Infection Control Follow all Worksafe BCs guidelines regarding infection control Always wear proper protective equipment(PPE) when using chemicals and handling biohazards Follow correct guidelines for sterilization of instruments Use proper containers for sharps and contaminated waste Follow correct guidelines for handwashing 10 January 2025 Confidential. All Rights Reserved. Cambria College. 12  Transmission Based Precautions 10 January 2025 Confidential. All Rights Reserved. Cambria College. 1 Transmission Based Precautions Transmission based precautions are the second tier of basic infection control and are able to be used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 Transmission Based Precautions There are 3 categories of Transmission Based Precautions ★ Droplet Precautions ★ Contact Precautions ★ Airborne Precautions 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 Droplet Transmission Droplet Transmission: occurs when a person is in close contact with someone who has respiratory symptoms (coughing or sneezing) and is therefore at risk of having their mucosae exposed to potentially infective respiratory droplets. Droplet Transmission may also occur through fomites in the immediate environment around the infected person. EXAMPLE: pathogens expelled from the respiratory tract through coughing or sneezing. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Droplet Precautions Use Droplet Precautions for patients known or suspected to be infected with pathogens transmitted by respiratory droplets that are generated by a patient who is coughing, sneezing, or talking. Source Control: Put a mask on the patient PPE: Don mask upon entry into the patient room or patient space. Patient Placement: A single room if possible. Limit Transport and movement of patients outside of the room to medically-necessary purposed 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5 Droplet Precautions 10 January 2025 Confidential. All Rights Reserved. Cambria College. 6 Contact Precautions Use Contact Precautions for patients with unknown or suspected infections that represent an increased risk for contact transmission. PPE: Wear gown and gloves for all interactions that may involve contact with the patient or patient’s environment. Don PPE upon room entry and properly discard before exiting the patient’s room. Use disposable or dedicated patient-care equipment (e.g. blood pressure cuffs) Prioritize cleaning and disinfection of the rooms of patients on contact precautions. Limit transport and movement of patients outside of the room to medically- necessary purposes 10 January 2025 Confidential. All Rights Reserved. Cambria College. 7 Contact Precautions 10 January 2025 Confidential. All Rights Reserved. Cambria College. 8 Airborne Transmission Airborne Transmission: occurs when an infectious disease is transmitted through small particles suspended in the air. Airborne transmission is sometimes referred to as Aerosol transmission. The infectious agents may be viruses, bacteria, or fungi. They may be spread through breathing, talking, coughing, sneezing, raising of dust, spraying of liquids, flushing of toilets or any activities which generate aerosol particles or droplets. EXAMPLE: Measles and TB are airborne-exclusive diseases. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 9 Airborne Precautions Use Airborne Precautions for patients known or suspected to be infected with pathogens transmitted by the airborne route ( e.g. tuberculosis, measles, chicken pox, disseminated herpes zoster). Source Control: Put a mask on patient PPE: A fit-tested NIOSH-approved N95 or higher level respirator Ensure patient placement in an airborne infection isolation room (AIIR). If this room is not available use a private room with the door closed. Limit transport and movement of patients outside of the room to medically necessary purposes. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 10 Airborne Precautions 10 January 2025 Confidential. All Rights Reserved. Cambria College. 11 Transmission Based Precautions For all 3 Categories of Transmission Based Precautions there will be a sign posted on the patient’s room door that indicates the following: Visitors need to STOP and not enter and check in with a nurse first. Indicated what PPE staff should be wearing upon entering and instructions regarding the removal Indicated what the Transmission Based Precaution is (i.e. droplet, contact, airborne or a combination of those.) 10 January 2025 Confidential. All Rights Reserved. Cambria College. 12 Transmission Based Precautions In general for most health authorities the specific PPE needed for the different categories of Transmission Based Precautions is as follows: Droplet: Mask Contact: Gown and Gloves Airborne: N95 respirator or better These items of PPE are in addition to what is needed for standard precautions, and if the patient has an illness that falls under a combination of categories than the PPE selection would reflect all categories involved. