SHARPS SAFETY IN A

MILITARY SET UP

LEBANESE ARMY

HEALTHCARE SERVICES

BY

Captain Haytham FARHAT

&

Ms. Annie PARLAKIAN

JUNE 14, 2013

Sharp Injuries

1- In The Field (Capt. Haytham Farhat)

2- At The Hospital (Ms. Annie Parlakian)

Medics

COMBAT MEDIC

Trained for:

Combat Live Saver (CLS) - basic level.

Emergency Medical Technician (EMT).

Provides life saving care in field, at P.O.I, till casualty transferred to C.C.P.

SENIOR MEDIC

Trained for :

Advance Trauma Life Support (ATLS)

Combat Medical Advance Skill (CMAST)

Casualty care prior to Evacuation (C.C.P & Clearing Station):

Collection, Triage, Treatment /Stabilization, Evacuation.

Medics

Levels Of Medical Support F L O T))

Casualty Evacuation

Med Resupply

Triage - Evacuation

Point of Injury (POI)

TURNIQUET

BAG

BANDAGE COMPRESSED

GAUZE

NASOPHARYNGEAL AIRWAY

TAPE

GLOVES

First Aid Kit Level I

Casualty Collection Point (CCP) Level I

Casualty Evaluation Stop The Bleeding Handle Chest Traumas ( Wound Care, Use Of

14G Needle In Case Of Pneumothorax…) Free The Airways Install An IV Line Prepare The Injured To Transfer …

Casualty Collection Point (CCP) Level I

Clearing Station Advanced Medics

LEVEL II

COMBAT MEDICS KIT LEVEL II

Body Substance Isolation BSI

Use PPE

Evacuation To Level III

Field Hospital LEVEL III

Level III Central Military Hospital

Sharp Injuries At CMH

Presented By Annie Parlakian

Quick Overview

Capacity 93 Inpatients / 52 Outpatients

Occupancy Rate 95 %

670 Operations Average/Month

Waste Management

• Start Date With Arc En Ciel: April 2011

• Trainings & Audits Twice A Year

Incident Accident Reporting System

• Start Date May 2010 (First Edition)

20 Categories

• 2nd Edition On August 2011 (23 categories)

Incident /Accident 2013 (%) 1st Trimester

n= 69

Sharp Injuries 2010-2013

Sharp Injuries / Position (%) 2010-2013

n= 91

Sharp Injuries/Position % (2010-2013)

Sharp Injuries By Department (%)

2010-2012

n= 87

Cause Of Sharp Injuries

Cause Of Sharp Injuries (%) 2010-2013

n= 91

Cause Of Sharp Injuries 2010-2012

Estimated Preventability

Root Cause Analysis

• Workload

• New Recruits

• Nonchalance Of HCW

• New Students

• Physicians Leaving Sharp Devices On The Table

• Patient Agitation

• …

Known/Unknown Source

n= 91

In Case Of Injury

Projection sur les

muqueuses: oeil,nez....

Infraction cutanée:

coupure, piqûre....

A.E.S.

Rinçage abondant à

l'eau pendant au moins 5 minutes

Lavage (eau + savon)

Annonce au responsable direct et par la suite au GR

Consultation immédiate au

service des Urgences

Envoi d'une fiche d'incidents et accidents au

département de qualité

Source

identifiée OUISérologie du

malade source

NON

Suivi médical

Bilan sanguin de l'accidenté sera précisé

par le médecin de travail

Prevention

• Vaccination For HBV

• Respect of Universal Precautions

• Continuous Education & Audits

• Use Of Safety Devices & Equipment like Sharps Container, Gloves, Goggles…

Benchmarking With A Lebanese Hospital (Per 1000 Occupied Beds)

QIP 2013

Goal : Sharp Injuries Rate

Internal Medicine

OR

ER

ICU

Thank you