Exposure to Medications

Published

Hello,

I would like to know about being exposed to medications at work if that could affect a nurse's health in the long term? This includes getting IV antibiotics accidentally spilled on the skin or inhaling those tiny particles when crushing medications, or even not using gloves when handling PO meds. I've already done those things a few times at work...anyone know of any studies or research if it could lead to resistance or allergies to medication in the future?

Up Vote Up Vote ×

There are a few medications that indicate the handler should reduce exposure to them when dispensing them, but other than that, I've never seen anything like what you're asking about.

Up Vote Up Vote ×

I've wondered this myself. When I'm filling syringes, and some of the mediation leaks out (my hands are sometimes stained red from the B-12 injections), I question whether I'm absorbing a small part of them.

Maybe I'm just being paranoid? :eek:

Up Vote Up Vote ×
Specializes in home health, dialysis, others.

In 36 years, I have been exposed to many things, but usually the quantity is very small. If anything liquid were to get on my hands, I would wash them - gently - immediately.

I am allergic to Sulfa drugs, and avoid handling them as much as possible, including the pills. When one of my kids was on Bactrim, I only opened the bottle and made him get the pill.

I can barely remember getting any injectables on my hands; why would the med leak out?

Ginger80 - be sure the needle is on tight to the syringe. If that doesn't help, then wear gloves.

Don't add too much air to the bottle of med, only as much as you need for withdrawal of the med.

Best wishes

Up Vote Up Vote ×

I have recently started wearing gloves to give HS meds. There is a warning that pops up on cholestrol meds and prostate meds not to touch or crush if you are pregnant. I am pregnant and 90% of my pts get one or both of these. My pregnant coworker also wears a mask when crushing these meds, but I find it too extreme for me. Other then IV primary fluids, I never get liquids on my hands.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have recently started wearing gloves to give HS meds. There is a warning that pops up on cholestrol meds and prostate meds not to touch or crush if you are pregnant. I am pregnant and 90% of my pts get one or both of these. My pregnant coworker also wears a mask when crushing these meds, but I find it too extreme for me. Other then IV primary fluids, I never get liquids on my hands.

I get the precaution but when I dispense meds.......I don't touch them. I take the wrapped pills to the bedside and open the bubble wrapper and dump them into the med cup in front of the patient. If I crush I use a pill crusher (Which I really do not like because of cross contamination with other meds). I usually crush them in the bubble wrap by smashing them and again open the container directly into the med cup. I scrape the rest of the meds, if necessary, with a q-tip swab or tongue depressor into the cup.

I was taught if you touch a pill or drop it on the floor ir is considered contaminated. A mask while crushing while probably uneccesary is her perogative if it makes her feel better. There are meds that require precatutions.......chemo, radioactive injectables are examples. I wear gloves when mixing charcoal because no matter how careful you are that black crap gets everywhere. I worked a cath lab once and there were times I would get IV nitro on my hands while priming a new line in the dark........talk about getting a headache:)

As far as antibiotics on your hands it should pose no threat......wash your hands don't "lick" it off :eek: (i'm joking, hopefully no one would consider this) and B12 won't hurt you but try asking everyone to use the smallest guage needle possible when removing B12. Even though it is thick and viscous a larger needle leaves a big hole so the next guy gets covered in smelly yellow fluid.:twocents:

Up Vote Up Vote ×
Specializes in ER, Trauma.

All I can add to the above is this. When drawing meds out of single use vials I don't add air. When I withdraw the needle I hear air being sucked in, rather than seeing some liquid squirt out on my hands or scrubs. It's not how I was taught, but sometimes neatness counts.

Up Vote Up Vote ×

Excellent advice in Esme12's post.

Don't forget the aerosolized meds and gases given by Respiratory Therapists. Know what the medication is that is being given rather than "just a neb". RTs have their studies both published and ongoing for 2nd hand aerosol exposure. Of course some of the old timers in the RT department had extensive Glutaraldehyde exposure. There are also studies for exposure from certain bacteria in the aerosol particles which is why we don't put two CF patients in the same room. Be extremely cautious when aerosolized antibiotics are in use and a sign should be placed on the door to avoid entry while the treatment is in progress. Of course Pentamidine and Ribavirin require special precautions not matter how many orders a doctor might write that it is "okay" to give anywhere. Flolan (epoprostenol), Iloprost and Ventavis have a list of precautions and reminders for care givers and the patient. Nitric oxide, which is now in home care as well as the ICU, also has precautions stated to avoid long term 2nd hand exposure although the ppm may be relatively small in most situations.

Old study for Ribavirin but it is still used in some hospitals with applications now in adults.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC171665/pdf/aac00060-0206.pdf

http://www.aft.org/pdfs/healthsafety/fs_ribavarin0806.pdf

Aerosolized meds

http://www.healthlinemed.com/PDF/Handout%20-%20Occupational%20Exposure.pdf

Nurses occupational exposure

http://www.ewg.org/node/28128

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Excellent advice in Esme12's post.

Don't forget the aerosolized meds and gases given by Respiratory Therapists. Know what the medication is that is being given rather than "just a neb". RTs have their studies both published and ongoing for 2nd hand aerosol exposure. Of course some of the old timers in the RT department had extensive Glutaraldehyde exposure. There are also studies for exposure from certain bacteria in the aerosol particles which is why we don't put two CF patients in the same room. Be extremely cautious when aerosolized antibiotics are in use and a sign should be placed on the door to avoid entry while the treatment is in progress. Of course Pentamidine and Ribavirin require special precautions not matter how many orders a doctor might write that it is "okay" to give anywhere. Flolan (epoprostenol), Iloprost and Ventavis have a list of precautions and reminders for care givers and the patient. Nitric oxide, which is now in home care as well as the ICU, also has precautions stated to avoid long term 2nd hand exposure although the ppm may be relatively small in most situations.

Old study for Ribavirin but it is still used in some hospitals with applications now in adults.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC171665/pdf/aac00060-0206.pdf

http://www.aft.org/pdfs/healthsafety/fs_ribavarin0806.pdf

Aerosolized meds

http://www.healthlinemed.com/PDF/Handout%20-%20Occupational%20Exposure.pdf

Nurses occupational exposure

http://www.ewg.org/node/28128

ABSOLUTELY!!!!!! Aerosol meds are a different story and follow all precatuions and manufacture's recommended administration precautions!!!!! Thanks!

Up Vote Up Vote ×
+ Join the Discussion