9. infection control in dental radiology
TRANSCRIPT
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Infection Control in
Dental Radiology
Dr. Raghunath Puttaiah
& Dr. Hui Liang
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Introduction & Rationale
Most oral and maxillofacial radiologynormally consists of non-invasiveprocedures
Although exposure to blood is notcommon, contact with saliva doesoccur
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What are the risks?? Common viruses seen in the oral cavity
include cytomegalovirus, herpes simplex viruses-1 &
2, hepatitis-B and D viruses, hepatitis-C virus,influenza viruses, Epstein-Barr virus (infectiousmononucleosis), Rhinoviruses (common cold),and HIV
Common bacterial pathogens seen are Pseudomonas, Flavobacterium, Staphylococci,
Streptococci, Diplococci, Pneumococci,
Mycobacterium, Chlamydia, and Spirochetesfrom human or inanimate sources
Candidiasis is also very common amongdental patients
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Rationale Most of Oral and Maxillofacial radiology (OMR)
procedures fall mainly in the semicritical andnon-critical categories of Spaulding'sClassification of inanimate surfaces
BUT
Many contagious diseases such as
Infectious mononucleosis and hepatitis-B canpossibly be spread by simple contact withsaliva
Therefore, it is necessary for aseptic techniques
to reduce ambiguity within protocols The purpose of this module is to present the
most recent information regarding aseptictechniques in OMR.
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What PPE is needed
It is not usually necessary to wear PPE such asimpervious gowns, long sleeves, masks andprotective eyewear during routine OMRprocedures when no aerosols, droplets or spatterare generated
One may use gloves, gowns, masks andprotective eyewear while treating patients withgagging problems
While handling the processor and the chemicals,
use full PPE Stay out of the Radiation Hazard area (behind ashield)
Patients must be protected with a lead apron
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Disinfectants and Barriers
Barriered films should be used whenavailable
Between patients, frequently touchedareas must be
Barriered with plastic barriersOR
-Disinfected with an Intermediate level, HospitalDisinfectant using a Spray-Wipe-Spraytechnique
If barriers are used between patients,disinfection is only needed at thebeginning or end of the day
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Steps in Infection Control
Unit Dose
1. Pre-procedural mouthrinsefor patients
Make them rinse forabout 30 seconds to
reduce the microbesin the mouth
2. PPE-GlovesMasks
EyewearGown
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Steps in Infection Control
Prepackaged films with plastic barriers
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Unbarriered films
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Barriered Films
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Steps in Infection ControlSteps in Infection Control
1. Unit dose supplies and sterile equipment on to a clean bib/worksurface
2. Set up the films on to the positioning devices
3. Label cups as Exposed and Unexposed
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Use of Disinfectants and Barriers
Disinfect surfaces atthe beginning and endof each day, andbetween patients onlyif contaminated
Avoid sprayingelectrical switches,wipe with disinfectantmoistened paper towel
Apply surface coversto the yoke, tubehead, cone, controlunit, head rest, armrest, and any hand
held switches
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Aseptic Procedures Place the sanitized lead apron and collar on the
patient after seating the patient
Set the required mA, kVp and exposure time onthe control unit and reset as required
Use Foot Controlled Trigger Switch if possible
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Now Please expose theRadiograph
The whole purpose in dental radiology is to
Get the radiograph
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Inside a daylight loader
Place the cup withexposed films on
one side and theEmpty one on theotherPlace a clean bib ornapkin as a barrier
Dispense a pair ofgloves
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Daylight Loader with Films Inside
Be sure toclose the lid
before exposingthe films
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Donning Gloves inside the Loader
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Various layers inside the polysoft film cover
Polysoft cover
Radio-opaque metal foilon the rear of the film
Paper folder that securesthe film
Film
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Barriered FilmsProcessing Barriered Films
Exposed film
Wear glovesPeel the outer cover and dropthe film into the Exposed cup
This should be done chairside
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Step 1 Step 2
Step 4Step 3
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Bare hands with barriered filminside a daylight loader
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Bare hands to be used to handleexposed and peeled film
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Unbarriered Films
Step 1 Step 2
Step 4Step 3
N t thi i id d li ht
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Now try this inside a daylightloader
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Bare hands to be used to handleexposed and peeled film
Remove your gloves and then handle the film that hasbeen taken out of the Polysoft cover
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Clean up after loading films
Carefully hold the edge of the napkin or bib and fold it over the wasteYou need not wear gloves if you hold the non-contaminated corners
i i f h li h d
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Disinfect the Daylight Loaderonce or twice daily if barriers
are used
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Panoramic Radiography
In panoramic radiography,infection control proceduresare very simple
Patient needs to have a leadapron
No contact of film with
saliva
Only one barrier is needed
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Panoramic Radiography
Chin rest
Bite block Barriered positioning device
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Panoramic Radiography
Infection Control in Panoramicradiography is very simpleAll one needs is a barrier forthe bite block
Make sure the lead apron is onFilm loaded on to the cassetteStay outside of the activeradiation area
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Panoramic Radiography
This film does not come in contact with saliva
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Panoramic Radiography
Position the patient correctly
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Panoramic Radiography
Make the patient remove the barrier on the bite block
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Digital Radiography
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Digital Radiography
Sensor
Barrier or sleeve
Sensor being insertedinto barrier
Sensor Barriered
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Digital Radiography
1. Insert the barriered sensor in the film holder on the Rinn holder
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Digital Radiography
Slide this dooropen
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Digital Radiography
Peel open the barrier withouttouching the sensor
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Digital Radiography
Slide the sensor into thechamber for the computerto read the image
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Digital Radiography
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Digital Radiography
Image appears on the screen within seconds