Safety Above Standard, by Liza Sims, CPCP:

As I peruse websites offering training, pictures of technicians working, pictures and videos of procedures being performed I’m shockingly reminded that our profession is often conducted on a wing and a prayer as far as safety precautions are concerned.

While I am quite certain that if questioned each and all would say that they operate per universal standard precautions in order to protect themselves and others from coming in contact with blood or OPIM (other potentially infectious material).

BUT…
…consider the following:

Eyewear: Even though some practitioners have perfect eyesight and may not think they need magnification it is my strong opinion that because of the intricacy of the work we perform we all should work with magnification glasses. Yes, they are difficult to get used to, but great things come of change. The need for magnification however is not the safety issue. My issue is that I see the same pair of magnifiers being worn while working on client #2 that was used while working on client #1. Obviously the magnifiers cannot sustain autoclave temperatures and very few have autoclaves anyway. Running them under water or wiping them with a disinfectant wipe does not perform adequate disinfection. Glasses may be unconsciously touched and adjusted many times throughout a procedure and to think they are not contaminated is naïve thinking. Depending on the strength of the FDA approved disinfectant wet bath being used, the immersion time is different. I doubt that each and all are savvy to exactly what they are using in their wet baths and exactly what the required immersion time is. AND… simply allowing the magnifier to sit in the bath is hardly good enough. ‘Gross debris’ which may very well have accumulated at the hand-to-eyeglass contact point must be scrubbed and put through and ultrasonic cleaner. Does everyone have an ultrasonic cleaner? Not the kind bought at Bed Bath and Beyond; rather the heavy duty stainless steel type that can withstand the corrosive properties of proper disinfectant.

I wish everyone would discontinue the use of the esthetician pull-over style magnifier lights. These cannot possibly be disinfected well enough and the possibility of splatter on them is too great for the safe use of them in our profession.
Photo courtesy of www.bestshoppingcenter.net

Tip: Have multiple pairs of magnifiers on hand and be prepared to allow enough soak time for soiled magnifiers.

Protective Clothing: My jaw spends a good deal of time on the floor as I see people tattooing while wearing bracelets, watches, and street clothing. It’s astounding. We would all grimace at the thought of using the same gloves on one person as the last and yet some think nothing of dragging a sleeve or shirt cuff across the face of someone being tattooed and then dragging the same sleeve across the next person! While the inexpensive plastic disposable aprons are better than nothing, they still leave the arms unprotected. There are plastic disposable sleeves available that offer a good finishing touch to the aprons, but better yet are the non-woven disposable isolation gowns as used in hospitals. Yes, they bring the cost of doing business up, but how important is it to each professional that a communicable blood borne disease never be traced back to them?

Masks: While hot, uncomfortable and claustrophobic, I will never understand why anyone would choose to work without them. We work in such close proximity to our clients’ faces, besides the safety factor of unwanted fluid exchange it is common courtesy to wear a mask and thus avoid misting clients with saliva when we speak to them. I even condone wearing masks during the consultation as I draw brows on faces.

“Single-use-all-disposable”: the misuse of this term sends me into a tailspin at times. Of course our needles, tips, tubes, etc., are single-use and disposable. I challenge each and every person performing permanent makeup to this: Just before placing needle to skin for the first time, take a look at the work station. Is absolutely every single item on the tray to be disposed of? If a resounding ‘YES’ is the answer, that’s perfect! But it’s normally not the case.

None of us machine users cannot say yes to that question. If something is not going to be disposed of, it must be wrapped tight and knowledge of exactly how to break that item down for proper disinfection must be practiced! How about the errant brow pencil, eye wash-out bottle? Once needle breaks skin EVERYTHING on the work station is considered contaminated and must be thrown away at the end of the procedure. (Or in the case of machine and cord; be wrapped and correctly broken down at end of procedure.)

Tip: If conducting an eyeliner procedure place two single-use ampoules of eyewash on work station. This is sufficient for the final rinse and if both are not used is no great loss to toss one at the end. Have the wrappedbottle of emergency eyewash within reach of the work station but not ON the work station.

The Bubble of Safety: I imagine a bubble surrounding myself, my work station tray, my chair, and client. I visualize this to make myself constantly aware of the safety perimeter of the work being performed. The client is draped with a disposable sheet from neck to thigh and neck to chest with poly-backed dental bib.

If called away from the ‘safety bubble’ the following steps must be taken:

1. Remove gloves, don new gloves.
2. Remove magnification glasses, place on tray.
3. Remove mask, throw away.
4. Remove isolation gown, fold front to front roll and dispose of.
5. Remove gloves, wash, and dry hands properly.

Note: never move about through the office area in the same lab coat that has been worn during a procedure; it is contaminated!

If supplying the work station with new ink, place in a new pigment cup and do NOT carry it to the work station without new gloves.

When ready to re-enter ‘safety bubble’:

1. Wash and dry hands.
2. Don new gloves.
3. Don new mask.
4. Don new isolation gown.
5. Resume procedure.

Once again I thank you for taking the time to listen to the ranting of this Germaphobe (smile) and I hope perhaps a light bulb went off in at least a few heads.

Practice good and honest business, keep your standards high, and give to your clients all that you expect from them.  Thank you.