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 13 Modes of Infection Transmission Modes of infection transmission refers to the way in which an infectious agent is transmitted from its natural reservoir to a susceptible host. Some modes of transmission are: Direct/indirect Droplet Airborne Ingestion Vector 10 January 2025 Confidential. All Rights Reserved. Cambria College. 14 Direct/Indirect Transmission Direct Transmission: occurs when there is physical contact between an infected person and a susceptible person. Indirect Transmission: occurs when there is no direct human to human contact. Contact occurs from a reservoir to contaminated surfaces or objects, or to vectors such as mosquitoes, fleas, ticks, or rodents. EXAMPLE: microorganisms being transferred to other patients from contaminated equipment and via the hands of healthcare staff. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 15 Student Breakout groups Divide the class into 3 groups and assign one of the 3 Transmission Based Precautions Droplet Airborne Contact Have them research each group and find a video on the proper donning and doffing of PPE 10 January 2025 Confidential. All Rights Reserved. Cambria College. 16 Heat Sterilization and Decontamination Principle/Conditions Advantages Disadvantages Uses Dry Heat Thermal inactivation: Non-corrosive Less effective than Materials that are destroys by oxidation Simple design and moist heat; requires damaged by, or are principle longer times and/or impenetrable to, higher temperatures moist heat Hot Air Oven 160-180°C for 2-4 hours · penetrates water- · slow diffusion, · anhydrous insoluble materials penetration materials, such as (e.g., grease and oil) · loading, packing oils, greases and · less corrosive to critical to powders metals and sharp performance · laboratory instruments than · not suitable for glassware, steam reusable plastics instruments · closed containers 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2 Heat Sterilization and Decontamination cont. Principle/Conditions Advantages Disadvantages Uses Red heat Flame · oxidation to ashes · rapid · initial contact with · inoculating loops, (burning) flame can produce a needles viable aerosol · possibility of accidental fire Incineration · oxidation to ashes · reduces volume of · improper use may · for decontamination of (burning) waste by up to 95% lead to emission of waste items prior to pathogens in smoke disposal in landfill · 1-60 minutes: · requires transport temperatures may exceed of infectious waste 1000°C · excess plastic (>20%) content reduces combustibility 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 Heat Sterilization and Decontamination cont. Principle/Conditions Advantages Disadvantages Uses Moist Heat Irreversible coagulation More rapid and of (microbial) proteins more effective than dry heat Pasteurization · heating to below · can be used on · not reliably · milk and dairy boiling point (generally heat sensitive liquids sporicidal products 77°C) for up to 30 and medical devices · some heat- minutes · low cost sensitive medical equipment Boiling · maximum · minimal · cumbersome: not · small instruments temperature obtainable equipment required practical for and equipment is approximately 100°C everyday lab use 10-30 mins · not reliably sporicidal 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Heat Sterilization and Decontamination cont. Principle/Conditions Advantages Disadvantages Uses Autoclaving · steam under pressure · minimal time · loading and · penetration of · 121°C/15 psi for 15- required packing critical to sterile glassware, 90 mins · most dependable performance media and sterilant for lab use · shielding dirt must instruments first be removed · decontamination · maintenance and of reusable supplies quality control and equipment essential · decontamination · damages heat- of infectious waste sensitive items 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5 Chemical Sterilant and Disinfectants Instruments or materials which cannot withstand sterilization in a steam autoclave or dry-air oven can be sterilized with a gas such as ethylene oxide or a broad spectrum liquid chemical germicide. Chemical decontamination of surfaces may also be necessary for very large or fixed items. Since liquid chemical germicides generally require high concentrations and several hours of exposure time for sterilization purposes, they are usually used for disinfection rather than for sterilization purposes. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 6 Chemical Sterilant and Disinfectants Effective Advantages Disadvantages Examples of Uses Concentrations, Contact Times Sodium hypochlorite · 100-10,000 ppm · broad spectrum · toxic, corrosive to · general disinfectant (.01-1%) free chlorine · inexpensive skin and metals · waste liquids · 10-60 minutes · widely available · unstable at optimum · surface · bactericidal at low effective pH of 6 decontamination temperature · inactivated by · emergency spill organic matter clean up · deteriorates under · instrument light and heat: shelf disinfection life of dilutions is less than 1 week 10 January 2025 Confidential. All Rights Reserved. Cambria College. 