Pehea e hana ai me ka ʻeha lāʻau nila ma ka hana

Inā ʻoe e hou a hou i kou ʻili me ka nila i hoʻohana ʻia, e hahai koke i kēia ʻōlelo aʻoaʻo kōkua mua:

paipai i ka ʻeha e kahe ke koko, ʻoi aku ka maikaʻi ma ka hoʻopaʻa ʻana i lalo o ka wai kahe
holoi i ka ʻeha me ka wai kahe a me ke kopa he nui
mai holoi i ka ʻeha i kou holoi ʻana
mai omo i ka eha
e hoʻomaloʻo i ka ʻeha a uhi ʻia me ka pulupulu wai a i ʻole ka lole

Pono ʻoe e ʻimi i ka ʻōlelo aʻoaʻo lapaʻau koʻikoʻi no ka mea pono ʻoe i ka lāʻau lapaʻau e hōʻemi i ka pilikia o ka loaʻa ʻana o kahi maʻi:

e hoʻokaʻaʻike aku i ka lawelawe Ola Ola a kāu mea hana inā e hōʻeha ʻoe iā ʻoe iho ma ka hana
a i ʻole, e kelepona i kāu GP, NHS 111 a i ʻole e hele i ke keʻena ulia pōpilikia kokoke loa (A&E).

Nā ʻeha lāʻau nila

ʻO nā ʻeha mai nā nila i hoʻohana ʻia i nā kaʻina hana lapaʻau i kekahi manawa i kapa ʻia ʻo ka lāʻau nila a i ʻole nā ʻeha ʻoi. Hiki i nā ʻoi ke hoʻokomo i nā lako lapaʻau ʻē aʻe, e like me nā syringes, scalpels a me nā lancets, a me ke aniani mai nā mea hana naha. Ke hoʻohana kekahi i ka nila, hiki ke hoʻohaumia i nā maʻi maʻi i loko o ko lākou koko, e like me ka maʻi hepa B, ka maʻi hepa C a i ʻole HIV. Loaʻa kēia i nā nila i hoʻohana ʻia e hoʻokomo i nā lāʻau lapaʻau. Hiki i ke koko ke hoʻohaumia i ka ʻoi.

Ke loiloi i kou ʻeha

Na ke kauka lapaʻau e mālama iā ʻoe e loiloi i nā pilikia i kou olakino a nīnau e pili ana i kou ʻeha – no ka laʻana, pehea a i ka wā i hana ʻia ai, a i ʻole ka mea nāna i hoʻohana i ka nila. Pono e ho’āʻo ʻia nā laʻana o kou koko no ka maʻi hepa B a me C a i ʻole HIV. ʻOiai kakaʻikahi, aia kekahi pilikia liʻiliʻi o nā maʻi ʻē aʻe i lawe ʻia e ke koko i hoʻohaumia ʻia, e like me ka cytomegalovirus (CMV) a me ka maʻi Epstein-Barr, ka mea e hoʻoulu ai i ka maʻi glandular. Hiki i kāu kauka mālama ola ke hoʻonohonoho e hoʻāʻo i nā laʻana o ke koko o kekahi inā hāʻawi lākou i kā lākou ʻae.

Makemake au i kahi lapaʻau?

Inā manaʻo kāu ʻoihana mālama ola he haʻahaʻa ʻoe i ka maʻi, ʻaʻole pono ʻoe i kahi lapaʻau. Inā nui aʻe ka pilikia o ka maʻi, pono paha ʻoe:

ka lāʻau antibiotic – no ka laʻana, inā loaʻa iā ʻoe ka cellulitis (ka maʻi o ka ʻili)
ka pale ʻana i ka maʻi hepatitis B
lapaʻau e pale ai i ka maʻi HIV

Inā nui ka pilikia o ka maʻi HIV, hiki i kāu kauka mālama ola ke noʻonoʻo i ka lāʻau i kapa ʻia ʻo post-exposure prophylaxis (PEP).

Loaʻa i ke kākoʻo

Hiki i kāu kauka mālama ola ke ʻōlelo aku e loaʻa iā ʻoe:

kākoʻo mai ka lawelawe olakino ʻoihana o kāu mea hana – hiki iā lākou ke aʻo e pili ana i ka hoʻomaha maʻi
kākoʻo noʻonoʻo – e like me ka ʻōlelo aʻoaʻo e kōkua i ke koʻikoʻi o ka ʻeha

Inā hōʻeha ʻoe iā ʻoe iho me kahi nila i hoʻohana ʻia ma ka hana, e hōʻike koke i ka hanana i kāu luna a luna paha. E heluhelu i nā pane i nā nīnau hou aʻe e pili ana i nā pōʻino, ke kōkua mua a me nā lāʻau lapaʻau.

