Hi Diane
I read your reply re in house Hep B vax and you covered a lot of valid
points. I'm actually involved in a new "in house" scheme and the question
was put to the powers that be, "should we not have O2 and a mask available
and basis resus' stuff"?
The answer that came back was a firm "no". Do you (or anyone else out there)
have any opinion on this? should O2 be available at the point of
vaccination? and further, is there any requirement to do so? as there do
seem to be many conflicting opinions.
Nita
>From: Diane Romano-Woodward <[log in to unmask]>
>Reply-To: Occupational Health mailing list <[log in to unmask]>
>To: [log in to unmask]
>Subject: [OCC-HEALTH] in house hepatitis b
>Date: Sun, 12 Aug 2007 13:56:54 +0100
>
>Dear All Whether to do it in house or externally depends on a lot of
>things. The questioner did not give any indication of what industry was
>involved or the numbers of people to be vaccinated and whether they are
>doing EPP, all on one site, work shifts etc.. First of all you will need
>some authority from a doctor to vaccinate. This may be individual
>prescriptions, medical instructions or patient group directions depending
>on how many people are to be done and if a pharmacist is involved in
>procuring the vaccine(you can get it straight from the manufacturer). There
>are at least 3 brands of vaccine to chose from...and several schedules Then
>you will need to consider storage of vaccine in a proper pharmacy fridge.
>If you are not already storing vaccine you will need also to consider
>setting up systems for maintenance of cold chain , such as daily recoding
>of actual, and minimum and maximum temp of the fridge. You will also need
>to have an idea of what to do if the power fails , as different vaccines
>can tolerate different amounts of time at higher temperature. Don't forget
>you will need some resuscitation equipment/ PGD/training- as a minimum
>adrenaline 1:1000 but some also stock other drugs, oxygen, bag and mask etc
>etc. Some places feel the requirement to have a physician on site when
>vaccinating- many public health and OH nurses function without this. Also
>extra sharps bins and the cost of disposing of them, plasters, nurse time
>etc. So you are all ready to vaccinate. What about admin support for
>appointment telephone calls/ reminders/ diary etc. Have you got an OH
>computer software system that can generate letters, reports etc. How about
>a re-call system for the appropriate intervals between doses and 5 year
>booster? Flexibility for post accident/inoculation injury follow up
>boosters? Will accident advice need to be 24 hours a day or only office
>hours? Blood test for antibody levels post vaccination-you can approach
>the local NHS lab, or use a private lab- no requirement for storage of
>samples then as they go straight in the post. How are you goign to
>communicate the results of tests to individuals?
>
>You may also need occasionally to do Hepatitis B surface antigen and core
>antibody on non responders, and also Hepatitis B surface antigen and
>possibly Hepatitis C antibody and HIV testing on those who have had
>accidental exposure from unknown sources. There is a lot to consider but
>if you have some of these systems in place already and there are not too
>many people to do, (without hiring more staff) it maybe viable... Good
>luck!Diane PS Bashyr, can I use this essay as evidence for migration by
>portfolio!!! (knows how? informing other PHNs?)
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