7 Chemical Sterilant and Disinfectants cont. Effective Advantages Disadvantages Examples of Uses Concentrations, Contact Times Alcohols · 70-80% ethanol · low toxicity · rapid evaporation · skin disinfectant · 60-95% · rapid action limits contact time (antiseptic) isopropanol · low residue · flammable, eye · surface · 10-30 minutes · non-corrosive irritant decontamination · may damage · benchtop, cabinet rubber, plastic, wipe down shellac · ineffective against 10 January 2025 Confidential. All Rights Reserved. Cambria College. 8  Chemical Sterilant and Disinfectants cont. Effective Advantages Disadvantages Examples of Uses Concentrations, Contact Times Hydrogen Peroxide · 3-30% aqueous · rapid action · limited sporicidal · surface solution · no residue activity decontamination · 10-60 minutes · low toxicity · corrosive to some · instruments and · 6% for 30 minutes · environmentally metals equipment may kill spores safe · potentially explosive at high concentrations · stock solutions irritating to skin and eyes 10 January 2025 Confidential. All Rights Reserved. Cambria College. 9 Chemical Sterilant and Disinfectants cont. Effective Advantages Disadvantages Examples of Uses Concentrations, Contact Times Glutaraldehyde · 0.5-2.5% alkalinized · broad spectrum · expensive · cold sterilant and aqueous solution · does not corrode · pH, temperature fixative · 2-30 mins; up to 12 metal dependent · surface hours to kill all spores · can tolerate organic · pungent odour decontamination load · toxic: skin, eye, · instruments, respiratory tract irritant equipment, glassware · activated solutions have less than 2-week shelf life 10 January 2025 Confidential. All Rights Reserved. Cambria College. 10 Chemical hazards Chemical present a variety of hazards. Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com Chemicals can be:  Flammable  Toxic  Caustic  Corrosive  Carcinogenic  Mutagenic A hazardous chemical is and liquid, solid, or gas that could present a physical or health hazard to an employee. Chemical Hazards Most clinical lab procedures use non-hazardous chemicals or Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com chemicals that present few serious hazards. Often, safer chemicals are substituted for more hazardous chemicals in lab procedures. Sometimes it is necessary to pipet or work with a hazardous reagent. Technician should always avoid direct contact with chemicals and inhalation of chemicals or fumes. Chemical Hygiene Plan A chemical hygiene plan is a comprehensive safety plan Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com for the hazardous use of chemicals at each workplace. It lays out the specific work practices , procedures, and PPE that must be used to ensure the employee is protected from health hazards associated with chemicals. Chemical Hygiene Plan cont. The chemical hygiene plan, should include the following: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Standard operating procedures for the safe use of hazardous chemicals  Measures to reduce exposure to hazardous chemicals. Including PPE and hand hygiene.  Specifications for safe function of protective equipment and fume hoods  Provisions for employee education and training. Chemical Hygiene cont. After handling and using chemicals: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Gloves should be removed carefully  Avoid touching bare skin with the outer glove surfaces  Any chemical that comes in contact with the skin should be washed with water for 5 minutes (unless the container label says otherwise).  An eyewash station must be made available to workers who accidentally have chemicals splashed in the eyes. Caustic Chemicals Caustic chemicals are strong acids or bases capable of Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com causing severe skin burns. Fumes or vapors from caustic chemicals can burn mucus membranes. Caustic chemicals must be used in a fume hood. Examples of Caustic Chemicals Some examples of caustic chemicals are: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Potassium hydroxide ( KOH )  Sodium hydroxide ( NaOH )  Sulfuric Acid ( H2SO4)  Nitric Acid (HNO3)  Concentrated sodium hypochlorite (chlorine bleach) Goggles, face shield, chemical-resistant gloves, and a protective apron should be worn to protect against injury from splashes and spills. Toxic Chemicals Chemicals, such as those containing heavy metals are Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com toxic or poisonous either through skin contact or by respiratory exposure. Chemical-resistant gloves and protective rubber or vinyl sleeves can be used to protect skin from contact. If a chemical produces harmful fumes, it should be used only in a fume hood. Carcinogens, Mutagens, Teratogens and Radioisotopes Carcinogens ( cancer-causing substance) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com   Mutagens ( substances that cause stable gene changes )  Teratogens ( substances that can harm a fetus or embryo)  Radioisotopes ( elements that can emit radiation ) These categories of specimens require special handling