It is very important to review the patient’s medical history before starting to take radiographs. Wear a clean pair of gloves and a mask for each patient. Disinfect the exposure button and tube head or cover with a fresh protective barrier for each patient. Anything touched during the procedure should be disinfected. The instruments must be sterile and stored in a closed container. As soon as the film is placed in the patient’s mouth, it is contaminated. It should be placed in a cup behind the barrier.
When the series is complete, assemble all contaminated instruments in a container then transport them to the sterilization area. Remove gloves and wash your hands. Transport the film to the darkroom. Use a clean pair of disposable gloves in the darkroom to open the packets. Remove the film from the packets without touching them (the powder from the gloves will leave an imprint on the final film). Collect contaminated packets on a disposable paper towel. When all films are out of the packets, discard the towel and the packets and remove the gloves. After washing hands, process the films as usual, and the darkroom equipment will not be contaminated. The film packets could also be decontaminated by wiping them with bleach before taking them into the darkroom.
Barrier envelopes are available for intraoral films. Film packets with the barrier envelopes are positioned in the patient’s mouth and exposed. After removing the exposed x-ray images, tear open the barrier envelope and drop the film into a clean cup without touching it with the gloved hand. After the films are placed in the cups, the gloves can be discarded. This not only prevents any patient fluids from coming into contact with films, it also keeps powder from the gloves from depositing onto the films. [i]
Direct Digital Radiography (DDR) Sensors
Effective cross-contamination prevention is critical for direct digital radiography, or DDR, sensors, which are not sterilizeable. Current manufacturers’ recommendations for standard precautions are limited to the use of plastic barrier sheaths, which are commonly known to tear or leak. One study showed that plastic barriers failed as much as 40% of the time. The authors of a study found that use of a latex finger cot over the plastic sheath significantly reduced leakage to no more than 6 percent. [ii] To minimize the potential for patient cross-contamination, the Centers for Disease Control and Prevention recommends cleaning and disinfecting the sensor with an EPA-registered intermediate-level (tuberculocidal) disinfectant after removing the barrier and before use on another patient. Because the sensors and associated computer components vary by manufacturer and are expensive, manufacturers should be consulted regarding specific disinfection products and procedures.
[i] Takes Steps to Protect Yourself, Your Patients from Potential Exposure to Infectious Diseases By: M. Kevin O Carroll, BDS, MSD Professor Department of Diagnostic Sciences School of Dentistry University of Mississippi http://www.kodak.com/US/en/health/dental/focus/dentHyInfDis.jhtml Downloaded 12/20/2001.
[ii] Hokett S.D., Honey J.R., Ruiz F., Baisden M.K., Hoen M.M. “Assessing the Effectiveness of Direct Digital: Radiography Barrier Sheaths and Finger Cots.” JADA April 2000