Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Organizing the District Hospital Surgical Service
Organizational and management of the district surgical service
The District Hospital
Leadership, team skills and management
Record Keeping
Disaster and trauma planning
The surgical domain: creating the envioronment for surgery
Infection control and asepsis
Operating room
Cleaning, sterilization and disinfection
Waste disposal
Waste Disposal

All biological waste must be carefully stored and disposed of safely. Contaminated materials such as blood bags, dirty dressings and disposable needles are also potentially hazardous and must be treated accordingly. If biological waste and contaminated materials are not disposed of properly, staff and members of the community could be exposed to infectious material and become infected. It is essential for the hospital to have protocols for dealing with biological waste and contaminated materials. All staff must be familiar with them and follow them.

The disposal of biohazardous materials is time consuming and expensive, so it is important to separate non-contaminated material such as waste paper, packaging and non-sterile but not biologically contaminated materials. Make separate disposal containers available where waste is created so that staff can sort the waste as it is being discarded. Organize things in a way to discourage the need for people to be in contact with contaminated waste.

All infected waste should then be disposed of by incineration. Incinerators must be operated in accordance with local regulations and the approval of the public health department.

Incineration is the ideal method for the final disposal of waste but, if this is not possible, other suitable methods must be used. These should also be regulated and approved by the public health department.

Burying waste is the only option in some areas. If this is the case, you should do as much as possible before burying it to minimize the risk of infection. Small amounts of infected waste should be soaked in a hypochlorite solution for at least 12 hours, put into a pit and then covered. Larger quantities should be put into a pit with a final concentration of 10% sodium hypochlorite, before covering immediately.

Do not mix waste chemicals, unless you are certain that a chemical reaction will not take place. This is essential to prevent any unwanted or even dangerous reactions occurring between the chemicals, which could endanger laboratory staff. Always follow local guidelines on the disposal of waste chemicals to ensure that chemical contamination of the surrounding land or water supply does not occur.

Provide a safe system for getting rid of disposable items such as scalpel blades or needles. The risk of injury with sharp objects increases with the distance they are carried and the amount they are manipulated. A container for the safe disposal of sharp objects should be:

:: Well labelled
:: Puncture proof
:: Watertight
:: Break resistant (a glass container could break and provide a serious hazard to the person cleaning up the mess)
:: Opening large enough to pass needles and scalpel blades, but never large enough for someone to reach into
:: Secured to a surface, such as a wall or counter, to ensure stability during use
:: Removable for disposal.

These containers must then be disposed of safely.

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