Urushinge rutunguranye, Gukomeretsa kwa Siringe, hamwe na Prophylaxis nyuma yo kwerekana¶

Kubabara igikomere gitunguranye giturutse ku nshinge zikoreshwa na hypodermique, lancet, cyangwa ibikoresho byubuvuzi bikaze ni ibintu byihutirwa biohazard bitera ubwoba bwinshi bwo kwandura amaraso. These injuries occur in two distinct settings: occupational healthcare or sanitation exposures (nurses, paramedics, phlebotomists, dental workers, housekeepers, and solid-waste handlers pricked while handling sharps or trash bags) and community discarded-syringe sticks (children stepping on or picking up a discarded syringe in a public park, beach, playground, or transit restroom, or adults pricked while reaching into a public trash bin or theater intebe).

Ibintu bitatu byambere bitera amaraso yibibazo byubuvuzi nyuma yurushinge rwa percutane ni ** Virusi ya Immunodeficiency Virusi (VIH) **, ** Hepatitis B Virusi (HBV) **, na ** Hepatitis C Virus (HCV) *, hamwe na ** tetanusi ( Clostridium tetani *) ** ivuye mu nshinge zanduye hanze. Indwara ya epidemiologiya y’umuryango w’ubuzima ku isi (OMS) hamwe n’ikigo gishinzwe kurwanya no gukumira indwara (CDC, Amerika) itanga ukuri gukomeye: icya mbere, amahirwe nyayo yo kwandura virusi itera sida avuye mu rushinge rwajugunywe mu baturage ahura n’ikirere cyo hanze n’ubushyuhe ni bike cyane (mu mateka hafi ya zeru mu bushakashatsi bwakozwe ku bushakashatsi bwashyizwe ahagaragara), mu gihe Hepatite B ifite umuvuduko ukabije w’ibidukikije; icya kabiri, ** ingamba zikomeye zubuvuzi, cyane cyane virusi itera sida nyuma yo kwandura virusi (nPEP) yatangiye mumasaha 72 (kandi nibyiza mumasaha 2 kugeza 24) na Hepatitis B Immune Globulin (HBIG) wongeyeho urukingo, irashobora gukumira serokonversion hafi ya yose mugihe itanzwe vuba **.

Kora ubu¶

Niba wowe cyangwa umwana wawe washyutswe gusa cyangwa ushushanyije urushinge rwakoreshejwe cyangwa rwajugunywe, inshinge, cyangwa igikoresho gityaye nonaha, kora izi ntambwe esheshatu:

1. ** Koza ako kanya ako kanya ukoresheje isabune n'amazi atemba muminota 5 kugeza 10 **: Fata urutoki, ikiganza, cyangwa ikirenge cyatobotse munsi yumugezi uhoraho wamazi meza akonje cyangwa ashyushye hanyuma ukarabe witonze ukoresheje isabune yoroheje. Reka igikomere kiva amaraso wenyine wenyine mugihe munsi y'amazi atemba.
2. ** NTUKIGERE ukanda, amata, yonsa, usukure cyane, cyangwa usukemo bleach cyangwa usukamo inzoga mu gikomere cyacumita **: Ntugakubite cyangwa ngo uce ingirangingo hafi y'urushinge kugira ngo "amata" amaraso, ntugashyire umunwa wawe ku gikomere ngo unywe, kandi ntugasukeho amavuta yo mu rugo, hydrogène peroxide, cyangwa inzoga zidafite umwanda. Ubushakashatsi bwakozwe na CDC n’Ubwongereza (UKHSA) bwemeza ko gukanda cyangwa gukonjesha byangiza inkuta za capillary, bigatera micro-inflammation yaho, kandi mu byukuri bikurura uduce duto twa virusi mu maraso aho kubirukana hanze.
3. ** Koza amaso, izuru, cyangwa umunwa ukoresheje amazi meza cyangwa saline muminota 15 niba amazi yatembye ava muri siringi **: Niba amazi ava muri barriène ya siringi yinjiye mumaso yawe, inzira zamazuru, cyangwa umunwa mugihe cyibyabaye, fungura amaso yawe ukoresheje amazi ahoraho cyangwa umunyu wa 0.9% muminota 15, hanyuma woge umunwa inshuro nyinshi n'amazi utamize.
4. ** Kureka inshinge zajugunywe zidakozweho cyangwa uzimure gusa hamwe nudupapuro mu icupa rikomeye rya pulasitike (Ntugasubiremo intoki) **: Ntukigere ukoresha intoki zawe zambaye ubusa kugirango usubize ingofero ya plastike ku nshinge (gusubiramo ni yo mpamvu ya mbere itera inshinge za kabiri). Reba uko singe yasaga (niba urushinge rwarimo ubusa, niba amaraso mashya yatose yagaragaye imbere muri hub, kandi niba plunger yarihebye). Komeza abandi bana kure y'urushinge, kandi wibuke ko ibyumba byihutirwa ** bitapima siringi zajugunywe ** kuri virusi kuko gupima ibisigazwa by’ibidukikije byumye ntabwo byizewe kandi bidindiza kwivuza.
5. ** Jya mu ishami ryihutirwa cyangwa ubuvuzi bwihutirwa (Mugihe cyamasaha 2 niba bishoboka, kandi mbere yamasaha 72) **: Ntutegereze iminsi ibiri kugirango usange umuganga usanzwe. Jya mu bitaro bishinzwe ubutabazi kugira ngo umuganga asuzume ibyago ushobora guhura na byo, kandi biramutse bigaragaye, utange urugero rwa ** rwa mbere rwa virusi itera sida nyuma yo kwandura virusi (PEP) mu idirishya rikomeye ry’amasaha 2 kugeza kuri 72, hamwe na Hepatitis B Immune Globulin (HBIG), urukingo rwa Hepatite B, hamwe na tetanusi.
6. ** Niba inkoni yarabaye kukazi, menyesha umuyobozi wawe hamwe nubuzima bwakazi bwihuse kugirango usuzume umurwayi winkomoko **: Mubitaro, ivuriro, cyangwa urushinge rwakazi aho umurwayi ukomoka azwi, menyesha ibyabaye ako kanya byihuse antigen / antibody yo mu gisekuru cya kane, antigen ya Hepatitis B (HBsAg), kandi Hepatitis C RNA / antibody yipimisha amara iminsi 28 ukenera imiti ikomokaho.

Inzira ya Needlestick hamwe na Post-Exposure Prophylaxis (PEP) ibyemezo byerekana¶

Koresha iki giti cya triage kugirango wimuke uve mubikomere byihuse ujye kwa muganga wihutirwa no gupima amaraso.

flowchart TD
    Prick["Impanuka ya Impanuka cyangwa Impanuka ya Siringe Yataye"] --> WashNow["1. Ako kanya Imfashanyo Yambere: Karaba witonze ukoresheje Isabune & Amazi atemba muminota 5 kugeza 10; Reka Amaraso Yisanzuye"]
    WashNow --> NoSqueeze["2. Ntugahunike, Amata, Scrub, Yonsa, cyangwa Shyira Bleach / Peroxide kurubuga"]
    NoSqueeze --> SettingCheck{"3. Urushinge rwabereye he?"}
    SettingCheck -->|"A. Ubuvuzi / Akazi (Inkomoko Umuntu Uzwi cyangwa Kumenyekana)"| OccReport["Menyesha Umugenzuzi / Ubuzima bw'akazi Ako kanya; Tegura virusi yihuse, HBV & HCV Kwipimisha Inkomoko Yumurwayi"]
    SettingCheck -->|"B. Umuganda / Parike rusange / Imyanda (Inkomoko itazwi)"| NoteNeedle["Ntugasubiremo urushinge ukoresheje intoki; Menya niba Hollow-Bore cyangwa Biboneka Amaraso meza; Raporo Ahantu ho Gutora"]
    OccReport --> GoER["4. Jya mu ishami ryihutirwa ryibitaro ako kanya (Byaba byiza mumasaha 2, bikabije munsi yamasaha 72)"]
    NoteNeedle --> GoER
    GoER --> PathogenTriage{"5. Ishami ryihutirwa rya kane-Pathogen Prophylaxis & Baseline Lab Protocol"}
    PathogenTriage -->|"Indwara ya 1: VIH"| HIVStep["Shushanya Baseline Byihuse VIH Ag / Ab; Tangira Iminsi 28-Ibiyobyabwenge Antiretroviral PEP Niba byerekanwe mumasaha 72"]
    PathogenTriage -->|"Indwara ya 2: Hepatite B (HBV)"| HBVStep["Reba abahohotewe barwanya HBs; Tanga Urukingo rwa HBIG + HBV Mugihe cyamasaha 24 niba udakingiwe"]
    PathogenTriage -->|"Indwara ya 3: Hepatite C (HCV)"| HCVStep["Shushanya Baseline Anti-HCV & ALT; Gahunda ya 4-kugeza-6-Icyumweru HCV RNA Ikizamini cya PCR (Irakira iyo igaragaye)"]
    PathogenTriage -->|"Pathogen 4: Tetanusi"| TetStep["Umuyobozi wa Tdap / Td Booster niba> Imyaka 5 Kuva Dose Yanyuma (Ongeraho TIG niba idakingiwe)"]