Hou kamailio

Pehea wau e hoʻolei aku ai i nā nila i hoʻohana ʻia a i ʻole ka ʻoi?
Hepatitis B
ʻO ka maʻi hepa C
HIV a me AIDS
ʻOihana Ola a me ka Maluhia: nā ʻeha ʻoi

ʻAoʻao i nānā hope ʻia: 8 Iulai 2021 Manaʻo
ʻia ka loiloi aʻe: 8 Iulai 2024

Nā ʻeha ʻoi

ʻIkepili

He aha kāu e ʻike ai
He aha kāu e hana ai
ʻO ka hoʻomaka ʻana o ka nānā ʻana
Ka hope i ka EU Directive
Nā Kūlana Ola a me ka Palekana (Sharp Instruments in Healthcare) Regulations 2013
Hou kamailio

ʻO nāʻehaʻeha he mea weliweli kaulana ia ma kaʻoihana olakino a mālama kaiaulu. Hiki ke ho’ouna ‘ia nā ma’i he 20 a ‘oi aku ka ma’i hepa B, C a me ka ma’i ma’i ma’i (HIV). Ma muli o kēia pilikia o ka hoʻouna ʻana, hiki i nā ʻeha ʻoi ke hoʻoulu i ka hopohopo a me ke koʻikoʻi i nā tausani he nui i loaʻa iā lākou.

He aha kāu e ʻike ai

He aha ka ʻoi?

ʻO ‘Sharps’ nā nila, nā lau (e like me ka scalpels) a me nā mea lapaʻau ʻē aʻe e pono ai no ka hoʻokō ʻana i nā hana mālama ola a hiki ke hōʻeha i ka ʻoki ʻana a i ʻole ke ʻoki ʻana i ka ʻili.

He aha ka ʻeha ʻoi?

ʻO ka ʻeha ʻoi ka mea e komo ai ka nila, ka maka (e like me ka scalpel) a i ʻole nā mea lāʻau lapaʻau ʻē aʻe e komo i loko o ka ʻili. Kapa ʻia kēia i kekahi manawa he ʻeha percutaneous.

He aha kāu e hana ai inā loaʻa iā ʻoe kahi ʻeha ʻoi

Inā loaʻa ʻoe i kahi ʻeha mai kahi ʻoi i hoʻohaumia ʻia:

E paipai i ka ʻeha e kahe mālie, e paʻa pono i lalo o ka wai kahe
Holoi i ka ʻeha me ka wai kahe a me ke kopa he nui
Mai holoi i ka ʻeha i kou holoi ʻana
Mai omo i ka eha
E hoʻomaloʻo i ka ʻeha a uhi ʻia me ka pulupulu wai ʻole
E ʻimi i nā ʻōlelo aʻoaʻo olakino koʻikoʻi (no ka laʻana mai kāu lawelawe olakino ʻoihana) no ka mea e loaʻa ana ka prophylaxis maikaʻi (nā lāʻau e kōkua i ke kaua ʻana i ka maʻi)
E hōʻike i ka ʻeha i kāu mea hana.

He aha ka pilikia?

ʻO ka pilikia nui mai ka hōʻeha ʻoi aku ka hiki ke loaʻa i nā maʻi e like me nā maʻi maʻi koko (BBV). Hiki i kēia ke hana ma kahi o ka ʻeha i hoʻopaʻa ʻia i ke koko a i ʻole ka wai kino mai ka mea maʻi. ʻO nā maʻi maʻi koko i hopohopo nui ʻia:

Hepatitis B (HBV)
Hepatitis C (HCV)
ʻO ka maʻi hoʻopalekana kanaka (HIV).

ʻO ka hoʻoili ʻia ʻana o ka maʻi ma muli o nā kumu he nui, ʻo ia hoʻi ka ʻōnaehana kūlohelohe maoli o ke kanaka. Ua ʻike mākou he kiʻekiʻe ka helu o nā ʻeha i kēlā me kēia makahiki, akā he helu liʻiliʻi wale nō ka mea i ʻike ʻia i hoʻokumu ʻia i nā maʻi i alakaʻi i ka maʻi koʻikoʻi. Eia naʻe, hiki i nā hopena o ka hōʻeha a me ka hopohopo e pili ana i nā hopena kūpono, me nā hopena ʻino o ka prophylaxis post-exposure hiki ke loaʻa i kahi hopena pilikino nui i kahi limahana i ʻeha.

ʻO wai ka pilikia?

Pilikia nā limahana a me nā mea ʻē aʻe i ke olakino a me ka mālama ola. Hoʻopili kēia i ka poʻe e lawelawe pololei ana i ka ʻoi akā ua komo pū kekahi poʻe limahana i hiki ke hoʻopilikia ʻia me ka ʻike ʻole ke mālama ʻole ʻia a hoʻolei ʻia paha nā ʻoi. ʻOi aku ka nui o ka pilikia o ka maʻi mai kahi ʻeha ʻoi e pili ana i nā nila hollow-bore. ʻO nā kaʻina hana koʻikoʻi e pili ana i ka cannulation intra-vascular, venepuncture a me nā injections a me ka hoʻohana ʻana i nā cannulae IV, nā ʻēheu kila-butterfly-needles, nā nila a me nā syringes a me nā nila phlebotomy.

