Title: Bloodborne Pathogen Training 2010
1Bloodborne Pathogen Training2010
- Advocate Condell EMS System
- Prepared by Sharon Hopkins, RN, BSN, EMT-P
2Objectives
- Upon successful completion of this module the EMS
provider will be able to - Define the mission of OSHA
- Describe what the OSHA Standard was designed for
- Describe the training program for bloodborne
pathogens - Define bloodborne pathogen
- Provide an example of potential bloodborne
pathogens - Define the term universal precaution
3Objective contd
- Define the term body substance isolation (BSI)
- List an example of engineering control
- List an example of a work place control
- List PPE products available to use
- Describe when PPEs should be used
- Recognize signs or labels that indicate the
presence of a bloodborne pathogen hazard - Describe components of housekeeping and when they
are performed
4Objective contd
- Describe necessary recordkeeping related to
bloodborne pathogens - Define an exposure incident
- Review the CMC EMS System Operating Guideline
(SOG) policy for infection control and exposure - Describe the Notification of Significant
Exposure form and how to complete - List routes of exposure to potential BBP
5Objective contd
- List transmission routes of bloodborne pathogens
in the workplace - List factors affecting disease transmission
- Describe the phases of the infectious process
- Discuss definition, incubation period,
transmission route, signs and symptoms, and PPE
to use for a variety of infectious diseases - Successfully complete the post quiz with a score
of 80 or better
6What is OSHA?
- A federal agency of the US Department of Labor
- Created by Congress in 1971 under the
Occupational Safety and Health Act - Mission
- To prevent work-related injuries, illnesses, and
death
7What is NIOSH?
- National Institute for Occupational Safety and
Health (NIOSH) created by the OSH Act - Functions as a research agency focusing on
occupational health and safety
8What is The Standard?
- In 1990, OSHA issued a standard (Bloodborne
Pathogen Standard) designed to prevent healthcare
workers and others from being exposed to
bloodborne pathogens such as hepatitis B and HIV
9Who does the Standard cover?
- All employees who could "reasonably
anticipate" - contact with blood
- contact with other potentially infectious
materials - while performing their job duties
10Compliance with the Standard
- The Bloodborne Pathogen Standard specifies
methods that are to be used to minimize the
transmission of bloodborne pathogens in the work
place. - These methods include
- Universal Precautions
- Engineering and Work Practice Controls
- Personal Protective Equipment (PPE)
- Appropriate Housekeeping Measures
11Training
- Employees must be provided information
- When first assigned a task with potential
exposure - Repeated annually
- During work hours
- When new tasks or procedures are added
- New exposure risk created must be addressed
12Training Requirements
- Make copy of standard accessible to all
- Have a general discussion of bloodborne pathogen
diseases and their transmission - Review your departments exposure plan
- Review how to obtain/view a copy of your
departments exposure plan 24/7 - Discuss how to recognize tasks and other
activities that may involve exposure
13Training Requirements contd
- Discuss the use and limitations of methods for
protecting or reducing exposure risk - Engineering practices
- Work practice controls
- PPEs
- Provide information on the Hepatitis B vaccine
- Review how to handle a response to an emergency
involving potential exposure
14Training Requirements contd
- Review the process when an exposure incident
occurs - Review your departments post exposure program
and follow-up program - Discuss signs, labels, and color-coding used to
indicate hazards - Provide an opportunity to ask questions and
receive answers
15Definition Bloodborne Pathogen
- Microorganisms that
- are present in human blood
- can infect and cause disease in people who are
exposed to blood containing the pathogen - can be transmitted through contact with
contaminated blood and body fluids
16Examples Bloodborne Pathogens
- Human Immunodeficiency Virus (HIV)
- Hepatitis B (HBV)
- Hepatitis C (HCV)
- Non A, Non B Hepatitis
- Syphilis
- Malaria
- Babesiosis
- Brucellosis
17Examples contd
- Leptospirosis
- Arboviral infections
- Relapsing fever
- Creutzfeld-Jakob disease
- Human T-lymphotrophic Virus Type 1
- Viral hemorrhagic fever
18Universal Precautions
- The concept that all blood and potentially
infectious materials must be treated as if they
are known to contain HIV, HBV, or other
bloodborne pathogens - You cant tell if material is or is not
infectious so treat all materials as if they are
infectious!