Sobanukirwa n'ingaruka zawe z'ubuvuzi: VIH, Hepatite B, na Hepatite C ugereranije¶

Iyo umubyeyi abonye umwana yatowe na siringi muri parike cyangwa umukozi agashyirwa mumufuka wimyanda, ubwoba akenshi bubatera kwibwira ko kwandura byanze bikunze. Mubyukuri, amakuru menshi yubuvuzi yatanzwe na CDC, OMS, na UKHSA yerekana ko virusi ziva mumaraso zitandukanye cyane mubushobozi bwabo bwo kubaho hanze yumubiri wumuntu no kwanduza inshinge imwe.

Ibintu bitanu byerekana niba urushinge ari Risk-Risk na Risk-Risk¶

Iyo ugeze mu ishami ryihutirwa, umuganga witabye cyangwa inzobere mu ndwara zandura azasuzuma ibintu bitanu by’imvune kugira ngo agufashe kumenya niba hasabwa inama y’iminsi 28 ya virusi itera SIDA:

1. ** Urushinge rwa Hollow-Bore Urushinge na Sharp Ikomeye **:
2. Urushinge rwa ** rwuzuye-rwitwa hypodermic syringe ** (rukoreshwa mu gushushanya amaraso cyangwa gutera inshinge zinjira mu mitsi) rurimo ibibyimba by'imbere bishobora gufata ibitonyanga bya microscopique by'amaraso y'amazi akingiwe mu kirere.
3. Urushinge rukomeye ** (nk'urushinge rwa suture, ipine yo kudoda, urushinge rwa tattoo, cyangwa diyabete ntoya yuzuye urutoki rwa diyabete) itwara umuvuduko muke w'amaraso kandi bitera ibyago byo kwandura cyane.
4. ** Gushya no kugaragara kw'amaraso ku gikoresho **:
5. Urushinge rwabaye mumasegonda cyangwa iminota mike urushinge rukuwe mumitsi yumuntu (urugero, mubyumba byibitaro cyangwa nyuma yo kureba umuntu utera mu bwiherero)?
6. Cyangwa siringi yari aryamye ishaje, ikirere, ingese, kandi yumye rwose mubyatsi cyangwa umucanga wa parike rusange? Urushinge rwumye, rwumuyaga rwugarije ibintu byo hanze muminsi myinshi rutwara virusi itera sida, nubwo Hepatitis B na tetanus prophylaxis biracyakenewe cyane.
7. ** Ubujyakuzimu bwo Kwinjira no Kwimuka **:
8. Kwishushanya bitagaragara hejuru yuruhu rwo hejuru cyangwa unyuze mu rukweto runini rwa rubber rwashushanyaga gusa amaraso atwara ibyago bike ugereranije no gucumita cyane mu mitsi aho icyuma cya syringe cyari cyihebye cyane mugihe cyinkoni.
9. ** Uturindantoki cyangwa Inkweto **:
10. Iyo urushinge runyuze muri gants ya latx / nitrile cyangwa rubber / canvas sole ya siporo mbere yo gukata uruhu, ibikoresho bikomeye bihanagura mu buryo bwa mashini mu buryo bwa tekinike kugeza kuri 50 kugeza kuri 86% by ibisigazwa byamaraso hanze yumutwe wurushinge.
11. ** Bizwi na Inkomoko Yamenyekanye **:
12. Niba umuntu ukomokaho azwi kandi afite virusi itanduye virusi itera sida ku buvuzi bwa virusi itera virusi, cyangwa yipimishije nabi ku kizamini cya virusi itera sida yihuta mu bitaro, PEP irashobora guhagarikwa neza.

Ibibera mu ishami ryihutirwa: Isaha-ku-Isaha Clinical Protocol¶

Kumenya ibizamini nubuvuzi ugomba kwitega, nicyo wabaza niba usuye ivuriro ryihutirwa ryihutirwa, menya neza ko nta ntambwe yo gukingira yabuze mugihe wasuye byihutirwa.