Ka olelo a ke kanawai

Pili ke kānāwai olakino a palekana i nā pōʻino mai nā ʻeha ʻoi, e like me nā pilikia ʻē aʻe mai nā hana hana. Aia nā kānāwai pili i:

ʻO ke olakino a me ka palekana ma ka hana a me ke kānāwai 1974.
Ka hoomalu ana i na mea pili i ke ola kino (COSHH) 2002
Hooponopono i na Kanawai Ola 1999
Hōʻike ʻana i nā ʻeha, nā maʻi a me nā hana ʻino 2013 (RIDDOR)

Nā Kūlana Ola a me ka Palekana (Sharp Instruments in Healthcare) Regulations 2013

ʻO kēia mau Regulations (PDF) — Portable Document Format e hoʻokō i ka EU Council Directive 2010/32/EU no ka pale ʻana i nā ʻeha ʻoi i ka haukapila a me ka ʻoihana mālama ola. Hoʻopili wale nā lula i nā mea hana, nā ʻaelike a me nā limahana ma ka ʻoihana mālama ola. ʻO NHS Trusts / Boards, nā ʻoihana mālama ola kūʻokoʻa a me nā mea hana ʻē aʻe nona ka hana nui i ka hoʻokele, hoʻonohonoho a me ka hoʻolako ʻana i ka mālama olakino e kau ʻia ma lalo o ka ‘Sharps Regulations’. Ua hoʻopuka ʻo HSE i ka Pepa ʻIke ʻOihana Ola 7 — Nā Kūlana Ola a me ka palekana (Sharps Instruments in Healthcare) Regulations 2013 e hāʻawi i ke alakaʻi i ke ʻano o ka mālama ʻana i nā Regulations. Hoʻopili ka Research Report RR1127 i ka hana i hana ʻia ma ka loiloi post-implementation (PIR), me nā nīnauele, nā hui kikoʻī a me nā noiʻi pūnaewele ma waena o nā limahana mālama olakino, nā luna a me nā limahana.

Alakaʻi pale

ʻO nā lāʻau nila kekahi o nā hōʻeha uku maʻamau o ka limahana i loaʻa i loko o kahi hui mālama ola. ʻO ka mea pōmaikaʻi, hiki ke pale ʻia kēia mau ʻano ʻeha me nā hana palekana i kahi hana. Pono nā hui mālama ola e hoʻopaʻa i nā mana, hiki ke kōkua i ka pale ʻana i nā ʻeha lāʻau nila. Hiki i nā mana ke hoʻokomo i nā palekana kaiapuni a me nā kulekele a me nā kaʻina hana, i kau ʻia e pale aku iā ʻoe a me kāu mau limahana. No ka pale ʻana i nā lāʻau nila, aia kēia mau mana:

Hāʻawi i nā ipu hoʻolei ʻoi maʻalahi me nā laina piha i kaha ʻia
Hāʻawi i nā limahana mālama ola me ka nila palekana a me nā mea koi e hāʻawi i ka pale ma o ka sheathing a i ʻole nā hana hoʻihoʻi nila
Ka mālama ʻana a me ka hoʻonaʻauao ʻana i nā limahana e pili ana i ka hoʻolālā ʻana o nā hui e hōʻike ana i nā hoʻolālā palekana e hōʻemi maikaʻi i nā pōʻino.

ʻO ka hapa nui o nā ʻeha lāʻau nila ke loaʻa ke (1) i ka hala ʻana a i ʻole ka hoʻolei ʻana i kahi nila, (2) hoʻomaʻemaʻe ma hope o ka hoʻohana ʻana i ka nila, a (3) pani pono ʻole i kahi pāpale palekana nila. No ke kōkua ʻana i ka pale ʻana i kekahi o kēia mau hihia kikoʻī, pono nā hui e hoʻokō i kēia mau hana:

E hoʻololi mau i ka pahu hoʻolei ʻoi i ka wā e hiki ai ke laina piha e pale ai i ka ʻeha i ka wā e hoʻolei ana i nā nila i hoʻohana ʻia.
E noʻonoʻo i kēlā me kēia manawa i nā ʻano hana kūpono (e laʻa, kau ma kahi pā ma kahi o ka hāʻawi pololei ʻana a ʻōlelo ʻia ʻaʻole e hoʻihoʻi hou) me nā limahana mālama ola.
E hōʻoia i ka ʻike pono ʻia o nā nila i hoʻohana ʻia ma mua o ka hoʻomaʻemaʻe ʻana (e laʻa, mai uhi ʻia me ka ʻiʻo, gauze, etc.)

Alakaʻi ma hope o ka ʻeha

Inā loaʻa kahi lāʻau nila, aia nā ʻanuʻu āu e hana ai e hōʻemi i ka hōʻeha.

