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Test FAQ's Office Design & Management Cont
Frequently Asked Questions (FAQs) On Dental Infection Control - Office Design & Management Cont

 

Frequently Asked Questions for Office Design & Management Cont

Q
What items do you suggest be found in the dental office first aid kit?
QWould the use of fans in the operatory be of concern because of aerosols?
QWhat is the best type of barriers for laptops in the dental operatory?

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QWhat items do you suggest be found in the dental office first aid kit?
A
States may have laws that OSAP is not aware of and each dental office will have different needs with regards to first aid kits and the medical emergency kit (sometimes referred to as the doctor's emergency drug kit). However, OSAP can provide you with information that will direct you to the resources that will help answer your question.

Dental medical emergency experts indicate that one of the most commonly seen medical emergency in the dental office is fainting. "Smelling salts” is ammonia inhalants and are used in the management of simple fainting. Therefore, it should be included in the medical emergency kit. Most dental offices keep extra ammonia inhalants in each operatory.

The OSHA regulation concerning standard first aid kits is Standard 29 CFR 1910.151. OSHA only addresses the need to have a first aid kit to treat injured employees and does not address the medical emergency kit that would be utilized for patient medical emergencies. Therefore, the office may have two types of first aid kits, a basic first aid kit (e.g. bandages, non-adhering dressing/gauze pads, eye products; tape, roller bandage, ointments/burn treatment, analgesics, antiseptics, cold pack, scissors/tweezers, etc.) and a medical emergency kit (e.g. sterile syringes, tourniquets, airway devices, oxygen equipment, antihistamines, anticonvulsants, epinephrine, ammonia inhalants, antihypoglycemics, bronchodilator, etc.).

First, with regard to the basic first aid kit, the OSHA Standard states the following:

1910.151(b): In the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available.

OSHA does not require any specific contents, however the kit should contain supplies to treat minor injuries. The selection of first aid supplies should be made by consulting a healthcare professional or by a person who is competent and knowledgeable of the workplace environment hazards. OSHA, however, does recommend the ANSI requirements for the basic first aid kit. All First Aid Kit Company industrial first aid kits meet or exceed Federal OSHA standards.

The size of the kit and the contents should be based on the number of employees and the types of injuries that would occur in the dental office. An example of the minimal contents of a generic first aid kit is described in the American National Standard (ANSI) Z308.1-1998. The contents of the kit would be adequate for small worksites (A basic fill has eight basic minimum required items: absorbent compress; adhesive bandages; adhesive tape; antiseptic; burn treatment; medical exam gloves; sterile pad; and triangular bandage). Any first aid kit that is labeled ANSI Z308 must contain these minimum required items and meet all other applicable requirements.

OSHA does not make the ANSI first aid kit requirement mandatory, however, many States have adopted ANSI standards as their State requirements.

If employees are trained, and would be called upon to perform CPR, the employer must provide a means to safely do so (e.g. one-way valve pocket mask/ventilation devices). In addition, if it is reasonably anticipated that employees will be exposed to blood or other potentially infectious materials while using first aid supplies, employers are required to provide appropriate personal protective equipment (e.g. medical exam gloves, eye protection, etc.).

To view OSHA's Standard and Interpretations for 29 CFR 1910.151 to go:

http://www.osha.gov/pls/oshaweb/owasrch.search_form?p_doc_type=INTERPRETATIONS&p_toc_level=3&p_keyvalue=1910.151&p_text_version=FALSE&p_status=CURRENT

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=24118&p_text_version=FALSE

Regulations (Standards - 29 CFR) Appendix A to § 1910.151 -- First aid kits (Non-Mandatory) - 1910.151 App A

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9807&p_text_version=FALSE

Further information concerning ANSI requirements and first aid products/information may be found at:

http://www.first-aid-product.com/pgOSHA&ANSI.htm

http://www.safetysourceinc.com/html/updates.html

Second, with regard to medical emergency kits, many State Boards of Dental Examiners/Licensing Boards have lists of emergency drugs and equipment that are required for dentists to obtain. Therefore, OSAP is referring you to your State Board of Dental Examiners and the American Dental Association Council on Scientific Affairs. The JADA Association Report, March 2002, addresses Office Emergencies and Emergency Kits. It is an excellent report that will answer all of your questions concerning medical emergency kit requirements. This report may be found at:

http://www.ada.org/prof/resources/pubs/jada/reports/report_emergency.pdf

To make sure you are compliant with State Laws, contact your State Board of Dental Examiners for further assistance. Your State and local dental society may also have additional information that would be helpful to you.

Listing of all State Boards: http://www.ms-flossy.com/boards.html

The American Dental Association has posted a directory for local and state organization on their website at:

http://www.ada.org/ada/organizations/index.asp


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Q
Would the use of fans in the operatory be of concern because of aerosols?
AOSAP is unaware of any literature concerning fans in an operatory. An extensive search failed to locate any such literature. Dental infection control expert Dr. Shannon Mills, Retired COL. United States Air Force, is also unaware of any literature on the use of fans in the operatory. However, he does believe the use of fans could theoretically spread aerosols or small droplets. On this empiric basis, he has discouraged the use of fans in dental clinics that he has managed.

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QWhat is the best type of barriers for laptops in the dental operatory?
AThe same barriers used to cover the dental unit and equipment (e.g. operator's cart, dental assistant's cart, x-ray tube head, etc.) may be used to cover the computer. Barriers can be made of different materials but they must all be fluid proof. Plastic is currently the most widely used barrier.

Dental infection control experts recommend using barrier protection to cover equipment, especially sensitive equipment such as computer keyboards and difficult-to-clean surfaces. Reminder, barriers must be changed between patients and surfaces must be cleaned and disinfected should the barrier be compromised.

In addition, the computer/equipment manufacturer should be consulted prior to cleaning and disinfecting with chemical agents. The equipment warranty may be void if chemicals not approved by the manufacturer are used on their product.

The Centers for Disease Control and Prevention's Infection Control Guidelines for Dental Healthcare Settings (December 2003) states the following:

Barrier protection of surfaces and equipment can prevent contamination of clinical contact surfaces, but is particularly effective for those that are difficult to clean. Barriers include clear plastic wrap, bags, sheets, tubing, and plastic-backed paper or other materials impervious to moisture. Because such coverings can become contaminated, they should be removed and discarded between patients, while DHCP are still gloved. After removing the barrier, examine the surface to make sure it did not become soiled inadvertently. The surface needs to be cleaned and disinfected only if contamination is evident. Otherwise, after removing gloves and performing hand hygiene, DHCP should place clean barriers on these surfaces before the next patient.

Additional information concerning computer keyboards may be viewed at:

The North Carolina Statewide Program for Infection Control and Epidemiology (SPICE) provides information on disinfecting computer keyboards in their current monthly report. The information may be viewed at:

http://www.unc.edu/depts/spice/report.html

The Journal of the American Medical Informatics Association also provides information concerning computer keyboards at:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=346637

Resource:

1) CDC's Infection Control Guidelines for Dental Healthcare Settings (December 2003):

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm

What is the best type of barriers for laptops in the dental operatory?

It should also be noted that there may be State Public Health Regulations that prohibit the use of fans in patient treatment rooms, the dental operatory, or open bay clinics. Therefore, you should contact your State Public Health Department/Agency for possible public health regulations concerning this issue.

In addition, states that operate their own OSHA plan must enforce the Federal Standards but they can also exceed those Standards. Therefore, if the dental practice is located in a state with a state operated OSHA plan, contact the state OSHA office for guidance on this issue.

Links to OSHA state operated plans are available at: http://www.osha.gov


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