19Body Substance Isolation
- Body Substance Isolation is an alternative
infection control method in which all body fluids
and substances are defined as infectious - Coverage of the Bloodborne Pathogen Standard
extended to include all body substances
20Controls in Place
- The objective of engineering controls and work
practice controls is the same - to reduce or minimize employee exposure to
bloodborne pathogens
21Engineering Work Practice Controls
- Differences
- One control isolates or removes the hazard from
the workplace - Engineering control
- One reduces the risk of exposure by altering how
tasks are performed - Work practice control
22OSHA Impact
- OSHA gives precedence to engineering controls,
where feasible, over work practice controls, as
stated in a November 1999 compliance directive - Enforcement Procedures for the Occupational
Exposure to Bloodborne Pathogens (OSHA CPL
2-2.44D) - "Where engineering controls will reduce employee
exposure either by removing, eliminating, or
isolating the hazard, they must be used."
23Implementing Controls
- To guide selection of proper engineering and work
practice controls to implement - Determine tasks and procedures performed in the
workplace where occupational exposure may occur - Determine which employees are at risk for
occupational exposure while carrying out their
normal duties
24Engineering Controls
- Examples
- labeled sharps disposal containers
- self-sheathing needles
- safer medical devices
- sharps with engineered sharps injury protections
and needleless systems - handwashing facilities
- antiseptic hand cleanser
- cleaning supplies and equipment
25Work Practice Control
- Examples
- Handwashing
- Prohibiting recapping of needles by a
two-handed technique - Handwashing
- No eating, drinking, smoking in the ambulance
- Handwashing
- Disinfecting equipment and vehicle
- Handwashing
- Removing a soiled uniform
- Handwashing
26Handwashing
- One of the simplest and most effective practices
used to prevent the transmission of bloodborne
pathogens - Prevents transfer of contamination from your
hands to other areas of your body, to other
persons, or to other surfaces you may contact
later
27Handwashing
- As soon as possible following an occupational
exposure to blood or other potentially infectious
materials - After removal of gloves
- Before and after every patient contact
- After toileting
- Before and after preparing food
- Before and after eating or smoking
- After coughing or sneezing into hands or blowing
nose
28Handwashing How-to
- Take off rings
- Turn on faucet
- Wet hands
- Apply soap
- Scrub your hands - minimum 15 seconds
- Rinse
- Dry hands
- Turn off faucet use paper towel
29Scrubbing Your Hands
- Rub palms and backs of hands
- Rub your fingers
- Special attention to thumb and fingertips
- Interlace fingers
- Get into web spaces
- Clean under and around fingernails
- Rub your wrists
- Go 2 - 3 inches up forearm
30Antiseptic Hand Cleaner
- Antiseptic hand cleaners may be used as an
appropriate hand washing practice IF - Your gloves remained intact
- You have had no occupational exposure to blood or
other potentially infectious materials - Material can be left to air dry on your skin
- Choose product with at least 60 alcohol
- Washing with soap and running water every time
you remove your gloves is the recommended
practice.
31Did You Know?
- Liquid soap is preferred
- Bar soap can transfer microorganisms
- Antimicrobial or plain soap?
- Plain soap good enough for ordinary washing
- Antimicrobial is preferred during patient care
32Antiseptic Cleanser Precaution
- Gels contain 60-65 ethanol
- Same type of product found in beer and wine
- Beer usually contains 3-6 alcohol
- Wine generally contains 8-16 alcohol
- Spirits contain over 40 alcohol
- A teaspoon or 2 could make a toddler intoxicated
or give them alcohol poisoning - Keep hand sanitizers out of childrens reach
- Source Illinois Poison Center
33Personal Hygiene
- Personal hygiene involves using good judgment
when working in areas with the potential for
exposure
34- Minimizing splashing, spraying, spattering and
generation of droplets when attending to an
injured person. - Refraining from eating, drinking, smoking,
applying cosmetics or lip balms, or handling
contact lenses where there is a reasonable
likelihood of occupational exposure. - Keeping food or drink away from refrigerators,
freezers, shelves cabinets or on countertops or
bench tops where blood or other potentially
infectious materials are present. - Refraining from mouth pipetting/suctioning of
blood or other potentially infectious materials.
