PH 156: CLINICAL MICROSCOPY

BIOSAFETY (LAB)
MICAELLA DATO, DMM, MSc (c) | FEBRUARY 2022
TABLE OF CONTENTS
● Autoclave
I. Safety Elements in Medical III. Proper Removal of Gloves
→ Before opening:
Laboratory Practice IV. Donning and Doffing of
▪ Check if temperature and pressure are normal
A. Introduction Personal Protective
▪ Make sure that the intake steam valve is off
B. Laboratory Responsibilities Equipment
→ Loosen caps of containers to prevent explosions and boil overs
C. Personnel Responsibilities A. Donning PPE
→ Do not forget to place autoclave tape
D. Main Points B. Doffing PPE
→ Wear proper gear when placing or removing items
II. Proper Handwashing V. References
▪ Apron and face shield
Technique
− Glass suddenly exposed room temperature air from the
I. SAFETY ELEMENTS IN MEDICAL LABORATORY PRACTICE autoclave can break or explode
▪ Heat retardant gloves
A. INTRODUCTION
− Be cautious as steam can permeate gloves easily
● Hazards present in the laboratory: → Do not overload autoclave as some equipment may not reach
→ Hazardous chemicals high enough temperatures to be sterilized
→ Infectious diseases ▪ Check if material is sterilized using autoclave tape
→ Gases ● Pipette
→ Radioactivity → Use a suction bulb (if there is no access to automatic ones)
→ Explosives → Always wash the pipette after use
● To protect the health and welfare of everyone, it is the responsibility: → Wash the suction bulb if liquid is drawn into it
→ Of the laboratory to ensure compliance with occupational safety → Do not mouth pipette
and health regulations
→ Of all personnel to know how to identify and safely deal with Handling Specimens
laboratory hazards ● Treat all specimens as potentially infectious
● Familiarize yourself with the universal precautions in the Activity
B. LABORATORY RESPONSIBILITIES Exposure Control Plan (AECP)
● Ensure laboratory requirements for safety and health are met ● There are different modes of transmission of infectious agents:
→ Based on the Occupational Safety and Health Administration’s → Airborne
Occupational Exposure to Hazardous Chemicals in Laboratory ▪ Wear mask and respirators
Rule (also known as OSHA lab standards) ▪ Properly cover containers
● Some OSHA lab standards are: ▪ Uncap containers only behind a protective barrier
→ Use of a chemical hygiene plan → Ingestion
▪ This covers practices, procedures, and policies ▪ Follow safe pipetting procedures
→ There should be an officer that ensures adherence to OSHA ▪ Thoroughly wash hands
standard procedures → Directly through the bloodstream (Inoculation)
→ Conducting employee training and information ▪ Be careful with needles, broken glass, sharp objects
→ Hazard identification and posting of warning signs and labels ▪ Properly dispose needles
→ Conducting medical examinations → Through mucous membranes (usually the eyes)
→ Provision of proper protective gear ▪ Wash hands
C. PERSONNEL RESPONSIBILITIES ▪ Remove gloves after handling specimens
▪ Avoid rubbing your eyes
Attire
● Clothes should not be made of a high percentage of acetate or Handling Radioactive Material
other highly flammable materials ● Follow SOP and federal regulations when working with radioactive
→ This is important when working with ether or other highly materials
flammable substances → Familiarize yourself with safety policies and SOP
→ It can create static electricity that send off sparks Handling Chemicals
● Shoes should cover entire foot ● Know the different types of chemical hazards:
● Do not wear dangling jewelry → Corrosive
→ It can get caught in equipment → Toxic
● Secure long hair back and off the shoulder → Ignitable
→ To prevent from shedding bacteria → Explosive
→ To prevent getting caught in equipment ● Labels contain:
Practices and Behaviors → Safe handling procedures
● Wash hands every time you: → Hazards present with use
→ Enter and exit the lab → Precautionary measures
→ Before and after being in contact with each patient, chemicals, or ● Recognize the National Fire Protection Association (NFPA) hazard
equipment identification diamond
● Eating, drinking, smoking, and applying cosmetics or perfumes → Color (type of hazard)
are prohibited in the work area ▪ Blue for health
● Wear lab coat and proper protective equipment when working ▪ Red for flammability
with hazardous materials or potentially infectious specimens ▪ Yellow for reactivity
● Know proper procedures when working with equipment ▪ White for other special instructions
→ Number (indicates level of danger)
Handling Equipment
▪ 0 (no danger) to 4 (serious danger)
● Centrifuge ● Be familiar with proper procedures for handling, storage, and
→ Operate only with covers closed and properly latched disposal
→ Always place cap or paraffin seal on specimen tube to prevent → Consult Material Safety Data Sheets (MSDS)
aerosolization

