solved

1. Hepatitis B
The Incident: When a new dental assistant previously interviewed for a job at Dr.Davidio’s office, the assistant misled Dr.D by indicating that the hepatitis B vaccination series was received in dental assistant school. The assistant refused the vaccinations, but the school still allowed completion of the 1- year training program. Last Friday, the assistant dismissed the last patient of the day and was gathering up the instruments from the bracket table when the assistant’s thumb was punctured with a contaminated explorer. After informing Dr.D, the well-organized post exposure medical follow-up procedures in Dr.D’s office were instituted. The assistant informed the evaluating physician that the hepatitis B vaccination had not been received. The medical evaluation confirmed that the assistant was not immune to hepatitis B and that the last patient of the day was a hepatitis B carrier (positive for the hepatitis B surface antigen [ HBsAg] ) but was negative for the hepatitis Be antigen ( HBeAg). The assistant was pretty shook up when she learned of these results. The hepatitis B immune globulin was administered along with the hepatitis B vaccination series, but the assistant remained anxious about the situation for quite a while.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?
2. Poste xposure Management
The Incident: Dr. Geebee recently graduated from a General Practice Residency program and was setting up a new three-chair practice with a hygienist (with 20 years of experience), two dental assistants, and a receptionist.
One Tuesday morning, the hygienist was running behind and rushing to complete a fourth patient to meet a friend who was visiting from out of town for lunch. During hastily sharpening a scaler, a slip of the hand caused a deep cut in the left index finger. The glove was removed, a bandage applied, the fresh glove was donned, and a new scaler retrieved. At the end of the appointment the hygienist called the physician’s office to ask about the seriousness of the injury. Because the main doctor was on vacation, an appointment was made after work with the on-call physician. That evening, the on-call physician asked the hygienist for information about the injury, how it occurred, the patient involved, and the hepatitis B immune status. The hygienist was a little anxious about the exposure and could only give the physician sketchy descriptions.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?
3. Needlestick and Culture of Safety
The Incident: Last week, Dr.M was seeing a new patient, and after giving a mandibular block, Dr. M laid the syringe on the bracket table. The chairside assistant picked up the syringe and, when removing the needle from the syringe, stuck the left index finger.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?

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