EMPERADOR ROLLY C.

10:30-12:30
W
BSN 2- ABAQUIN NOV 7, 2022

ACTIVITY 4
GOLDEN RULE IN GIVING EMERGENCY CARE

1. What is the meaning of the Golden Rule in Giving Emergency Care?

- The Golden Rule in Giving Emergency care serves as the guideline when having emergency
care. The Golden Rule is consist of things on what to do and what not to do in Emergency Care.
What to do:
 do obtain consent, when possible
 do think the worst
 do provide comfort and emotional support
 do be as calm and as directed as possible
What not to do:
 do not let the victim see his own injury
 do not assume that the victim's obvious injuries are the only one
 do not make a promise

2. What are the different precautions to prevent disease transmission?

- The different precautions to prevent disease transmission are the following.

1. Hand hygiene.
Hand hygiene is the most important measure to prevent the spread of infections among patients
and DHCP. Education and training programs should thoroughly address indications and
techniques for hand hygiene practices before performing routine and oral surgical procedures.
For routine dental examinations and nonsurgical procedures, use water and plain soap (hand
washing) or antimicrobial soap (hand antisepsis) specific for health care settings or use an
alcohol-based hand rub. Although alcoholbased hand rubs are effective for hand hygiene in
health care settings, soap and water should be used when hands are visibly soiled (e.g., dirt,
blood, body fluids). For surgical procedures, perform a surgical hand scrub before putting on
sterile surgeon’s gloves. For all types of hand hygiene products, follow the product
manufacturer’s label for instructions.
2. Personal Protective Equipment (PPE)
It refers to wearable equipment that is designed to protect DHCP from exposure to or contact
with infectious agents. PPE that is appropriate for various types of patient interactions and
effectively covers personal clothing and skin likely to be soiled with blood, saliva, or other
potentially infectious materials (OPIM) should be available. These include gloves, face masks,
protective eye wear, face shields, and protective clothing (e.g., reusable or disposable gown,
jacket, laboratory coat). Examples of appropriate use PPE for adherence to Standard Precautions
include—
 Use of gloves in situations involving possible contact with blood or body fluids, mucous
membranes, non-intact skin (e.g., exposed skin that is chapped, abraded, or with
dermatitis), or OPIM.
 Use of protective clothing to protect skin and clothing during procedures or activities
where contact with blood or body fluids is anticipated.
 Use of mouth, nose, and eye protection during procedures that are likely to generate
splashes or sprays of blood or other body fluids.
DHCP should be trained to select and put on appropriate PPE and remove PPE so that the chance
of skin or clothing contamination is reduced. Hand hygiene is always the final step after
removing and disposing of PPE. Training should also stress preventing the further spread of
contamination while wearing PPE by:
 Keeping hands away from the face.
 Limiting surfaces touched.
 Removing PPE when leaving work areas.
 Performing hand hygiene.

3. Respiratory Hygiene/Cough Etiquette

Respiratory hygiene/cough etiquette infection prevention measures are designed to limit the
transmission of respiratory pathogens spread by droplet or airborne routes. The strategies target
primarily patients and individuals accompanying patients to the dental setting who might have
undiagnosed transmissible respiratory infections, but also apply to anyone (including DHCP)
with signs of illness including cough, congestion, runny nose, or increased production of
respiratory secretions.

4. Sharps Safety
Most percutaneous injuries (e.g., needle stick, cut with a sharp object) among DHCP involve
burs, needles, and other sharp instruments. Implementation of the OSHA Blood borne Pathogens
Standard has helped to protect DHCP from blood exposure and sharps injuries. However, sharps
injuries continue to occur and pose the risk of bloodborne pathogen transmission to DHCP and
patients. Most exposures in dentistry are preventable; therefore, each dental practice should have
policies and procedures available addressing sharps safety. DHCP should be aware of the risk of
injury whenever sharps are exposed. When using or working around sharp devices, DHCP
should take precautions while using sharps, during clean up, and during disposal.

5. Safe Injection Practices

Safe injection practices are intended to prevent the transmission of infectious diseases between
one patient and another, or between a patient and DHCP during the preparation and
administration of parenteral (e.g., intravenous or intramuscular injection) medications. Safe
injection practices are a set of measures DHCP should follow to perform injections in the safest
possible manner for the protection of patients. DHCP most frequently handles parenteral
medications when administering local anesthesia, during which needles and cartridges containing
local anesthetics are used for one patient only and the dental cartridge syringe is cleaned and heat
sterilized between patients. Other safe practices described here primarily apply to the use of
parenteral medications combined with fluid infusion systems, such as for patients undergoing
conscious sedation. Unsafe practices that have led to patient harm include
1) the use of a single syringe with or without the same needle to administer medication to
multiple patients,
2) reinsertion of a used syringe with or without the same needle into a medication vial or solution
container (e.g., saline bag) to obtain additional medication for a single patient and then using that
vial or solution container for subsequent patients, and
3) preparation of medications in close proximity to contaminated supplies or equipment.

