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					    DENT 1260

   Infection Control

      UNIT 2
PROTECTIVE BARRIERS
                    Unit 2

PPE
     PERSONAL PROTECTIVE EQUIPMENT


 Barriers used in dentistry to protect DHCW
    Reasons for protective barriers

 Contamination of the    Better to prevent this
  body with                exposure or
  microorganisms must      contamination (when
  occur before disease     possible) than to rely
  can develop.             on body’s resistance to
                           fight off disease after
                           contamination.
                        PPE

 Gloves                  Protective value
                          Uses
 Masks
                          Types
                          Limitations
 Protective Eyewear

 Protective Clothing
                     PPE

 GLOVES:
 PROTECTIVE VALUE--------
 Protect DHCW from direct contact with
  microbes in patients’ mouth
 Protect Patients from microbes on the hands
  of DHCW
                      Gloves

 Protection of the Dental Team
      Skin is an excellent barrier
      Cuts or abrasions cause port of entry

      Protection against contact with chemicals
                       Gloves

 Protection of Patients
     Microorganisms are present on many surfaces
     Ungloved hands touch contaminated surfaces
     Ungloved hands contact patient’s mouth
     Spread of microbes
                    Gloves

 Documented case of disease spread:
 Ungloved dental hygienist with dermatitis
  cared for patient with active herpes
 Spread of microbes to 20 other patients
 Modes: /patient to dental team member/
  /dental team member to patient/
  /patient to patient
                       Gloves

 Patient Care Gloves
     Also called exam gloves
     Always disposable
     Never to be washed
     Never to be reused
           Gloves in Dentistry

 Patient care:      Utility gloves
  surgical                Heavy latex gloves
                          Heavy nitrile gloves
  latex exam              Thin copolymer gloves
  vinyl exam              Thin plastic “food
  nitrile exam             handlers” gloves
                     Other gloves:
  powderless exam
                          Heat resistant gloves
  flavored exam           Dermal (cotton) gloves
               Sizes of gloves

 EXAM gloves:
 Extra small, small, medium, large, extra large
 Ambidextrous
 Surgeon’s gloves:
 Provided in half-sizes ranging from 5-9
 Made for right hand and left hand
             Specialty Gloves

 Operatory cleanup and instrument processing
  requires the use of heavy duty utility gloves
 Utility gloves when handling contaminated
  laundry or contaminated waste
 Heat-resistant gloves when unloading
  sterilizers
           Limitations of gloves

 High level of protection against direct
  contact with infectious agents through
  touching
 Little protection against injuries with sharp
  objects such as instruments, needles, and
  scalpel blades
          Limitations of gloves

 Never use gloves that are torn
 Handle sharps carefully even when wearing
  utility gloves
 If utility gloves are cracked or punctured,
  discontinue using
     Harmful Reactions to Gloves

 Some health-care workers and patients have
  reactions
 Reactions can be to the latex proteins in
  gloves or the other chemicals used in the
  manufacturing processes (up to 200 different
  chemicals)
             Items containing latex

 Dental Products
     Gloves
     Rubber dams
     Prophy cups
     Nitrous oxide masks
     Bite blocks
     Mixing bowls
     Blood pressure cuffs
          Other Products containing
                   Latex
   Stethoscopes                  Automobile tires
   Tourniquets                   Handlebar grips
   Electrode pads                Raquet handles
   Rubber aprons                 Elastic bands
                                  Condoms & diaphragms
   Catheters & tubing
                                  Balloons & rubber toys
   Syringe stoppers
                                  Baby bottle nipples
   Carpeting & adhesives         Pacifiers
   Erasers and rubber bands      Hot water bottles
        Three types of reactions:

 Irritant Contact Dermatitis

 Allergic Contact Dermatitis

 Latex Allergy
Latex allergy
         Irritant Contact Dermatitis

 Most reactions are irritants of the skin
     From non-latex chemicals used in the making of
      gloves
     From handwashing soaps
     Not rinsing the hands
     Not drying the hands thoroughly
      Irritant Contact Dermatitis

 Consider Changing Glove Brands
 Consider Changing Handwashing Agent
  Brands
 When changing glove brands, check the
  manufacturer. Same glove may be sold
  under different brands
        Allergic Contact Dermatitis

 Delayed Hypersensitivity or allergy
 Most frequently occurring reaction to gloves
 Limited to area of contact
     Itching, redness, sores within 24-48 hours
 Type IV allergy
 Similar to reaction of poison ivy
                Latex Allergy