No nā limahana i ʻeha:

Lapaʻau: ʻO ka mua, e mālama i ka ʻeha ʻoi ma ka holoi koke ʻana i ka ʻoki a i ʻole ke ʻoki ʻana me ke kopa a me ka wai. (E hoʻomanaʻo: inā loaʻa ka ʻike ma ka paʻi ʻana i ka ihu, ka waha, ka ʻili, a i ʻole nā maka, e holoi koke a hoʻoinu me ka wai maʻemaʻe a i ʻole ka paʻakai).
Hōʻike: ʻO ka lua, e hōʻike i ka hanana i kāu luna.

No nā luna hoʻomalu:

Lapaʻau: ʻO ka mua, e noʻonoʻo i ka loaʻa ʻana o ka maʻi (e laʻa i ka HIV, HBV, a i ʻole HCV) a inā pono kekahi lāʻau lapaʻau hou aʻe, e like me nā prophylactic post-exposure.
Ho’āʻo: ʻO ka lua, e hana i ka hoʻāʻo ʻana ma hope o ka ʻike ʻana i ke kanaka kumu (inā ʻaʻole ʻike ʻia ke kūlana) a me ka limahana i ʻike ʻia me ka HIV wikiwiki, HCV Ab, a me HBV surface antigen inā ʻaʻole i hoʻopaʻa ʻia.
Hōʻike: ʻO ke kolu, e hoʻopaʻa i nā ʻeha lāʻau nila e pili ana i ka hana e pili ana i nā mea maʻi maʻi i loko o kāu log hōʻeha ʻoi (a i ʻole OSHA 300 Log for Hospitals). Inā ʻike ʻia ka mea hana i hōʻike ʻia he maʻi maʻi maʻi, e hoʻohou i ka lāʻau hōʻeha ʻoi a hoʻokaʻawale iā ia ma ke ʻano he maʻi. (E hoʻomanaʻo: inā ʻike ʻia kahi limahana ma o ka splash, i hoʻohālikelike ʻia me kahi ʻōpala, e hōʻike ʻo “maʻi wale nō” inā loaʻa ka maʻi maʻi maʻi). Pono e hōʻike ʻia nā ʻeha lāʻau nila i ka mea lawe uku uku o kāu hui.
E ho’āʻo hou: ʻO ka hope, e hahai me ka hoʻāʻo HIV ma 6-wiki, 3-mahina, a me 6-mahina inā he maikaʻi ke kanaka kumu. No ka HCV, e hana i kahi ho’āʻo HCV RNA i loko o 1-2 pule ma hope o ka ʻike ʻana. Inā maikaʻi nā hopena no ka maʻi maʻi, e nānā i kahi loea no ka mālama ʻana

Inā loaʻa i kāu hui ka uku uku o nā limahana me MagMutual e ʻoluʻolu e kelepona i kāu ʻelele a i ʻole leka uila [email protected] e hōʻike i nā koi uku uku o kāu hui. Nā kumuwaiwai hou aʻe:

Ke kikowaena o ka maʻi hoʻopaʻa i ka maʻi – ʻike ʻo Emergency Sharps
OSHA – Nā koi hōʻike ʻo Needlestick

06/21 Hoʻolele ʻO ka ʻike i hāʻawi ʻia ma kēia punawai ʻaʻole ia he ʻōlelo aʻoaʻo kānāwai,
lāʻau lapaʻau a i ʻole kekahi ʻōlelo aʻoaʻo ʻoihana ʻē aʻe, ʻaʻole hoʻi e hoʻokumu i kahi kūlana
mālama. Ua hana ʻia kēia kumuwaiwai i mea kōkua iā ʻoe i kāu hana.
ʻO ka hoʻoholo hope loa e pili ana i ka hoʻohana ʻana i ka ʻike i hāʻawi
ʻia iā ʻoe wale nō, ka PolicyOwner.

Mea pili

Pono e hoʻopaʻa ʻia nā luna mālama halemai?
Ka Papa Hoʻopiʻi Kāohi a me ka Papa Hana Hoʻopiʻi Hoʻomāinoino
Hoʻomākaukau, pane a me ka hoʻihoʻi ʻana i ka Hurricane no nā hana mālama ola kino
Nā Hana a me nā Hana o nā Kokua Lapaʻau a me nā kahu hānai Laikini
Ka mālama ʻana i nā pilikia kānāwai a me nā hoʻoponopono o nā kauka Locum Tenens