and disposal. Carcinogens, Mutagens, Teratogens and Radioisotopes cont. Carcinogens: Must be handled with care, following all recommended safety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com precautions and wearing appropriate PPE. Mutagens & Teratogens: Must be clearly identified so that females of childbearing age can avoid exposure. Radioisotopes: Present the potential of exposure to radioactivity. Workers must complete special radiation safety training before working with radioisotopes. Gloves and radiation shields must be used. Special disposal is required and is regulated by federal guidelines. Chemical Storage General Guidelines: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Store all hazardous chemicals in a secure location, accessible only by lab personnel.  Use un-breakable or shatter-proof containers.  Store chemicals away from direct sunlight or sources of heat.  Store hazardous liquids in devices capable of containing spills. E.g. trays, lined storage cabinets.  Store larger containers on lower shelves.  Store liquids below eye level.  Segregate chemicals by reactivity class and flammability.  Maintain up-to-date chemical inventory list.  Examine storage areas weekly - replace faded or loose labels on containers. Chemical Safety ▪ Chemical safety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ General rules ▪ Always ▪ Never ▪ Wear PPE ▪ Store chemicals above eye ▪ Clean up chemical spills properly level ▪ Add water to acid ▪ Indiscriminately mix chemicals together ▪ Store chemicals in unlabeled containers ▪ Pour chemicals into dirty containers ▪ Use chemicals in unintended ways Chemical Safety cont. ▪ Chemical safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ OSHA Hazard Communication (HazCom) Standard (HCS) ▪ HazCom labeling requirements ▪ Statement of warning (“danger” or “poison”) ▪ Statement of hazard (toxic, flammable, combustible) ▪ Precautions to eliminate risk ▪ First aid measures for spills or other exposure ▪ Safety data sheets (SDS) ▪ General, precautionary, and emergency info on product See Figure 3-13 for the HCS eight specific GHS hazard category pictograms for use on labels. Chemical Safety cont. Chemical safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com DOT hazardous material label example. Figure 3-14 Example of a DOT hazardous material label. © Wolters Kluwer. Chemical Safety cont. Chemical safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com National Fire Protection Association labeling system Figure 3-15 National Fire Protection Association 704 marking system example and explanation. © Wolters Kluwer. Chemical Safety cont Chemical Safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com National Fire Protection Association labeling system Chemical Safety cont. ▪ Chemical Safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Safety showers and eyewash stations ▪ Phlebotomist should know their location ▪ Used for chemical spill or splash to eyes/body ▪ Flush affected part with water at least 15 minutes ▪ Visit ER for evaluation Figure 3-12 Eyewash basin. To use, push the lever on the right. A stream of water forces the caps from the nozzles. Lower your face and eyes into the stream and continue to wash the area until the eyes are clear. © Khamkhlai Thanet/Shutterstock. Chemical Safety cont. ▪ Chemical safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Chemical spill clean-up ▪ Use chemical spill kit Figure 3-17 Spill cleanup kit. © Wolters Kluwer. Electrical Safety Electricity is a potential ignition source and cause of more that 25% of fires. Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com Electricity can burn human tissue along the pathway of the current flow. Electricity can cause muscle contraction and ventricular fibrillation by way of electrical effects on the nervous system. Electricity can be fatal even at low voltage and low current. Electrical Safety cont. Some precautions to take for electrical safety: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Be familiar with the locations of circuit breakers and fuse boxes  Avoid the use of extension cords and multiple adapters  Only use outlets with a grounding connections and three-prong plug  Only use electrical equipment displaying CSA approved labels  If electrical equipment smokes or has a burning smell - cut the power supply immediately  Inspect electrical cords and equipment regularly  Avoid placing electrical cords across areas of pedestrian traffic  Use a class C fire extinguisher Electrical Safety ▪ Electrical Safety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Actions to take if electrical shock occurs ▪ Shut off source of electricity ▪ Can’t shut it off? Use nonconducting item to remove electricity source from victim ▪ Call for medical assistance ▪ Start cardiopulmonary resuscitation if needed ▪ Keep the victim warm Fire Safety ▪ Fire Safety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ All employees should know: ▪ Procedures to follow in case of fire ▪ Location of fire extinguishers and how to use them ▪ Location of fire blankets or heavy towels and how to use them ▪ Location of emergency exits and evacuation routes Fire Safety cont. ▪ Fire safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Components needed for fire to occur ▪ Fuel: combustible material ▪ Heat: to temperature of material until ignition ▪ Oxygen: to maintain combustion ▪ Chemical reaction: produces fire ▪ Keep components apart to prevent fire Fire Safety cont. ▪ Fire safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Fire tetrahedron Figure 3-20 Fire tetrahedron. © Wolters Kluwer. Fire Safety cont. Some precautions to take for fire safety are: Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com  Minimize the quantities of flammable liquids kept in the laboratory.  