Page updated 9 October 2006
Managing Blood or Body Fluid Spillages on Surfaces
- Wear disposable gloves (use masks and plastic aprons if using hypochlorite, and use eye protection visor/ goggles if splashing is likely)
- Wipe area with a disposable alcohol wipe or alternatively if the surface is non-porous and compatible with hypochlorite use a paper towel soaked in diluted hypochlorite (1:100 dilution household bleach)
- If you have used hypochlorite, then rinse off with clean water to avoid corrosion or bleaching of the surface
- Clean area with water and detergent
- Dry the surface with disposable paper towels
- Discard gloves alcohol wipe, paper towels as hazardous infectious waste
- Remove gloves and clean hands immediately
- Remove protective clothing and dispose of as hazardous infectious waste
- Wear disposable gloves, masks and plastic apron (and use eye protection visor/ goggles if splashing is likely)
- Cover spill completely with the granules and wait for the fluid to absorb.
- Leave for 5 minutes.
- Collect granules using disposable paper towels and/or cardboard. Discard as hazardous infectious waste
- Clean area with disposable towels using a fresh hypochlorite solution (1 in 100 dilution) and rinse with clean water as the hypochlorite solution may be corrosive
- Dry the surface with disposable paper towels
- Dispose of towels as hazardous infectious waste
- Remove gloves and immediately clean hands thoroughly
- Remove protective clothing and dispose of as hazardous infectious waste
- Wear disposable gloves, masks and plastic apron (and use eye protection visor/ goggles if splashing is likely)
- Cover area with disposable towels to limit spread and absorb the liquid
- Pour on freshly prepared hypochlorite solution (1 in 10 dilution household bleach) or prepare solution in accordance with manufacturers instructions. For Haz tabs, dissolve one tablet in 250ml of water to give 10,000 ppm available chlorine or 4 tablets in 1 litre and apply to spill.
- Wait for spill to absorb
- Discard towels as hazardous infectious waste
- Clean area with disposable paper towels using chlorine solution of 10,000 ppm (or freshly prepared 1 in 100 dilution of household bleach) and rinse with clean water as the hypochlorite solution may be corrosive
- Dry the surface with disposable paper towels
- Dispose of towels as hazardous infectious waste
- Remove gloves and immediately clean hands thoroughly
- Remove protective clothing and dispose of as hazardous infectious waste
- If the patient sucks or closes their lips around the saliva ejector. Pressure in the patient's mouth is less than that in the saliva ejector and a partial vacuum is formed resulting in the back flow of previously aspirated fluids.
- When a reversal of pressure is created as the suction tubing is elevated above the patient's mouth. Care should be taken to ensure that the suction tip and line are held below the patients mouth at all times so that gravity enhances the removal of oral fluids.
- When the high volume suction is switched on in other parts of the suction system either in the same or adjacent surgeries.
Blood and body fluid spillages must be dealt with immediately. The size of the spill (spot, small (<30ml) or large spill) will determine the management. The majority of blood and body fluid spills in the dental surgery are likely to be spots and splashes. NaDCC granules or a liquid solution of hypochlorite at 10,000 ppm (1%) should be used for small and large spills respectively. Disposable gloves, masks and plastic aprons should be worn (use eye protection visor/ goggles if splashing is likely). Vomiting may be due to a viral infection, so vomit should be covered immediately with paper towel to prevent aerosolisation and spread of virus particles. If there is a large amount of vomit, debulk it first by removing with disposable papers towels before applying the hypochlorite solution otherwise the action of the disinfectant is likely to be overwhelmed by the volume of organic material and may fail to penetrate the entire depth of the spill.
Splashes and spots
Small spills (<30ml, Then the use of NaDCC hypochlorite granules (e.g. Haz-tabs granules, Precept) is recommended, if unavailable follow procedure for large spills outlined below:
Large spills (>30ml) Using hypochlorite solution (e.g. Milton , Haz tabs, or 1 in 10 dilution of household bleach):
Use of Saliva ejectors and compressors
Saliva ejectors
Saliva ejectors (high speed, low volume aspirators) are prone to back flow during use and the contents could potentially be expelled into the patient's mouth. Oral and waterline bacteria, blood borne viruses, buccal cells, saliva, and blood have all been recovered from suction lines.
Back flow can happen under the following circumstances:
Fortunately, to date there are no documented cases of infection that have been directly linked to back flow from saliva ejectors. However, members of the dental team should be made aware of the small but potential risk of cross infection associated with saliva ejectors if they not handled correctly.
Compressors
Compressed air is used to operate dental chairs, airturbine handpieces, ultrasonic scalers and other equipment in the dental surgery. Oil lubricated compressors which are the commonest type used in dental practices are prone to colonisation with fungi and pathogenic bacteria such as E. coli (normally found in the human gut and natural waters). Unless precautions are taken a small quantity of the lubricating oil, water and bacteria escapes through the oil filters and into the airlines and ultimately into the patient's mouth and the surgery environment. Oil contamination of the compressed air compromises the performance of airturbines reducing their longevity and interferes with resin bonding of composite restorations. Dental air needs to be clean and dry. The dryer system should be capable of producing air with a dew point not less than minus 20 o C. You can minimise the risk of microbial contamination, by installing a bacterial filter in addition to a dryer and dust filter. Regularly check the dryness of the dental air supplied to the bacterial filter, as microorganisms can penetrate a bacterial filter if the material becomes wet. You will need to test the quality of the air each year in accordance with manufacturer's instructions. Further information on the requirements and standards for dental air quality are described in HTM 2022 available at www.dh.gov.uk
Compressors are covered under The Pressure Systems Safety Regulations 2000 (PSSR ) (see section 3). Before a compressor can be used a "competent person" must draw up a written scheme for periodic examination of the compressor, which outlines the frequency and the nature of the examination. Records must be kept to show that examinations have been carried out and that the examination scheme is reviewed regularly as the equipment ages and is kept up to date. This requirement is separate from servicing and performance testing.
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