5 Nā ʻanuʻu e hana ai ma muli o kahi lāʻau kui a pehea e pale ai i kahi ʻeha ma kahi hana Kākau ʻia e Anne Carrie Wahi a The Centers for Disease Control and Prevention (CDC), aia ma kahi o 385,000 mau ʻeha e pili ana i nā koi e kū nei i kēlā me kēia makahiki ma ka ʻoihana mālama olakino US, ʻo ia ka awelika o 1,000 i kēlā me kēia lā. ʻO ka ʻeha ʻoi loa ke komo ʻana i ka ʻeha hou mai ka nila, ka scalpel, a i ʻole kekahi mea ʻoi aku ka hopena i ke koko a i ʻole ka wai kino. ʻOi aku
ma mua o 20 mau pathogens i lawe ʻia i ke koko i hōʻike ʻia mai kēia mau ʻano
ʻeha. Hiki i kekahi ke alakaʻi i nā maʻi koʻikoʻi a make e like me ka maʻi hepa B, ka maʻi hepa
C, a i ʻole ka maʻi maʻi immunodeficiency kanaka (HIV). ʻO ka ʻoiaʻiʻo, ma kahi o 2 pakeneka o nā hōʻeha needlestick
e hoʻohaumia ʻia me (HIV). ʻO ka hapa nui o nā
ʻeha pili i ka ʻoi e pili ana i nā kahu hānai, nā kauka, nā limahana limahana, a me nā
limahana mālama ola ʻē aʻe. He hopena maʻamau ia o ka luhi, ka hoʻohana ʻana i nā
kaʻina hana kūpono ʻole, nā lako pilikia, nā ʻike limahana liʻiliʻi, a me nā kūlana hana
koʻikoʻi i kahi kaiapuni wikiwiki. Hiki ke hōʻeha i ka wā e hoʻolei aku ai nā limahana
i nā nila, hōʻiliʻili i nā mea i hoʻohana ʻia i nā kaʻina hana lapaʻau, huki koko, a
lawelawe paha i ka ʻōpala a i ʻole nā lole lepo lepo. ʻO ke
kumukūʻai o ka lāʻau lapaʻau a me ka hana ʻana mai nā ʻeha pili i nā koi i
manaʻo ʻia he $188.5 miliona i kēlā me kēia makahiki ma US. Me nā kumu kūʻai pololei
mai $ 500 a i $ 5,000 no ka hōʻeha ma muli o ka mālama ʻana i hāʻawi ʻia. He mea paʻakikī
ke hoʻolālā i nā kumukūʻai maoli no ka mea kokoke i ka 50% o nā pōʻino āpau i hōʻike ʻole ʻia
. Eia nō naʻe, ʻike maopopo ʻia nā ʻeha ʻeha i ka hopena waiwai nui
i ka ʻoihana mālama ola. Wahi a ka American Hospital Association, hoʻokahi
hihia o ka maʻi koʻikoʻi e nā maʻi pathogens hiki ke hoʻonui i ka $ 1 miliona a
ʻoi aku paha i nā lilo no ka hoʻāʻo ʻana, ka hahai ʻana, nā manawa nalowale a me nā uku kīnā.
ʻO nā kumukūʻai ʻoi aku ka paʻakikī o ka helu ʻana, ʻo ia ke koʻikoʻi mai ka hōʻeha ʻana,
ke kumukūʻai noʻonoʻo mai ka makaʻu a me ka hopohopo o ka loaʻa ʻana o kahi maʻi lele a i ʻole ka maʻi,
nalowale ka manawa mai ka hana, nā lilo mai ka hoʻāʻo ʻana i ka hale hoʻokolohua, ka lāʻau lapaʻau, a me
ke kumukūʻai o kekahi hihia. Aia
nā alakaʻi maʻamau ma hope o kahi hōʻeha ʻeha e pono ai nā limahana mālama ola
e hoʻohana no ka pale ʻana ma hope o ka wehe ʻana, me nā lāʻau antiviral no
nā poʻe i loaʻa i ka maʻi HIV a me ka maʻi hepatitis B a i ʻole C. Aia ma lalo kahi papa inoa o nā ʻanuʻu
i ʻōlelo ʻia e ka CDC e pono e hahai ma hope o kahi hōʻeha ʻoi. Nā ʻanuʻu e hana ai ma hope o ka lāʻau
kui: Inā loaʻa
iā ʻoe kahi ʻeha ʻoi i ka wā o kāu hana, e hahai koke i kēia mau
ʻanuʻu:

Holoi i ka ʻeha me ke kopa a me ka wai
E holoi i ka waha, ka ihu, a me ka ʻili me ka wai
E hoʻoinu i nā maka me ka wai, ka paʻakai, a i ʻole
nā mea hoʻoheheʻe sterile
E hōʻike i ka hana i kāu luna
E ʻimi koke i ka lāʻau lapaʻau ma ke
keʻena ER kokoke loa.