35Personal Protective Equipment - PPE
- The type of protective equipment appropriate for
your job or research varies with the task and the
degree of exposure you anticipate
36PPE - Gloves
- Should be made of latex, nitrile, rubber, or
other water impervious materials - If particularly thin or flimsy, double gloving
can provide an additional layer of protection - If you have cuts or sores on your hands, cover
these with a bandage or similar protection as an
additional precaution before donning your gloves
37Gloves
- Always inspect your gloves thoroughly before
putting them on - Never use gloves that are damaged, such as torn
or punctured - Remove contaminated gloves carefully, avoiding
touching the outside of the gloves with bare skin - Dispose of contaminated gloves in a proper
container
38Removing Gloves
- Grab one glove cuff and pull
off glove - Capture removed glove in other palm
- Pull off remaining glove by grabbing inside of
cuff - Pull glove off and over first
removed glove - Dispose of gloves
39PPE Eye Protection
- Bloodborne pathogens can be transmitted through
the mucous membranes of the eyes. - Use eye protection whenever there is a risk of
splashing or vaporization of contaminated fluid - Airway control (ie intubation, suctioning)
- Cleaning up spills
- Cleaning equipment
40Mask and Face Shields
- Masks and face shields provide additional
protection for potential eye, nose, or mouth
contamination - Used during tasks that may generate blood or
other potentially infectious materials via - Splashes
- Spray
- Spatter
- Droplets
41Protective Clothing
- Appropriate protective clothing such as, but not
limited to, gowns, aprons, lab coats, clinic
jackets, or similar outer garments shall be worn
in occupational exposure situations - Type and characteristics will depend upon the
task and degree of exposure anticipated.
42General Guidelines for Personal Protective
Equipment Use
- Persons should be trained to use the equipment
properly. - The equipment should be appropriate for the task
and should fit properly, especially gloves. - Equipment should be free from physical flaws that
could compromise safety. - Persons must use appropriate protective equipment
each time they perform a task involving
potentially infectious materials.
43Employer Responsibilities
- Issue PPE or make it readily accessible in the
work area - Maintain, replace or dispose of any PPE at no
cost to employees - Employer can provide the engineering controls
- The employee needs to exercise the work practice
controls for the process to be effective
44Signs, Labels Color Coding
- Signs and labels in the workplace communicate
bloodborne pathogen hazards to employees. - Warning label must include the universal
biohazard symbol and the term "biohazard" in a
color that contrasts with the fluorescent orange,
orange-red background
45Using Warning Labels
- Warning labels must be affixed to containers of
regulated waste, refrigerators and freezers
containing blood or other potentially infectious
material, and other containers used to store,
transport, or ship blood or other potentially
infectious materials. - Red bags or red containers can be substituted for
labels.
46Warning Labels
- Contaminated equipment which is to be serviced or
shipped must also have a warning label and a
statement regarding which portions of the
equipment remain contaminated.
47Research Laboratories
- HIV and HBV Research Laboratory and Production
Facilities must have biohazard signs posted at
the entrance. - Signs must also include
- Name of the infectious agent
- Special requirements for entering the area
- Name, telephone number of the laboratory director
or other responsible person
48Cleaning and Decontamination Duties
- Review product labeling for any special
directions/precautions - Wear appropriate PPE for task being performed
- Remove all blood and debris from surface to be
cleaned - Products cant clean the surface if they cant be
in contact with the surface - Allow disinfectant to air dry
- Leave surface wet 30 seconds for HIV disinfection
- Leave surface wet 10 minutes for HBV disinfection
49Clean Up Involving Blood or Body Fluids
- Wear appropriate Personal Protective Equipment
(PPE). - Carefully cover the spill with absorbent
material, such as paper towels, to prevent
splashing. - Decontaminate the area of the spill using an
appropriate disinfectant, such as a solution of
one part bleach to ten parts water. When pouring
disinfectant over the area always pour gently and
work from the edge of the spill towards the
center to prevent the contamination from
spreading out.
50Clean Up of Spills contd
- Wait 10 minutes to ensure adequate
decontamination, and then carefully wipe up the
spilled material. - Be very alert for broken glass or sharps in or
around the spill. - Disinfect all mops and cleaning tools after the
job is done. - Dispose of all contaminated materials
appropriately. - Wash your hands thoroughly with soap and water
immediately after the clean up is complete.