Intambwe ya 1: Guhita uhita (Bwira ameza "Imbere ya Needlestick Exposure: Igihe cyunvikana kuri PEP")¶

Mugihe winjiye mubitaro byihutirwa byihutirwa, ntukavuge gusa * "Nakandagiye ku kintu gityaye." * Vuga neza umuforomo wa triage: ** "Nagize inshinge zimpanuka zatewe na siringi yakoreshejwe [X] hashize iminota mike kandi nkeneye isuzumabumenyi rishingiye ku gihe kuri virusi itera sida na Hepatitis B nyuma yo kwandura indwara. mu minota 60.

Intambwe ya 2: Gushushanya Amaraso Yibanze (Kwipimisha Umunsi 0)¶

Mbere cyangwa ako kanya umaze gufata igipimo cya mbere cya PEP, itsinda ryubuvuzi rizashushanya ** Baseline (Umunsi 0) laboratoire yamaraso **. Kuki kwipimisha kumunsi 0 mugihe urushinge ruvuye kumasaha ashize rudashobora kugaragara mumaraso yawe?

• Igeragezwa ryibanze ryerekana inyandiko z’indishyi z’ubuvuzi n’abakozi zerekana ko wabaye ** wanduye virusi itera sida, Hepatite B, na Hepatite C mu gihe cy’imvune **.
• Iragenzura kandi ** Hepatitis B Surface Antibody (anti-HBs) ** titer (kugirango igaragaze niba inkingo zawe zo mu bwana zikigukingira) ikanagenzura imikorere yawe yimpyiko ** (creatinine / eGFR) hamwe na enzymes yumwijima (ALT / AST) ** kugirango umuganga ashobore gutegeka neza gahunda yiminsi 28 ya PEP.

Intambwe ya 3: Gucunga uburyo 3 bwo kuvura indwara¶

1. ** Kurinda Hepatite B (Urukingo na / cyangwa HBIG) **:
2. ** Niba warakingiwe mbere ukaba wanditseho ubudahangarwa (anti-HBs cyangwa hejuru ya 10 mIU / mL) **: Nta muti wa Hepatite B ukenewe.
3. ** Niba udakingiwe, urukingo rutuzuye, cyangwa utazi neza uko uhagaze **: Muganga azahita atanga urugero rwambere rwurukingo rwa ** Hepatitis B ako kanya mumitsi yawe ya deltoid ** (ikurikirwa na dosiye mumezi 1 na 6) kandi, ku nshinge zifite ibyago byinshi, inshinge ya ** Hepatitis B Immune Globulin (HBIG) **, itanga virusi idafite umubiri. igisubizo.
4. ** Indwara ya sida nyuma yo kwandura virusi (Gahunda y'iminsi 28) **:
5. Muri iki gihe CDC, OMS, hamwe n’ishyirahamwe ry’ababana na virusi itera SIDA mu Bwongereza (BHIVA), uburyo bwa virusi itera SIDA nPEP ku bantu bakuru n’ingimbi ni bwo bwihanganirwa neza ** imiti itatu yo mu kanwa imiti igabanya ubukana bwa virusi ifatwa rimwe cyangwa kabiri buri munsi mu minsi 28 yuzuye **: mubisanzwe ** Tenofovir disoproxil fumarate / Emtricitabine (TDF / FTC), cyangwa TAF / FTC .
6. ** Menya neza ko uvuye mu ishami ryihutirwa ufite "Starter Pack" mu ntoki **: Farumasi y'ibitaro ubusanzwe itanga ibipapuro byiminsi 3 kugeza kuri 7 byo gutangira ibinini bya PEP mbere yuko usohoka hanze kugirango udatakaza amasaha 24 utegereje farumasi icuruza abaturanyi gutumiza imiti muri wikendi.
7. ** Indwara ya Tetanusi **:
8. Kuberako inshinge zajugunywe mumihanda, parike, cyangwa imyanda yanduye yanduye umwanda, uzakira ** Tdap cyangwa Td tetanus booster ** niba hashize imyaka irenga 5 kuva tetanus yawe iheruka kurasa.

Gucunga imiti yiminsi 28 ya virusi itera sida no kubona ubufasha bwamafaranga¶

Ku barwayi banditse amasomo yo kurwanya virusi ya virusi y'iminsi 28, kubahiriza ni kimwe mu bintu byerekana ko imiti igenda neza. Kubura inshuro zikurikiranye mugihe cyibyumweru bibiri byambere bituma virusi ikomeza kubaho mbere yuko selile zanduye zisanzwe zipfa.