He aha nā mea e hiki ai i nā mea hana a me
nā limahana ke hana i mea e pale ai i ka ʻeha ma kahi hana? Nā mea hana:

E hoʻokō
i ka hoʻohana ʻana i nā mana ʻenekinia e hōʻemi i nā ʻeha needlestick.
E hōʻalo i ka hoʻohana ʻana i nā nila ke loaʻa nā
mea palekana ʻē aʻe.
E hoʻohana i nā mea hana me nā
hiʻohiʻona palekana.
E hoʻonohonoho i nā mea nui a me nā hoʻolālā no ka pale ʻana i ka hōʻeha needlestick ma ka nānā
ʻana i ka ʻike kūloko a me ka ʻāina e pili ana i nā kumu pilikia.
E hōʻoia i ka hoʻomaʻamaʻa kūpono o nā limahana i ka hoʻohana palekana a me ka hoʻolei ʻana i nā nila.
Hoʻololi i nā hana hana i ʻoi aku ka nui o ka pōʻino o ka ʻeha lāʻau kui.
E hoʻolaha i ka ʻike palekana ma ke kaiapuni hana.
Hoʻokumu i nā kaʻina hana no ka hoʻoikaika ʻana i ka hōʻike ʻana i nā ʻeha a pau
e pili ana i ka ʻiʻo.
E loiloi i ka pono o nā hana pale a hāʻawi i nā manaʻo no ka
hana.

Nā limahana:

Hōʻalo i ka hoʻopaʻa hou ʻana i nā nila.
Ma mua o ka hoʻomaka ʻana i kekahi kaʻina hana me ka hoʻohana ʻana i
nā nila, e hoʻolālā no ka mālama pono ʻana a me ka hoʻokuʻu pono ʻana.
E kōkua i kāu mea hana e koho a loiloi i
nā mea me nā hiʻohiʻona palekana.
E hoʻohana i nā mea hana me nā hiʻohiʻona palekana.
E hōʻike i nā ʻeha a pau e pili ana i ka ʻoi
.
E hoʻolei i nā nila i hoʻohana ʻia i loko o
nā pahu hoʻolei ʻoi kūpono.
E hōʻike i kāu mea hana i nā pōʻino mai nā nila
āu e ʻike ai ma ka hana.
E komo i ka hoʻomaʻamaʻa ʻana i ke koko
a hahai i nā hana pale ʻana i ka maʻi i manaʻo ʻia, e like me ka
lāʻau lapaʻau hepatitis B.

Kuhikuhi: http://www.who.int/occupational_health/topics/needinjuries/en/ http://www.ncbi.nlm.nih.gov/pubmed/17655812 http://www.cdc.gov/niosh/topics/bbp/emergnedl.html http://www.cdc.gov/niosh/docs/2000-108/pdfs/2000-108.pdf https://www.osha.gov/Publications/osha3161.pdf He mea maʻamau ka needlesticks i ka ʻoihana mālama ola. Ua manaʻo ʻia he 600 000 a 800 000 mau ʻeha needlestick i kēlā me kēia makahiki ma ʻAmelika Hui Pū ʻIa. ¹ ʻO kēia mau mea, he nui, inā ʻaʻole ka hapa nui, i hōʻike ʻole ʻia. ² I ka pane ʻana i ka pilikia o ka hoʻolaha ʻana, ua kālele nā ʻoihana i ka pale mua ʻana ma ke ʻano he mea e hōʻemi ai i ka ulu ʻana o nā lāʻau kui a ma laila e hoʻemi ai i ka nui o nā hoʻouna ʻana i ke koko. Aia nō naʻe nā ʻeha ʻo Needlestick, a he mea nui ia e ʻike maikaʻi ʻia ka poʻe o ke kahua mālama ola e pili ana i nā pilikia o ka hoʻolaha ʻana a aʻo ʻia e pili ana i ka pane kūpono.

He aha nā pathogens mua i lawe ʻia?

1. Human Immunodeficiency Virus (HIV): ʻO ka awelika o ka pilikia o ka seroconversion ma hope o ka hōʻeha ʻana i ka lāʻau nila mai kahi kumu HIV i hoʻopaʻa ʻia ma kahi o 0.3 pakeneka me ka ʻole o ka lāʻau lapaʻau post-exposure. ¹ Hoʻopili kekahi mau mea i ka piʻi ʻana o ka pilikia: ³

Hoʻonui ʻia ka hohonu o ka ʻeha ʻeha
ʻIke ʻia ke koko ma ka nila
Hoʻohana ʻia ka nila i loko o ke aʻa a i ʻole ke aʻa o ka mea maʻi
ʻO ka mea maʻi me ka maʻi HIV hope ke kumu o ka wai