51Housekeeping and Waste Disposal
- Keeping the worksite clean and sanitary is a
necessary part of controlling worker exposure to
bloodborne pathogens. - Cleaning schedules and decontamination methods
depend on - type of surface to be cleaned
- type of soil that is present
- particular tasks or procedures that are being
performed
52General Housekeeping Guidelines
- Clean and decontaminate all equipment and working
surfaces after contact with blood or other
potentially infectious materials - Disinfect contaminated work surfaces, such as
counters, cots, side rails, B/P cuffs - after completing procedures
- immediately or as soon as feasible if they are
heavily contaminated or if there has been a spill
of blood or other potentially infectious
materials - at the end of the work shift if the surface may
have become contaminated since the last cleaning.
53Housekeeping contd
- Inspect and decontaminate bins, pails, cans, and
similar receptacles intended for reuse which have
a reasonable likelihood for becoming contaminated
with blood or other potentially infectious
substances on a regularly scheduled basis. - Clean and decontaminate receptacles immediately
or as soon as feasible upon visible
contamination.
54Cleaning Glucometers
- Clean surface when visible blood or body fluids
are present - Wipe with a cloth dampened with soap and water to
remove any visible organic material - If no visible organic material is present,
disinfect exterior surfaces after each use
following the manufacturers directions - Use a cloth/wipe with either an EPA-registered
detergent/germicide with a tuberculocidal HBV/HIV
label claim, or a dilute bleach solution of 110
(one part bleach to 9 parts water) to 1100
concentration
55Cleaning Glucometers
- Alcohol should never be used because it can
damage the light emitting diodes (LED) readout - Can cause fogging" of the plastic screens
- All manufacturers caution that having the cloth
too saturated with appropriate cleaning product
could allow liquid to get inside the glucometer
and cause damage - Screens and ports currently are not sealed on
these devices.
56Handling and Disposing of Broken Glassware
- Do not pick broken glassware up directly with
your hands. - Use items such as a brush and dust pan, tongs, or
forceps to clean up glassware. - Sterilize broken glassware that has been visibly
contaminated with blood with an approved
disinfectant solution before disturbing it or
cleaning it up. - Dispose of decontaminated glassware in an
appropriate sharps container. Sharps containers
should be closable, puncture-resistant,
leak-proof on sides and bottom, and appropriately
labeled. - Dispose of uncontaminated broken glassware in a
closable, puncture resistant container such as a
coffee can.
57Waste Disposal
- Regulated waste refers to
- Any liquid or semi-liquid blood or other
potentially infectious materials - Contaminated items that would release blood or
other potentially infectious materials in a
liquid or semi-liquid state if compressed - Items that are caked with dried blood or other
potentially infectious materials and are capable
of releasing these materials during handling - Contaminated sharps
- Pathological and microbiological wastes
containing blood or other potentially infectious
materials
58Recordkeeping
- Medical records must be kept for each employee
with occupational exposure for the duration of
employment plus 30 years, must be confidential
and must include name and social security number
hepatitis B vaccination status (including dates)
results of any examinations, medical testing and
follow-up procedures a copy of the healthcare
professional's written opinion and a copy of
information provided to the healthcare
professional.
59Recordkeeping contd
- Medical records must be made available to the
subject employee, and anyone with written consent
of the employee, but they are not to be available
to the employer.
60Recordkeeping contd
- Training records must be maintained for three
years and must include dates, contents of the
training program or a summary, trainer's name and
qualifications, names and job titles of all
persons attending the sessions.
61Exposure Incidents
- An exposure incident is an event resulting from
the performance of an employee's duties in which
there has been - A percutaneous injury involving a potentially
contaminated needle or other sharp - A splash of blood or other potentially infectious
materials to the eyes, mouth, or mucous membranes
- Blood or other potentially infectious materials
contacting broken skin
62Potential Exposure
- An occupational exposure should always be
considered an urgent medical concern to ensure
timely postexposure management and administration
of hepatitis B immune globulin (HBIG), hepatitis
B vaccine, and/or HIV post-exposure prophylaxis
(PEP). - If you are injured or exposed, tell your
supervisor immediately. Your supervisor is
responsible for reporting your injury correctly.