Nigute ushobora gukemura ingaruka rusange za PEP utahagaritse ibinini byawe¶

Gahunda igezweho ya integrase-inhibitor ya PEP (nka TDF / FTC wongeyeho dolutegravir cyangwa raltegravir) iritonda cyane kuruta gahunda ya protease-inhibitor yo mu myaka ya za 90, abarwayi barenga 90 ku ijana barangiza iminsi 28 yuzuye nta nkomyi. Nyamara, ingaruka zoroheje zigihe gito zishobora kubaho muminsi 4 kugeza 7 yambere:

1. ** Kwitonda byoroheje cyangwa Kuribwa mu gifu **: Fata ibinini byawe bya buri munsi bya PEP hamwe nifunguro ryoroheje cyangwa ibiryo aho gufata ku gifu cyuzuye ubusa, hanyuma usabe umuganga w’ishami ryihutirwa gusaba imiti mike imiti igabanya ubukana bwo mu kanwa (nka ondansetron) kubika murugo mugihe bibaye ngombwa. ** Niba urutse mugihe cyisaha 1 uhereye kumira ibinini bya PEP **, fata undi muti ako kanya; niba urutse kurenza isaha 1 nyuma yo kumira, imiti yamaze kwinjizwa kandi ntukeneye kongera kunywa.
2. ** Imikoreshereze yibiyobyabwenge-minerval (Antacide, Kalisiyumu, Iron, na Magnesium) **: Integrated inhibitor nka ** dolutegravir na raltegravir bihuza imiti na catale ya polyvalent (calcium, magnesium, aluminium, na fer) ** mumitsi yawe igifu, ibuza imiti ya sida kwinjira mumaraso yawe. ** Ntuzigere umira ibinini bya PEP mugihe kimwe na calcium ya karubone (Tums / Rolaids), magnesium / aluminium antacide, ibyuma byongera ibyuma, cyangwa vitamine nyinshi.
3. ** Niki wakora niba ubuze ikinini **: Niba wibagiwe ibinini byawe bya buri munsi, fata umwanya wibutse keretse niba ari hafi yigihe cya gahunda yawe itaha; ntuzigere ufata inshuro ebyiri icyarimwe kugirango uhimbe ibinini byabuze.

Nigute ushobora kubona iminsi 21 kugeza 25 isigaye yibinini bya PEP byishyuwe¶

Niba icyumba cyihutirwa kiguhaye ipaki yiminsi 3 kugeza kuri 5, ntutegereze kumunsi wa 5 kugirango wuzuze ibisigaye byandikirwa iminsi 28, kuko farumasi zicuruza rimwe na rimwe zikenera amasaha 24 kugirango utumire virusi idasanzwe:

• ** Ahantu ho gukorera cyangwa mu buvuzi bukenewe **: Yapfunditse 100 ku ijana ku giciro cya zeru kitari mu mufuka na ** Indishyi z’abakozi ** hamwe na gahunda y’umukoresha wawe w’ubuzima bwa Occupational Health Bloodborne Pathogens nkuko amategeko abiteganya (OSHA 29 CFR 1910.1030 muri Amerika, amabwiriza ya HSE mu Bwongereza).
• ** Urushinge rwabaturage mu Bwongereza, Kanada, Umuryango w’ubumwe bw’ibihugu by’Uburayi, na Ositaraliya **: Yatanzwe ku buntu (cyangwa ku mushahara usanzwe wishyurwa) binyuze mu ishami ryihutirwa rya NHS n’ubuzima bw’imibonano mpuzabitsina / Amavuriro ya GUM (UK), ibitaro by’ubuzima rusange by’intara (Kanada), cyangwa farumasi y’ibitaro bya Leta.
• ** Abarwayi badafite ubwishingizi cyangwa benshi-bandukuye muri Reta zunzubumwe zamerika **: Amakarita yamakopi yakozwe (Galeedi Advanced Access na ViiV Connect), gahunda ya leta ya Ryan White / ADAP yihutirwa ya PEP, hamwe n’amavuriro y’ubuzima rusange y’amakomine atanga amasomo yihutirwa y’iminsi 28 ya PEP ku giciro cya zeru ku baturage badafite ubwishingizi bw’abaturage.

