Safety for health care personnel

Give the high rates of HIV and other bloodborne pathogens worldwide, it is imperative that health workers be provided with adequate protection. This is generally true, but especially so in trauma care, where blood and other body secretions are abundant and where the hectic nature of resuscitation may lead to an increased propensity to contact. Capabilities for universal precautions are deemed essential at all levels of the health care system. This includes the training necessary to apply these. It also implies provision of the necessary materials, including gloves and goggles, as well as capabilities for the safe disposal of sharps and biological materials. All of these are considered essential at all levels of the health care system. In the course of trauma resuscitation, large volumes of fluids may sometimes come into contact with health workers' skin. In such cases, adequate water-resistant clothing/gowns should be available. These are essential at all hospital levels. They are listed as desirable at the basic level, as some such facilities may not care for severely injured patients under such scenarios. Finally, capabilities for anti-HIV, post-exposure prophylaxis with anti-retroviral medications is deemed desirable at all levels.

Throughout these guidelines, numerous invasive procedures have been discussed. Implicit in all of these is that they be conducted under appropriate sterile conditions. The capability to achieve sterility is likewise implicit whenever these procedures are mentioned.

TABLE 14 Safety for health care

personnel

Facility level

Safety for health care personnel

Basic

GP

Specialist

Tertiary

Training in universal precautions

E

E

E

E

Gloves

E

E

E

E

Goggles

E

E

E

E

Sharps disposal

E

E

E

E

Biological waste disposal

E

E

E

E

Gowns

D

E

E

E

Post-exposure prophylaxis for HIV

D

D

D

D

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