2. Hepatitis B Virus (HBV): He ʻokoʻa ka pilikia o ka loaʻa ʻana o ka maʻi hepa i ke kula kiʻekiʻe i ka HBV percutaneous exposure ma muli o ke kūlana serological o ka mea maʻi. ʻO ka hihia ʻino loa, inā loaʻa i ka mea maʻi ka hoʻopiʻi hou ʻana o ka maʻi (i hōʻike ʻia e ke koko HBeAg-maikaʻi) ⁴ a laila ʻoi aku ka nui o ka hoʻomohala ʻana i ka maʻi hepatitis ma kahi o 31 pakeneka. ³ Ke loaʻa i ka mea maʻi ke koko HBsAg-positive akā he HBeAg-negative (e hōʻike ana i kahi kūlana maʻi liʻiliʻi), emi loa ka pilikia, ma kahi o 1 a 6 pakeneka. ³ 3. Hepatitis C Virus (HCV): ʻO ka pilikia o ka HCV seroconversion ma hope o ka hōʻeha ʻana i ka nila mai kahi maʻi i loaʻa i ka HCV ma kahi o 1.8 pakeneka. ¹ ʻO ka mea pōʻino, ʻaʻole liʻiliʻi nā hōʻike e kākoʻo i ka mālama ʻana ma hope o ka wehe ʻana ma ke ʻano he mea e hoʻemi ai i ka pilikia o ka maʻi.

Ke kuleana o ka hoʻopaʻa ʻana

ʻO kēia mau maʻi 3, loaʻa ka lāʻau lapaʻau no HBV wale nō. I nā makahiki 1970, ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka HBV i nā manawa he 10 i nā limahana mālama olakino ma mua o ka lehulehu. ³ Ua emi loa kēia pilikia, ma muli o kahi hoʻolaha hoʻopaʻapaʻa hoʻopaʻapaʻa i hoʻonohonoho ʻia i nā limahana o ka haukapila. ³ Nā ʻike e pili ana i ka lāʻau lapaʻau: ⁵

Hāʻawi ʻia kahi pūʻulu o 3 kiʻi i hana ʻia mai HBsAg.
Hiki ke hōʻoia ʻia ka pane ʻana i ka lāʻau lapaʻau ma ka loiloi ʻana no nā anti-HBs 2-3 mau mahina ma hope o ka pau ʻana o ka moʻo.
ʻO ka maikaʻi ma kahi o 95 pakeneka i nā mākua olakino.
Noho ka pale ma kahi o 10 mau makahiki ma hope o ka hoʻopaʻa ʻana, akā hiki ke lōʻihi aku. ⁶
I kēia manawa, ʻaʻole ʻōlelo ʻia ka booster.

He aha ka protocol e pono e hahai ma hope o kekahi needlestick?

ʻO ka mua, mai hopohopo. Aia nā protocols e hōʻemi i ka pilikia o ka maʻi ma hope o ka hoʻolaha ʻana. ʻO ka lua, mai haʻalele i ka hōʻike. ʻO ka hana ʻana i loko o nā manawa i kuhikuhi ʻia hiki ke alakaʻi i ka emi nui o ka hoʻouna ʻana o kekahi mau maʻi. Pono e hanaia keia mau hana penei: ¹

Pono e holoi koke ʻia ka pūnaewele me ke kopa a me ka wai.
Pono e hōʻike ʻia ka hanana a hoʻopau ʻia kahi palapala hōʻike hōʻike.
Pono e loiloi ʻia ka ʻike (ke ʻano o ka wai, ke ʻano o ka nila, ka nui o ke koko ma ka nila, a pēlā aku).
Pono e loiloi ʻia ke kumu hoʻolaha:
a. HIV, HBV, a me HCV kūlana o ka mea maʻi;
b. ʻO kaʻae a me ka ho’āʻoʻana i ka mea maʻi no kēia mau maʻi ināʻaʻoleʻikeʻia ke
kūlana;
c. Loaʻa ka maʻi ma muli o ke kaiāulu i lawelawe ʻia e ka
haukapila inā ʻaʻole i
loaʻa ka mea maʻi e hoʻāʻo ʻia.
Pono ka hoʻoponopono kūpono o kēlā me kēia hōʻike maikaʻi

Hoʻoponopono ma hope o ka wehe ʻana i ka maʻi virus

1. HIV: Hiki i ka hoʻohana ʻana i ka prophylaxis post-exposure ke hōʻemi i ka pilikia o ka loaʻa ʻana o ka maʻi HIV. Hiki ke loaʻa ka pōmaikaʻi ma ka hoʻomaka ʻana i ka mālama ʻana i loko o nā hola o ka ʻike. Aia nā alakaʻi i kēia mau mea: ¹

E hoʻomaka i ka prophylaxis post-exposure i ka hikiwawe.
E noʻonoʻo hou i ka mea i hōʻike ʻia i loko o 72 mau hola, e nānā pono ana i ka ʻike hou e pili ana i ke kumu a me ka ʻike.
Inā hoʻoholo ʻia ke kumu he HIV-negative, hiki ke hoʻopau ʻia ka prophylaxis post-exposure.
Inā ho’oholo ‘ia ke kumu no ka ma’i HIV, e ho’omau i ka mālama ‘ana no 4 pule ke ‘ae ‘ia.
Pono nā limahana āpau i loaʻa i ka maʻi HIV e hoʻāʻo i ka HIV antibody ma 6 pule, 12 pule, a me 6 mahina.