Ubuyobozi bwihariye kubabyeyi mugihe umwana yatowe na seringe yataye¶

Kumenya ko umwana muto cyangwa umwana wimyaka yishuri yatoye inshinge mumikino yo gukiniraho, ibihuru, cyangwa ubwiherero rusange biteye ubwoba kubabyeyi bose. Inzobere mu ndwara zanduza abana zirasaba izi ntambwe zihariye z'abana:

1. ** Gumana ituze kugirango umwana wawe akubwize ukuri aho urushinge rwabakoreye **: Niba umubyeyi afite ubwoba cyangwa ataka umwana watoraguye urushinge muri parike, abana bato bakunze gutinya guhura nibibazo bagahakana ko urushinge rwatemye uruhu rwabo. Vuga mu ijwi rishyushye, rituje, ritanga icyizere: * "Ntabwo uri mu bibazo na gato, kandi wakoze akazi gakomeye umbwira. Nyereka urutoki rwarukozeho kugira ngo dusukure n'amazi." *
2. ** Suzuma intoki, imikindo, ibirenge, hamwe ninkweto za siporo munsi yumucyo mwinshi **: Reba neza amaboko namaguru yumwana kugirango akadomo gato cyangwa umutuku. Hindura kandi inkweto z'umwana hejuru hanyuma urebe amabuye ya reberi kugirango umenye neza ko urushinge rwacitse rutaracumbikiwe imbere.
3. ** Indwara ya Hepatite y'abana **: Kubera ko urukingo rw’abana bato Hepatite B rwagize uruhare muri gahunda zisanzwe zo gukingira abana kuva mu myaka ya za 90 mu bihugu byinshi, umubare munini w’abana bakingiwe usanzwe ufite antibodiyite zikomeye zirinda Hepatite B, ari na virusi yangiza ibidukikije ku nshinge zajugunywe. Niba umwana wawe yandikiwe virusi itera sida y'abana, farumasi y'ibitaro irashobora gutanga uburemere bushingiye ku buremere, ibinini bitatanye, cyangwa imiti ishobora guhekenya abana bato badashobora kumira ibinini bikuze.

Kurikirana gahunda yo gupima amaraso no kurangiza amasomo yawe yiminsi 28 ya PEP¶

Nyuma yo kuva mucyumba cyihutirwa, uburinzi bwawe bushingiye kubintu bibiri: ** kurangiza iminsi 28 yose yimiti yawe ya PEP udasibye dosiye ** (niba virusi itera sida yaranditswe) na ** ukarangiza gahunda yawe yo gukurikirana amaraso ** kugirango ubone 100% byanyuma "Byose birasobanutse."

Ibipimo Byihuta Nyuma ya Laboratoire Yipimisha Igihe¶

Icyitonderwa cyo gufata mugihe cya 6 -12 -cyumweru-ikurikira-idirishya¶

Mugihe utegereje ibyumweru 12 bya nyuma bya laboratoire, inzobere mu ndwara zandura zitanga inama enye zokwirinda (nubwo bishoboka ko wanduye ari muto cyane):

• ** Ntutange amaraso, plasma, ingingo, tissue, cyangwa amasohoro ** kugeza ibizamini bya nyuma byo gukurikirana byemeza ko uri mubi.
• ** Koresha kurinda inzitizi (agakingirizo) mugihe cyimibonano mpuzabitsina ** nabafatanyabikorwa kugeza ibyumweru 12 byuzuye.
• ** Ntugasangire urwembe, koza amenyo, imisumari, cyangwa inshinge ** hamwe nabagize urugo.
• ** Menyesha umuriro wose "umeze nk'ibicurane", kubyimba lymph node, kubyimba mu muhogo, cyangwa guhita uhita **: Niba urwaye umuriro udasobanutse, kurwara umubiri, cyangwa kubabara mu muhogo hagati y'icyumweru cya 2 n'icyumweru cya 8 nyuma y'urushinge, hamagara ivuriro ryanyu rikurikiranwe vuba kugira ngo wipimishe virusi ya virusi RNA na HCV RNA.

Nigute ushobora gutandukanya neza cyangwa guta seringe yabonetse muri parike cyangwa aho ukorera¶

Niba ubonye inshinge zajugunywe ku kibuga cyo gukiniramo, ku mucanga, ku kayira kegereye umuhanda, cyangwa mu bwiherero rusange, cyangwa nyuma yuko umuntu yatowe, kubuza umuntu wa kabiri kwizirika ni ngombwa.