6. Sterilization and Disinfection of Patient-Care Items and Devices

Instrument processing requires multiple steps using specialized equipment. Each dental practice
should have policies and procedures in place for containing, transporting, and handling
instruments and equipment that may be contaminated with blood or body fluids. Manufacturer’s
instructions for reprocessing reusable dental instruments and equipment should be readily
available ideally in or near the reprocessing area. Most single-use devices are labeled by the
manufacturer for only a single use and do not have reprocessing instructions. Use single-use
devices for one patient only and dispose of them appropriately.
Cleaning, disinfection, and sterilization of dental equipment should be assigned to DHCP with
training in the required reprocessing steps to ensure reprocessing results in a device that can be
safely used for patient care. Training should also include the appropriate use of PPE necessary
for the safe handling of contaminated equipment. Patient-care items (e.g., dental instruments,
devices, and equipment) are categorized as critical, semi-critical, or noncritical, depending on the
potential risk for infection associated with their intended use.

7. Environmental Infection Prevention and Control

Policies and procedures for routine cleaning and disinfection of environmental surfaces should
be included as part of the infection prevention plan. Cleaning removes large numbers of
microorganisms from surfaces and should always precede disinfection. Disinfection is generally
a less lethal process of microbial inactivation (compared with sterilization) that eliminates
virtually all recognized pathogenic microorganisms but not necessarily all microbial forms (e.g.,
bacterial spores).
Emphasis on cleaning and disinfection should be placed on surfaces that are most likely to
become contaminated with pathogens, including clinical contact surfaces (e.g., frequently
touched surfaces such as light handles, bracket trays, switches on dental units, and computer
equipment) in the patient-care area. When these surfaces are touched, microorganisms can be
transferred to other surfaces, instruments, or to the nose, mouth, or eyes of DHCP or patients.
Although hand hygiene is the key to minimizing the spread of microorganisms, clinical contact
surfaces should be barrier protected or cleaned and disinfected between patients. EPA-registered
hospital disinfectants or detergents/disinfectants with label claims for use in healthcare settings
should be used for disinfection. Disinfectant products should not be used as cleaners unless the
label indicates the product is suitable for such use. DHCP should follow manufacturer
recommendations for use of products selected for cleaning and disinfection (e.g., amount,
dilution, contact time, safe use, and disposal). Facility policies and procedures should also
address prompt and appropriate cleaning and decontamination of spills of blood or other
potentially infectious materials. Housekeeping surfaces, (e.g., floors, walls, sinks) carry less risk
of disease transmission than clinical contact surfaces and can be cleaned with soap and water or
cleaned and disinfected if visibly contaminated with blood.

3. Identify the Body Substance Isolation or Body Precautions and Practices and define
each. Give examples if necessary
Body substance isolation is a practice of isolating all body substances (blood, urine, feces, tears,
etc.) of individuals undergoing medical treatment, particularly emergency medical treatment of
those who might be infected with illnesses such as HIV, or hepatitis so as to reduce as much as
possible the chances of transmitting these illnesses. Here are a few safety tips:
 Handwashing is one of the best ways to keep yourself germ-free.
 Always wear gloves. Using gloves protects your hands while performing personal care
tasks such as bathing, toileting, cleaning the bathroom, and even doing laundry and
washing dishes. When these duties are performed, everything that’s touched can carry
germs and bacteria. Also, it is a good protocol to change gloves to avoid cross-
contamination.
 Wear a mask if you or the person you are caring for is coughing or sneezing.
  Gowns and booties are good for protection for your clothes, usually only needed for
extremely contagious illnesses.
 Even while caring for a family member or friend, these precautions are necessary because
we all carry bacteria and germs on our persons, and some things (viruses, bacteria, etc.)
don’t need to be shared.

4. Identify Equipment, Cleaning and Disinfecting Procedures. Give the steps to follow.
HIGH-TOUCH LOCATIONS AND EQUIPMENT:
The following are locations and equipment with high frequency of handling and contact. As such
these represent a higher probability of viral loading in the work area and should be disinfected on
a routine basis.
 Benchtops  Faucet handles and sprayer grips
 Equipment handles and latches  Baskets, bins, trays, etc.
 Equipment controls and touchpads  Outsides of shared chemical bottles
 Drawer and cabinet handles and caps
 Bin and water incubator lids  Chair backs and arm rests
 Hand tools  Pens, whiteboard markers, etc.
 Micropipettes and other shared tools

Specific Laboratory Equipment:

Follow these additional guidelines for managing specific laboratory equipment before
maintenance service or disposal. All items and samples must be disposed of via the appropriate
waste stream:
 Refrigerator / Freezer – Remove all items.
 Incubator – Remove all samples and thermometers; drain water.
 Centrifuge – Remove all tubes and samples.
 Water bath – Remove all samples and thermometers; drain water.
 High-Performance Liquid Chromatography (HPLC) – Drain solvents from columns and
waste lines.
 Tissue dehydrating unit – Remove all items; drain solvents from storage tank.
 Colorimeter – Remove cuvets.
 Spectrophotometer – Remove sample containers or standards

Cleaning procedures:
 Wear disposable gloves to clean and disinfect.
  Clean surfaces using soap and water, then use disinfectant.
 Cleaning with soap and water reduces the number of germs, dirt, and impurities on the
surface. Disinfecting kills germs on surfaces.
 Practice routine cleaning of frequently touched surfaces. More frequent cleaning and
disinfection may be required based on the level of use. Surfaces and objects in public
places, such as shopping carts and point-of-sale keypads should be cleaned and
disinfected before each use.
 The laboratories should be cleaned by the laboratory staff. Cleaning staff should only
enter the laboratories under the supervision of the laboratory staff and will only be
involved in the cleaning of the office space and corridor.
 All surfaces and equipment within the laboratory should be regarded as potentially
infectious and should be cleaned on a daily basis. Exterior surfaces of equipment should
be wiped with 5% Lysol, then wiped with water to remove any residue.
 Floors should not be swept or waxed, but should be mopped weekly with soap solution
followed by an appropriate mycobactericidal disinfectant.
 Cleaning and maintenance of equipment is covered in the equipment SOPs (e.g. biosafety
cabinets, incubator, fridge and freezers, centrifuge).
 Floors and work surfaces should be kept as free of clutter as possible. Materials should be
stored in closed cupboards where possible. Excess reagents should be boxed, labeled and
stored in an appropriate store room.
 Check spill kit contents on a monthly basis. Fresh disinfectant must be prepared each
week. Record all cleaning and maintenance in the Laboratory Cleaning and Maintenance
Logbook.

Daily cleaning:
 Prepare sufficient fresh cleaning solutions.
 Put on protective clothing and gloves.
 Clean the bench tops and PCR equipment before work is done in the room, using 1%
sodium hypochlorite solution.
 After work in the room has been completed, repeat the cleaning in the manner described
 above.
 Clean the Twincubator exterior and interior surfaces with 1% sodium hypochlorite.
 Specimen trays and PCR racks should be immersed in 1% sodium hypochlorite and left
to
 air-dry after each use, before taking them to the designated rooms where they will be
used.
Disinfecting Procedures:
- PPE is required when cleaning or processing equipment and instruments, to protect against
splashing, spraying or aerosols.
 1. Wash the equipment with soap (e.g. liquid dish soap) and clean water.
2. Rinse the equipment completely with clean water.
3. Disinfect the equipment to inactivate any remaining pathogens.
There are several ways to disinfect equipment, and the products available at the health-care
facility should be used. Safe methods of disinfection include:
 heat for heat-resistant equipment that can withstand high temperature (e.g. 80 °C); such
equipment can be disinfected using a washer–disinfector;
 if a washer or pasteurizer is not available, use a high-end or commercial dishwasher with
a “sanitize” feature that can reach 70 °C ;
 for plastic equipment that may not tolerate 80 °C and for equipment that may be damaged
by boiling, or in the absence of the equipment described above, use chemical disinfection
(e.g. soak in 1:100 sodium hypochlorite solution for 30 minutes).
4. If using chemical disinfection, rinse with sterile or clean water (i.e. water boiled for 5 minutes
and cooled). Sterile water is preferred for rinsing off residual liquid chemical disinfectant from a
respiratory device that has been chemically disinfected for reuse, because tap or distilled water
may harbour microorganisms that can cause pneumonia. However, when rinsing with sterile
water is not feasible, instead, rinse with tap water or filtered water (i.e. water passed through a
0.2 μ filter), followed by an alcohol rinse and forced-air drying.
5. Dry equipment.
 Physical equipment (e.g. a washer, pasteurizer, or autoclave) often has a drying feature
within the machine.
 For chemical methods, let equipment parts air dry on a clean towel or cloth.
6. Store equipment dry in closed packages.

REFERENCES:
https://www.studocu.com/ph/document/university-of-the-philippines-system/bs-
community-nutrition/uploaddd-emergency-care/13787511
http://thenursingprofession.blogspot.com/2015/02/golden-rules-in-giving-emergency-
care.html
https://www.cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/
standard-precautions.html
https://www.ncbi.nlm.nih.gov/books/NBK214361/
https://www.paraquad.org/blog/body-substance-isolation-safety-tips/?fbclid=lwAR3c4qN4a
1qwarTn-BK3vn70m1st8tdFWpGsSz4p7v9VS6f2s1dp.Ja60EE