Use and store flammable liquids and gases only in well ventilated areas.  Conduct work involving the release of flammable vapours in a fume hood.  Keep containers closed.  Keep flammable liquids away from heat, sparks, open flames, electrical motors and direct sunlight.  Clean up spills of flammable liquids promptly to minimize the surface area if the spilled liquid - to avoid vapours reaching flammable limit. Fire Safety cont. ▪ Fire Safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Classes of fire ▪ Class A ▪ Ordinary combustible materials (wood, paper) ▪ Require water/water-based solutions to extinguish ▪ Class B ▪ Flammable liquids and vapors (paint, oil, grease, gasoline) ▪ Require blocking oxygen or smothering to extinguish ▪ Class C ▪ Electrical equipment ▪ Require nonconducting agents to extinguish Fire Safety ▪ Fire Safety (cont.) Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Classes of fire (cont.) ▪ Class D ▪ Combustible or reactive metals (sodium, potassium, magnesium, lithium) ▪ Require dry powder agents or sand to extinguish ▪ Class K ▪ High-temperature cooking oils, grease, or fats ▪ Require agents that prevent splashing and cool and smother fire Fire Safety cont. Most fire extinguishers operate according to the PASS Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com technique Pull and turn the locking pin to break the seal Aim low (point the nozzle at the base of the flames) Squeeze the handle Sweep from side to side Radiation Safety ▪ Radiation Safety Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com ▪ Principles of radiation exposure ▪ Distance ▪ Shielding ▪ Time ▪ Radiation present in: ▪ Patients injected with radioactive dyes ▪ Specimens from radiology or nuclear medicine Figure 3-22 The radiation hazard symbol. ▪ Radioimmunoassay lab area © Wolters Kluwer. Radiation hazard symbol Laboratory Spill Cleanup A successful spill clean up is one in which no one gets exposed or injured during the clean up. Make sure you are familiar with the material spilled and the properties of the chemical or substance – CHECK THE SDS SHEET For flammable or combustible liquids eliminate all potential sources of ignition immediately. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 2  Absorbent pads Masks Granular absorbent material (zorball, “x- Duct Tape sorb”, dry sand, cat litter) Nitrile gloves (resistant to most chemicals, Acid neutralizer Laboratory except phenols) or Neoprene gloves Protective eyewear (goggles) Caustic (alkaline) neutralizer Spill kit Plastic 20L pails with tight closing lids 10% Sodium Hypochlorite bleach supplies Garbage bags (use as liners for pails) Detergent Biohazard autoclave bags Scoops Forceps (to pick up glass) Brush and dust pan 10 January 2025 Confidential. All Rights Reserved. Cambria College. 3 Spill Cleanup Procedures ACID SPILLS: - Neutralize with Sodium Bicarbonate or “Neutrasorb,” or a 1:1 mix of sand and soda ash. - Contaminated mop up pads or towels from a Perchloric Acid spill must be kept wet to prevent combustion and placed in a plasti c bag, sealed, and put into a flammable waste disposal container. CAUSTIC (ALKALINE) SPILLS: Neutralize with Sodium Citrate (Citric Acid powder). BIOHAZARDOUS MATERIAL SPILLS: - Soak with disinfectants such as Sodium Hypochlorite (10% bleach), methylphenol compounds (Lysol, Cresol) FLAMMABLE SOLVENT SPILLS: - Apply “solusorb: (organic liquid absorbent material) from perimeter inward - Mop up with absorbent towels, dispose in flammable waste container 10 January 2025 Confidential. All Rights Reserved. Cambria College. 4 Spill Kit Materials Laboratories should be prepared for chemical spills by having a spill kit or materials available and supervisory personnel trained to respond. The spill kit must be in an obvious location and all persons responsible for the activities conducted in the laboratory must be knowledgeable in the use of the spill kit. Spill kits can be specialized for individual laboratories or can contain general supplies necessary to handle a variety of spills. Spill kits are commercially available, or it may be requested from OSHA/WorkSafe BC. Departments, centres or units are responsible for purchasing and refurbishing spill kit items. 10 January 2025 Confidential. All Rights Reserved. Cambria College. 5  Spill Category Category Quantity Response Treatment Materials Small Spilled Material