 Immediate Hypersensitivity
 Person is allergic to the proteins in latex
 Symptoms begin within 20 minutes of
  contact
 Hives (urticaria), redness, burning, itching
 Respiratory symptoms can develop
       Managing Latex Allergies

 In the dental worker: avoid contact with
  latex protein
      Use non-latex gloves
      Establish “latex-safe” environment
      Or Reduced presence of latex in office
         Managing Latex Allergies

 In patients:
     Ask appropriate questions on health history
     Provide treatment in a specially prepared room
     Minimize previous contact of items with latex
     Prevent latex from directly contacting patient
     Minimize patient exposure to airborne proteins
                  Handwashing

 Protective Value:
     Hands are one of the most important sources of
      microorganisms in disease spread.

     Handwashing is a primary disease prevention
      procedure.
                    Handwashing

 Two types of Microbial Flora on hands:
     1. Resident skin flora
       Always there
       Never be totally removed

     2. Transient skin flora
       Contaminate the hands during the touching of or other
        exposure to contaminated surfaces
       “come and go” --
                   Handwashing

 Procedures:
     Mechanical action is important to suspend dirt
      and microorganisms from the skin surface so
      they can be rinse away with water
     Plain soap removes dirt
     Plain soap removes some transient microflora
     Antimicrobial soap needed for healthcare
         Antimicrobial Agents

 Common agents in handwashing products:
 CHG – chlorhexidine digluconate
 PI – povidone iodine
 PCMX – para-chlorometaxylenol
 TLS – triclosan
       Handwashing procedures

 Frequent use of 10- to 30-second routine
  handwashing procedures minimizes the
  number of transient microorganisms on the
  hands and aids in reducing the number of
  resident bacteria by means of their
  bactericidal chemical activity.
               When to Wash??

   Beginning of each day
   Before and after patient care
   Before placing gloves
   After removing gloves
   Before and after breaks
   End of day
   Other: whenever hands become contaminated
    Handwashing Before Gloving
     and After Glove Removal
 When skin is tightly covered up with gloves,
  members of resident flora dramatically
  increase, as great as 4,000-fold per hour
 Increased growth of microorganisms in
  warm, moist environment
                   MASKS

 Protective Value:
 Protects the patient from microbes from
  respiratory tract of operator
 Protects the wearer from disease agents that
  might be present in sprays, splashes, or
  aerosol particles
                     Masks

 Uses and types:
  New one worn for each procedure
  Covers nose and mouth
  Worn any time risk of spraying or splashing
  Masks can be secured with ties, ear loops, or
  elastic bands
                    Masks

 Limitations of masks:
 Do not provide a perfect seal around edge
 Wet masks must be replaced
      PROTECTIVE EYEWEAR

 Protective value:
 Disease agents may cause infection of eyes
 Or enter the mucous membranes and cause
  systemic infections
 Protects against physical damage by
  propelled objects such as tooth fragments
                   Eyewear

 All DHCW need to protect eyes
 At Chairside
 During Clean-up
 When working in dental laboratory
 Patients should wear protection during
  treatment
                   Eyewear

 Uses and types:
 Used whenever potential for harm
 Protection from high intensity lights
 Decontaminated before reuse
 Provide front, top and side protection
                 Eyewear

 Limitations:
 Goggles may be worn by themselves or over
  prescription eyeglasses
 Fogging can occur
 Face shields should be chin-length
           Protective Clothing

 Protective Value:
 Outer clothing can protect forearms and chest
  from contamination
 Covering up street clothes provides
  protection
            Protective Clothing

 Uses and types:
 Worn whenever there is chance for
  contamination of skin or other clothing with
  spray or splashes of saliva, blood, or OPIM
  (other potentially infections materials)
 Uniforms, clinic jackets, laboratory coats,
  aprons, and gowns
      Placing and removing barriers

 PUTTING ON:

 1.   Protective clothing
 2.   Mask
 3.   Protective eyewear
 4.   Gloves
      Placing and removing barriers

 REMOVING:

 1.   Disposable gown
 2.   Gloves
 3.   Protective eyewear
 4.   Mask
            Removing barriers

 All disposable items are put immediately into
  the waste receptacle.
 Do not touch underlying clothes or skin with
  the contaminated gloves.

 ALWAYS WASH, RINSE AND DRY
  HANDS AFTER REMOVING GLOVES

				
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posted:6/26/2011
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