Glutaraldehyde Safety

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Glutaraldehyde Safety High Level Disinfection
of Flexible Endoscopes
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Endoscopes

• A flexible device used to visualize the interior
  of a hollow organ such as the GI tract,
  respiratory tract, urinary tract etc.
• Flexible endoscopes are considered semi-critical
  devices because they come into contact with mucus
  membranes but do not ordinarily enter sterile
  tissue or the vascular system. At a minimum,
  endoscopes are to be cleaned, decontaminated and
  high level disinfected prior to re-use.

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High Level Disinfection

• An EPA registered chemical agent with a label
  claim as a high level disinfectant/sterilant is
  used per the manufacturers instructions for
  appropriate concentration, submersion and contact
  time to kill all microorganisms except high
  numbers of bacterial spores or prions that cause
  CJD.

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Effects of Acute Exposure to Glutaraldehyde(Refer
to MSDS Sheets)

• Inhalation Low to mild irritant nose and
  throat irritation, nausea headaches
• Eye Contact Vapors irritating to eyes may
  cause eye damage on contact
• Skin Contact/Absorption Mild to moderate
  irritant.
• Ingestion Toxic. Irritation if consumed in
  small amounts Toxic effects similar to alcohol
  poisoning including CNS depression, nausea
  vomiting if consumed in large amounts

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Effects of Acute Exposure (Continued)

• Chronic Exposure repeated skin contact may
  cause dermatitis
• Sensitization to Product Limited evidence to
  support possible skin and respiratory
  sensitization
• NO reported evidence of carcinogenicity.
  Glutaraldehyde is metabolized in the body
  predominantly to carbon dioxide and is exhaled
  via the respiratory tract. There is little
  potential for accumulation of the product in the
  body.

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Personal Protective Equipment

• Face Shield OR Safety glasses with a general
  surgical mask to protect eyes mucus membranes
• Nitrile gloves with long cuffs
• Cover gowns waterproof to protect clothing from
  splashes
• Respirators may be used, but not required. Call
  Plant Operations to obtain. N-95 masks are ONLY
  used during endoscopic procedures on patients
  requiring airborne isolation. N-95 masks are not
  to be used while performing high level
  disinfection.

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Personal Protective Equipment Whats wrong
with this picture?
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Engineering Controls

• Room large enough to ensure adequate dilution of
  vapors
• 10 Air changes per hour
• Exhaust that pulls vapors away from the users
  breathing zone
• Fresh air entering at ceiling
• Routine maintenance of system
• OR ductless fume ventilation devices that contain
  filters to absorb glutaraldehyde vapors from the
  air

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Examples of Ductless Fume Ventilation Devices
that contain filters to absorb glutaraldehyde
vapors from the air
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Storage Requirements for Glutaraldehyde

• Keep containers tightly closed
• Store in a cool dry, well ventilated area (not
  under sinks!)
• Do not store with acids, alkalines or oxidizers
• Do not store with incompatible products
• Protect containers from damage
• Avoid skin eye contact (dont store the bottle
  above eye level)
• No food or drink in the area

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Management of Glutaraldehyde Spills or Leaks

• Stop discharge and contain spill
• Keep others at a safe distance
• Don PPE ASAP
• Absorb any product with an inert absorbent
• Call Operation of Plant to assist with large
  spills X 1793 (fix office)

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WASTE DISPOSAL

• Wastes must be disposed in accordance to local
  state regulations flush thoroughly with water
  into sewage disposal system.
• When disposing of large quantities of
  glutaraldehyde, use glut out
• Do not reuse empty container
• Rinse the container out and place it in general
  trash for disposal

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First Aid

• Skin wash skin with soap water
• Eyes Use emergency eyewash station to flush
  eyes for 15 min
• Inhalation move to fresh air
• After first aid is given, follow-up with Employee
  Health Services as needed or Emergency Care
  Center if after hours

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Questions?
Following Q A session Introduction of Barbara
Moore Sue Sylvain High Level Disinfection
Policy Procedure
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Manual Cleaning

• Meticulous manual cleaning of all instruments
  must precede exposure to any high-level
  disinfectant or sterilant. Inadequate cleaning
  of instruments has been one factor cited in
  transmission of infection by flexible endoscopes.
  
• Appropriate cleaning reduces the number of
  microorganisms by 99.9.
• Always follow the manufacturers guidelines for
  design features that are unique to a particular
  instrument. (place this in your manuals
  section 9)

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Questions?
Following Q A Session Linda McCormack to
discuss Outbreak Identification Investigation
Procedure Review Forms
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Competency Test Certificate of Attendance