Porotokole Yizewe Yintambwe 4-Intambwe¶

1. ** Ihitamo ryiza muri parike rusange / Umuhanda (Ntukoreho: Kurinda & Hamagara 311 / Ibidasanzwe) : Niba udafite ibikoresho byo gukingira kandi ntamuntu numwe ufite ibyago byo guhita ubikandagira, shyira umuntu mukuru kugirango uhagarare metero 2 (metero 6.5) kugirango abana n'imbwa bisubire inyuma, hanyuma uhamagare umurongo wa komine utari muto ( 311 ** muri parike ya parike ya Australiya).
2. ** Niba Ugomba Kwimura Syringe Ako kanya Kurinda Abana **:
3. ** Ntukigere ukora ku mutwe w'urushinge kandi ntuzigere ugerageza gusubiza umupira inshinge. **
4. Zana ikintu cya ** gikomeye, kidashobora kwihanganira icyuma cya pulasitike gifite umupfundikizo wuzuye hejuru ya , nk'icupa ryuzuye amazi yo kumesa, icupa ryuzuye rya pulasitike, cyangwa icupa rikomeye rya HDPE / icupa rya soda ( ntukigere ukoresha ikirahuri cy'ikirahure **, gishobora kumenagura no gukora ibirahuri by'amazi byononekaye cyangwa aluminiyumu).
5. Shira ikintu cya plastiki gifunguye ** kiringaniye hasi iburyo bwa siringe ** (ntuzigere ufata ikintu mu kuboko kwawe kwi bumoso mugihe usunikamo urushinge ukoresheje ukuboko kwawe kwi buryo, cyangwa uzatera icyuma cyibumoso niba ubuze gufungura).
6. Koresha ** pliers, igikoni, igikoni, cyangwa ibice bibiri bikaze byikarito / umukungugu ** (wambaye uturindantoki twinshi two gukora uruhu cyangwa uturindantoki twa rubber niba uhari) kugirango uhitemo seringe hejuru ya ** plastike plunger / barrel end ** hamwe nurushinge rukomeye rwerekeje kure yumubiri wawe.
7. Tera inshinge ** inshinge-ngingo-yambere ** mumacupa ya plastike ikaze aryamye hasi, shyira umupira hejuru, ushireho kashe hamwe na kaseti iremereye, andika ** "NTIBYEMEZO: SHARPS BIOHAZARD" ** mukimenyetso gihoraho kumacupa, hanyuma ujyane muri farumasi ikarishye ya kiosk, cyangwa ibyumba byihutirwa bya komini.

Ibibazo bikunze kubazwa¶

Nakagombye gukanda urutoki kugirango ruve amaraso menshi cyangwa ngasukaho bleach nyuma y'urushinge?¶

Oya, ntugomba na rimwe gukanda, gukomeretsa, amata, cyangwa gukuramo igikomere cyatewe urushinge, kandi ntukigere ukoresha imiti ikaze nka blach yo murugo, hydrogen peroxide, cyangwa inzoga zidasukuye. Ubushakashatsi bw’ubuvuzi bwakozwe na CDC na OMS bwerekana ko gukanda cyangwa gusya bijanjagura imiyoboro yamaraso yoroheje ya microscopique kandi bigatera uburibwe bukabije bw’ibanze, mu byukuri bikurura uduce twinshi twa virusi mu maraso aho kubirukana hanze. Ahubwo, fata ahantu hacukuwe munsi y'amazi meza atemba, oza witonze ukoresheje isabune muminota 5 kugeza 10, hanyuma ureke amaraso asanzwe atemba wenyine.

Nakagombye kuzana siringi yataye mu cyumba cyihutirwa cyibitaro kugirango abaganga basuzume virusi itera sida?¶

Oya, amabwiriza yubuvuzi yatanzwe na CDC, OMS, hamwe n’imiryango yita ku buvuzi bwihutirwa itanga inama ku buryo butaziguye bwo kwinjiza siringi yabonetse mu ishami ryihutirwa kugira ngo isuzume virusi. Gupima ibisigazwa byumye cyangwa microscopique imbere muri siringi y’ibidukikije ntabwo ari siyansi yizewe (igipimo kinini cyibinyoma-cyiza), itakaza amasaha akomeye mugihe utegereje ko laboratoire idasanzwe, kandi bigatera akaga gakomeye ko gufatira umuforomo, umuganga, cyangwa wowe ubwawe mugihe cyo gutwara. Ahubwo, fata gusa ifoto y'urushinge kure yumutekano cyangwa wibuke niba ari urushinge rwatewe inshinge kandi niba amaraso mashya yatose yagaragaye imbere.

