Healthcare professionals use intravenous (IV) drips for a variety of reasons. These include providing key medicines, electrolytes, vitamins and minerals, but they are also used for sedation as an alternative to anaesthesia.
Midazolam (a benzodiazepine) is the most commonly used sedative outside of hospital settings, according to the NHS. It helps keep patients conscious during procedures, but removes the risk of anxiety or pain throughout.
Dental professionals should know how to store this substance and manage all related waste items. This can be confidently achieved with the help of a specialist waste management service, such as Initial Medical.
Management in the practice
When judging how to store and manage pharmaceuticals in a healthcare setting, it’s important to recognise whether you are working with a controlled drug. These are detailed in the Misuse of Drugs Regulations 2001. It organises some pharmaceuticals into Schedules, which are each subject to different rules and regulations.
Midazolam is a Schedule 3 pharmaceutical, notable because most other benzodiazepines fall under Schedule 4. As a Schedule 3 controlled item, midazolam does not need to be stored in a controlled drug cupboard, nor does its presence on site need to be registered.
You should keep invoices for this product in your records for at least two years, in line with NHS guidance, but it is advisable to extend this to six years for HM Revenue and Customs requirements.
Waste management of pharmaceuticals
Disposal of controlled drugs must be completed with care. If an item comes into contact with people or the environment without any changes, it could cause illness, harm and pollution.
Like all Schedule 2, 3 and 4 (part 1) controlled drugs, midazolam needs to be denatured before disposal, rendering it irretrievable. This helps protect individuals who may come into contact with the waste. Clinicians must not place midazolam ampoules and syringes into waste without this step.
Once the drug denaturing kit has fulfilled its role, it must be placed in a pharmaceutical waste bin. This is signified by a blue lid, and the waste will typically be incinerated.
Drug denaturing kits are available from leading waste management specialists, including Initial Medical.
Managing contaminated items
During the process of providing IV sedation, a variety of items may become contaminated, including needles, syringes, the IV bag and lines, and PPE materials.
Health Technical Memorandum 07-01 (HTM 07-01) is the gold standard for clinical waste guidance. It notes that IV bags (and similarly contaminated material) should be placed in the yellow waste stream, for infectious, medical and anatomical waste that requires incineration or alternative treatment.
This also applies to sharps, which need to be placed in a dedicated yellow-lidded sharps container. This will be puncture-resistant and seepage-proof, and in turn protect individuals from both injury and contamination. If a syringe has excess liquid left inside, leave it inside the syringe and place it inside the container without emptying it into the drain or another waste container.
Solutions from Initial Medical
Initial Medical offers a range of effective waste containers suitable for managing IV and pharmaceutical waste. This includes Controlled Drug Denaturing Kits and environmentally-friendly Eco Sharps Bins. These are made from 40% recycled plastic and are designed in line with the NHS colour code to protect your patients and team.
Learn more by contacting the Initial Medical team today.
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