ʻO kekahi mau manaʻo hou aʻe e pili ana i ka mālama ʻana i ka maʻi HIV: Aia ka hiki ke make me nā antiretrovirals, no laila pono e kaupalena ʻia ka hoʻohana ʻana i nā hōʻike i loaʻa ka pilikia kūpono o ka hoʻouna ʻana.

Manaʻo ʻia ʻo 2-drug therapy (me 2 nucleoside analogues), ʻoiai ʻo 3-drug therapy hiki ke hoʻopaʻa ʻia ma lalo o kekahi mau kūlana (ʻo ia hoʻi, kahi kumu me ka loaʻa viral kiʻekiʻe a i ʻole ke kūʻē ʻana i ka lāʻau lapaʻau).
Pono e hoʻomaopopo i ke kauka lapaʻau e pili ana i ke kūlana o ka hāpai ʻana a me nā lāʻau lapaʻau o kēia manawa no ka mea hiki i kēia ke hoʻololi i ke koho ʻana o kahi ʻano lapaʻau.

2. HBV: He ʻokoʻa ka lāʻau lapaʻau ma hope o ka hoʻolaha ʻana ma muli o ke kūlana o ka lāʻau lapaʻau o ke kanaka i ʻike ʻia a me ke kūlana HBV o ka mea maʻi: ¹

Ma waho o ke kūlana o ka mea maʻi, inā loaʻa kekahi kanaka i ka lāʻau kui a ʻaʻole i hoʻopaʻa ʻia, pono e hoʻomaka ka ʻano o ka lāʻau lapaʻau.
Inā ua lapaʻau ʻia ke kanaka a ua loaʻa iā ia kahi pane i kākau ʻia i ka lāʻau lapaʻau, a laila ʻaʻole pono e mālama ʻia ma hope o ka hōʻike ʻana.
Inā ʻaʻole ʻike ʻia ke kūlana o ka lāʻau lapaʻau o ka mea i hōʻike ʻia, pono e hoʻāʻo ʻia ʻo ia no nā anti-HBs ma mua o ka hoʻoholo ʻana i ka lāʻau lapaʻau.

3. HCV: ʻAʻohe lāʻau lapaʻau i hōʻike ʻia e pale aku i ka maʻi no nā limahana i loaʻa i ka HCV. Kuhi ʻia nā manaʻo ma ka hahai ʻana i nā limahana ma hope o ka hōʻeha a me ka nānā ʻana no ka HCV RNA i ka serum. ʻO nā ʻōlelo paipai: ⁷

E hoʻomaka i ka hoʻāʻo ʻana no nā mea ʻeleʻele HCV, nā pae HCV RNA, a me nā pae alanine aminotranferase (ALT) ma hope koke o ka hanana.
E hana hou i ka ho’āʻo 2-8 pule ma hope.
Inā loaʻa ka maʻi, pono e hāʻawi ʻia ka limahana mālama ola i kahi loea no ka hoʻokele.

Nā kuhikuhi

National Institute for Occupational Safety and Health. NIOSH Alert: Ka pale ʻana i nā ʻeha o ka lāʻau kui ma ka hoʻonohonoho mālama olakino. NIOSH Publication No. 2000-108. Wakinekona, DC: National Institute for Occupational Safety and Health; 1999. Loaʻa ma: http://www.cdc.gov/niosh/2000-108.html. Loaʻa iā Kepakemapa 2, 2005.
Henry K, Campbell S. Needlestick/sharps injuries and sharps injuries and HIV infection among health care workers: national estimates based on a survey of US hospitals. Minn Med. 1995;78:41-44.
Nā kikowaena no ka hoʻopaʻa ʻana a me ka pale ʻana i ka maʻi. Hōʻano hou ʻia nā alakaʻi lawelawe olakino lehulehu o US no ka mālama ʻana i nā hōʻike ʻoihana i ka HBV, HCV, a me HIV a me nā ʻōlelo aʻoaʻo no ka prophylaxis postexposure. MMWR. 2001;50(RR-11):8.
Crawford JM. ʻO ke ake a me ka ʻāpana biliary. Ma: Cotran RS, Kumar V, Collins T, eds. Robbins Pathological Kumu o ka ma’i. 6th ed. Niu Ioka, NY: WB Saunders; 1999:845-901.
Teo EK, Lok ASF. ʻO ka maʻi maʻi hepatitis B. Loaʻa ma: http://uptodateonline.com. Loaʻa iā ʻAukake 11, 2005.
Yuen MF, Lim WL, Chan AO, et al.
18-makahiki hahai-no ka noiʻi o ka prospective randomized ho’āʻo o ka maʻi hepatitis B me ka booster doses i na keiki.
Clin Gastroenterol Hepatol.2004;2(10):941-945.
Nā Hui Ola Ola. NIH Consensus Statement on Management of Hepatitis C: 2002. NIH Consens State Sci Statements. 2002 Iune 10-12;19:1-46.

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