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(LAB)
● Know where and how to operate eyewash stations and emergency PERSONAL PROTECTIVE EQUIPMENT
showers ● Personal Protective Equipment:
Handling Explosives → Designed to protect against infections
● Be particularly cautious of explosive materials → Acts as a barrier to prevent or limit contamination of skin, mucous
→ Handle them with extreme care membranes, or clothing to prevent transmission of infectious
● Gases can also cause explosions and fire too agents
→ Place cylinders where they cannot be knocked over or damaged A. DONNING PPE
→ Keep restraints on cylinders securely tightened 1. Perform Hand Hygiene
▪ A broken valve head can turn a cylinder to a missile → Considered the most important and effective infection prevention
Handling Fires and control measure to prevent the spread of infections
● Read the warning signs and labels 01. Wet hands with warm water
→ Do not ignore and take for granted 02. Apply soap to produce lather
● To prevent fires 03. Rub hands together for 10-20 seconds (see part II for more
→ Know correct procedures for handling and storing ignitable and detailed instructions)
explosive materials 04. Rinse
→ Make sure all electrical devices are in proper working order 05. Dry hands with a paper towel
through: 06. Use paper towel to turn off tap
▪ Regular maintenance → If using an alcohol-based hand sanitizing product, ensure it
▪ Prompt reporting of wiring or switch problems contains 70%-90% alcohol
→ Know what atmospheres constitute fire hazards 2. Gown
▪ Always be sure that the atmosphere is safe before operating → Should fully cover torso from
electrical equipment ▪ Neck to knees
● To fight fires ▪ Shoulder to wrists
→ Know how to activate fire alarm system 01. Wrap the gown around your torso, from the front to back
→ Know proper reporting procedures 02. Secure with ties at the neck and the waist
→ Know location and how to use all fire extinguishers and fire → If the gown is too small, use two ties
blankets ▪ First tie in front and the second one on the back
3. Mask
D. MAIN POINTS → There are various kinds of masks and respirators but worn in a
● Good housekeeping is important similar fashion
→ Keep floors clean and dry to prevent falls ▪ Medical face masks
→ Keep countertops clean with no unnecessary clutter − Loose fitting
▪ Put all materials and equipment away after use − Designed to filter some of exhaled organisms to reduce
→ Dispose of broken glass immediately exposure to others
● Knowledge is important ▪ Respirators
→ Know how to properly handle, store, and dispose hazardous − Tight fitting
materials − Requires certification from the national institute for
→ Know correct reporting procedures occupational safety and health
→ Know labs policies covering safe work procedures − Designed to filter inhaled organisms tor reduce exposure to
● Proper and immediate action is important the wearer
→ Follow safe work procedures − Be sure to use an appropriate size mask as determined by
→ Use correct protective clothing and equipment approved fit testing
→ Report any unsafe work conditions observed 01. Cup the outside of the mask with clean hands
▪ Take what immediate corrective action you can before leaving 02. Place the mask over your nose, mouth, chin
to report the unsafe condition 03. Secure with earloops, ties, or elastic straps to ensure snug,
→ If accidents occur, report them immediately secure fit
II. PROPER HANDWASHING TECHNIQUE → For those with elastic straps, place the upper head strap
1. Remove watch and jewelry before washing hands behind the head above the ears; the lower head strap behind
→ Wedding rings are okay but make sure to clean them as well the head below the ears
→ Make sure to cover cuts and grazes → Do not cross the straps
2. Run the water at a comfortable temperature 04. Shape the flexible nose piece to fit
3. Get hands all wet 05. Adjust to make sure mask is snug and extends to below the chin
4. Use 1 squirt of liquid soap 06. For respirators: perform a seal check
5. Work up a lather, start washing (wash hands for at least 25 seconds): 4. Eye Protection
→ Start with palms, then 01. Position eyewear over the eyes
→ Back of the hands, then → If you have glasses, wear them first before the eye protection
→ Wrists, then 02. Secure to head using the earpieces
→ Between fingers, then 03. If required: fit face shield over the brow
→ Nails (using the soap in the palm), then 5. Gloves
→ Thumbs 01. Insert hands into the gloves
6. Rinse hands 02. Extend the gloves to cover the cuffs of your gown
7. Turn of taps (note: in the video, the elbows were used to close the → Keep gloves away from the face
faucet) → Avoid touching and adjusting other ppes
8. Dry your hands (note: in the video, paper towels were used) → Limit surfaces and items touched
→ When discarding paper towels, do not touch the trash bins → Remove gloves if torn
→ Always perform hand hygiene before putting on new gloves
III. PROPER REMOVAL OF GLOVES
1. With your gloved hand, completely remove the glove front the other B. DOFFING PPE
hand ● All PPE should be removed in sequence and discarded carefully
2. While still holding the removed glove, use your naked finger to ● Important since equipment is now contaminated
access the inside of the cuffs of the remaining glove (do not touch 1. Glove Removal
the outside part of the glove) 01. Grasp the outside edge of the glove at the inside of the wrist and
3. Pull the whole glove off, with the first removed glove inside the peel away turning the glove inside out
second one 02. Hold glove in the opposite (still) gloved hand
4. Discard the gloves. 03. Slip a finger under the wrist of the remaining glove
04. Peel of the glove, creating a “bag” for the two gloves
IV. DONNING AND DOFFING OF
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 05. Discard immediately

2. Gown Removal
01. Unfasten the ties, starting on the neck
02. Peel the gown in a forward and downward movement, away from
the neck and shoulder, turning it inside out
03. Fold and roll it into a bundle then discard
3. Perform Hand Hygiene
4. Eye Protection Removal
01. Handle eyewear by the ear pieces
02. Pull away from the face
03. Place into a designated receptacle for cleaning
→ Personally owned eyewear can be cleaned by the individual
5. Mask Removal
01. Handle mask only by the earloops, ties, or elastic straps
02. Bend forward and pull mask forward in a downward motion then
discard
6. Perform Hand Hygiene
→ Also perform hand hygiene whenever you suspect your hands are
contaminated during removal of PPE
V. REFERENCES
● PublicResourceORg. (2011, November 19). Safety elements in
medical laboratory practice. [Youtube Video]. Retrieved from
● Azita Racquel Gavino-Lacuna. (2020, September 12). Free hand
washing techniques video. [Youtube Video].
https://youtu.be/g8hrGoBPdcU
● Azita Racquel Gavino-Lacuna. (2020, September 12). PPE removing
gloves properly refre. [Youtube Video].
● Azita Racquel Gavino-Lacuna. (2020, September 14). PPE don doff
updated for 2013. [Youtube Video].

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