Ni kangahe ibyago byumwana wanjye kwandura virusi itera sida nyuma yo gukandagira cyangwa gukora ku nshinge zajugunywe muri parike cyangwa ku mucanga?¶

Mugihe igikoma cyose cyajugunywe gisaba isuzuma ryihutirwa ryihutirwa, ababyeyi barashobora guhumurizwa cyane mumibare yubumenyi: VIH ni virusi yoroshye cyane ipfa vuba iyo ihuye numwuka wo hanze, yumye, nizuba. Mu myaka ibarirwa muri za mirongo ikurikirana ubuzima rusange bw’abaturage ku isi na CDC, Ikigo cy’ubuzima rusange cya Kanada, na UKHSA nyuma y’abana ibihumbi n’ibihumbi batoranijwe n’urushinge rwajugunywe muri parike, mu bibuga by’imikino, no ku nkombe z’inyanja, igipimo cy’abanduye virusi itera sida kiva mu rushinge rwataye hanze ni hafi ya zeru. Ibyibanze byubuvuzi byihutirwa mugusura byihutirwa ni ukugenzura umwana wawe Hepatitis B na Tetanusi yo gukingira no gufata icyemezo hamwe n’umuganga w’abana niba PEP ikingira byemewe.

Mugihe kingana iki nyuma y'urushinge ngomba gutangira virusi itera sida (PEP)?¶

Ugomba gutangira virusi itera sida nyuma yo kwandura (PEP) mugihe ntarengwa cyamasaha 72 (iminsi 3) nyuma yinshinge, kandi nibyiza mumasaha 2 kugeza 24. Imiti igabanya ubukana bwa PEP ikora mukubuza virusi kwigana ahacitse mbere yuko igera kuri lymph node; buri saha mbere umira ibinini byambere byongera imbaraga zo kurinda, kandi gutangira PEP nyuma yamasaha 72 bitanga bike kubwinyungu.

Inkomoko yagenzuwe¶

• ** Ibigo bishinzwe kurwanya no gukumira indwara (CDC) hamwe n’Urwego rushinzwe ubuzima rusange muri Amerika (Amerika) **: * Kuvugurura Amabwiriza y’ubuzima rusange bw’Amerika muri Leta agenga imicungire y’imyuga iterwa na virusi itera sida ndetse n’ibyifuzo by’ubuvuzi bwa Postexposure, Amabwiriza ya PEP (nPEP), no kwirinda indwara ya Hepatite B na C.
• ** Ishami ry'Umuryango w'Abibumbye ryita ku Buzima (OMS) **: * Amabwiriza ahuriweho na virusi itera sida nyuma yo kwandura virusi itera SIDA (PEP) na OMS uburyo bwiza bwo gutera inshinge hamwe n’uburyo bukoreshwa mu gitabo *.
• ** Ikigo gishinzwe umutekano w’Ubwongereza (UKHSA) n’ishyirahamwe ry’ababana na virusi itera SIDA mu Bwongereza (BHIVA, mu Bwongereza) **: * Amabwiriza y’Ubwongereza yo gukoresha virusi itera sida nyuma yo kwandura no gucunga ibikomere bya Needlestick na Sharps mu baturage no mu buzima bw’ubuzima *.
• ** Ubuyobozi bushinzwe umutekano n’ubuzima (OSHA) na NIOSH (Amerika) **: * Igipimo cy’indwara zandurira mu maraso (29 CFR 1910.1030) hamwe n’ubukangurambaga bwo guhagarika inkoni *.
• ** Umuryango w’abana muri Kanada (CPS, Kanada) n’ibitaro by’abana by’umwami Melbourne (Ositaraliya) **: * Amabwiriza y’ubuvuzi bw’amavuriro: Gucunga ibikomere by’abaturage bikenerwa mu bana *.

Kuyobora¶

• Gukata, gusiba, no kuvura ibikomere
• Kuva amaraso menshi no gushira amarushanwa
• Kurumwa ninyamaswa nimbasa ubufasha bwambere
• Opioid irenze urugero nubuyobozi bwa naloxone
• Gukomeretsa ku kazi no guhahamuka mu nganda
• Ububiko bwihutirwa