1. Injection Safety Practices TOT Refresher Training of EPI Technicians Abbottabad -23 Feb 2012 Dr Bilal Ahmed Immunization Officer UNICEF

2. Statistics Vaccination12 billion/yrs 50% is unsafe practices 8-16 Million people got Hep-B 2.3 – 4.7 Million people suffered from Hep-C 80,000 – 0.16 Million effected by AIDS

3. Who are effected? Who are vaccinated Who give vaccination Community

4. Who are vaccinated Reuse of needle and syringe Use of new needle on old syringe Use of prepared BCG & Measles vaccines after 06 hrs Reuse of syringes and needles after cleaning with bactericidal drugs Repeated use of syringe Injection in buttocks in children Not adding diluent in proper quantity

5. Who give vaccination Wound due to Re-capping Injury due to keeping syringe and needle for long time Keeping syringe and needle in hand and entering in crowded places where children and mothers are present

6. Community Throwing used syringes and needles in open ground Selling used syringes and needles Repeated use of syringes and needles

7. Syringes in EPI Single used syringes and needles Standard Disposable Syringe Auto Disable Syringe or Auto Destruct Syringe Sizes of Syringes and Needles UseSyringe SizeNeedles Size For BCG0.05 ml26 G & 3/8 Inches/10 mm For Remaining vaccine 0.5 ml24 G & 3/4 Inches/23-25 mm For diluents2 ml/ 5 ml22 G/18 G

8. Parts of Syringes and Needles Syringes Adaptor Scale Plunger Seal Barrel Plunger top Needle Shaft Adaptor Bevel

9. Injection safety practices Use only a sterile packed disposable syringe for reconstitution of vaccine and AD syringe for administering vaccine Dont use the same disposable syringe for reconstituting multiple vaccine vial/ampoule One syringe for one vial/ampoule If the syringe pack is torn or expiry date is over, dont use the syringe Never touch the needle or rubber cap of the vaccine vial during reconstitution or drawing vaccine

10. Injection safety practices Drop the needle cap in the safety box immediately after taking it off the syringe DONT RECAPE A SYRINGE Drop the syringe needle end down in the safety box immediately after its use No need to cut the needle using a needle cutter Dont fill more than ¾ of a safety box

11. Safe waste disposal Safety box MUST be used for sharp waste disposal in each and every vaccination session Soon after use (reconstitution or vaccine administration) each and every syringe must be dropped in the safety box Contents of safety box never be taken out Safety box containing sharp waste must be kept out of reach of children When a safety box is filled up to ¾ of its volume, close its mouth and keep in a secured place till final disposal

13. Final disposal of waste Method: Incineration or pit burning & burry To be done in a health facility premises under responsible supervision Ensure the burning is complete A standard pit should be In a isolated place away from reach of children or animal Away from a building At least 4 feet deep and proportionately wide To be covered with thin layer of earth (1 – 2 inch) after each burning Waste burned & covered with earth in a disposal pit