History, magnitude and rationality of injection use--a compilation.

Injection is a skin piercing event performed by a syringe and needle with the purpose of introducing a curative substance or vaccine into a patient. Dated back to 1657 with the first injection in animals the device is traced till 1991. The concern for proper management of injections is for occupational risk to the health worker, newer technologies to protect health workers is discussed including risk to patients and indirect risk via the environment to the community. Injection overuse is a cause of worry as it exposes the patient the risk of acquiring infections. In healthcare settings in India, most injections are unnecessary. Moreover irrational injection prescription is harmful. There also lies the misconceptions about injectable and oral medications. All professionals, in particular the doctors and nurses should become the advocates of safe injections.

Injection safety for immunisation--Andhra Pradesh experience.

Injection safety is one component of a major immunisation project being implemented in partnership with Government of Andhra Pradesh and PATH, an international NGO. Prior to the project wrong and dangerous injection giving practices were present among the staff which needed immediate attention. It was decided to introduce auto disable syringes along with safety boxes with high quality training to staff and make all these available to all districts along with hepatitis B introduction in the routine immunisation. The State of Andhra Pradesh became the first to implement 'bundling' concept in the immunisation project. Implementation was planned to be done in a phased manner to cover all the 23 districts over a five-year period. For routine immunisation sessions, smaller locally produced boxes may be more acceptable. The Government of India made a decision on 21st July, 2004 on implementing injection safety. Injection safety and proper disposal of used needles and syringes can be successfully advocated if medical associations, paediatric associations, key governmental bodies and international agencies come together. PATH established a group and holds the secretariat for the India injection safety coalition on similar basis as the Safe Injection Global Network of WHO (SIGN). Description of AP system for safe disposal of needles and syringes using manual needle-cutters and plastics recycling has been depicted in this article.