63Advocate CMC EMS System Policy
- Notification of significant exposure is to be
reported immediately to the receiving hospital - Complete Notification of Significant Exposure
form - Leave in sealed envelope for EMS coordinator
- The ED MD on duty will advise the appropriate
medical follow-up or need for consultation with
private physician
64EMS System Policy contd
- Follow-up fees responsibility of the provider
- If ED care is rendered to the provider, they must
sign-in as a patient in the ED - Guarantees proper documentation the incident and
of care rendered
65Notification of Significant Exposure Form
- Fill in information in the 1st four columns as
completely as possible - Check all means of exposure that apply
- Provide information on the type and brand of
device, if involved - Receiving hospitals in Illinois are required to
notify ambulance providers if a patient has been
diagnosed as actively contagious - Notification made within 72 hours of diagnosis
66(No Transcript)
67- Early treatment can significantly reduce the
chance of disease transmission!
68Postexposure Prophylaxis
- The U.S. Public Health Service (PHS) has
published Guidelines for the Management of
Occupational Exposures to HBV, HCV, and HIV and
Recommendations for Postexposure Prophylaxis",
which can be accessed at http//www.cdc.gov/mmwr/
preview/mmwrhtml/rr5011a1.htm.
69Microorganisms
- Disease causing organisms
- Microscopic in nature
- Can be part of the normal flora or pathogenic
(able to cause disease) - Bacteria
- Viruses
- Fungi
- Protozoa
- Parasites
70Routes of Exposure
- Bloodborne
- HIV, HBV, HCV, syphilis
- Airborne
- TB, influenza, common cold, RSV, chickenpox
- Droplet
- Influenza, meningitis, measles, mumps, rubella,
chickenpox (varicella) - Fecal-oral
- HAV, food poisoning
- Note Multiple diseases could be airborne and/or
droplet
71Disease Transmission
- Direct contact
- Person to person
- Physical transfer of microorganisms
- Coughing, sneezing, kissing, sexual contact,
contact with blood or body fluid - Indirect contact
- Susceptible person infected from contact with
contaminated surface - Person most likely brings contaminated hands to
their face - Telephones, door knobs, steering wheels, B/P
cuffs, EKG cable, handrails, pens - Via food products, water, soil
72Bloodborne Exposure
- Direct or indirect contact with blood or infected
body fluids - Needle stick
- Splash on broken skin
- Splash on mucous membranes
- Eyes, nose, mouth
73Airborne Exposure
- Particles remain suspended in air a long time and
float a distance - At risk when less than 6 feet from patient
- Transmitted via sneezing, coughing, talking,
shedding of skin - Healthcare worker should wear a N95 mask
- Patient should wear a tight fitting surgical mask
- TB, polio, pneumonia, influenza, chicken pox
74Droplet Exposure
- Droplet of moisture expelled from the upper
respiratory tract and then inhaled into the
respiratory system or contacts the mucous
membranes - Droplets too heavy to remain airborne for long
- Transmitted during sneezing, coughing, talking
- Most at risk when within 3 feet of patient
- Wear surgical masks when threat of droplet
exposure - Common cold, influenza, H1N1, meningitis, rubeola
(measles), whooping cough
75Fecal-oral Route
- Ingestion of contaminated food or water
- Contaminated hands (usually from improper
handwashing or lack of handwashing) transfers
microorganisms to all surfaces and objects
touched - Recipient touches surface and then brings
contaminated hands to their face or ingests
contaminated product - HAV, food poisoning
76Terms Defined
- Communicable disease
- Capable of being transmitted to another host
- Contamination
- Infectious agent on surface of host but not
penetrating it - Infection
- Penetration of agent has occurred to host
- Having the infection does not automatically imply
having the disease
77Factors Affecting Disease Transmission
- Mode of entry
- Intact skin an excellent barrier
- Mucous membranes often the point of entry
- Eyes, nose, mouth
- Virulence
- Organism strength (ability to infect)
- HBV infectious for weeks
- HIV die when exposed to air and light
- Dose
- Number of organisms
- Host resistance general health
78Phases of Infectious Process
- Latent period
- Host infected, does not transmit to others
- Communicable period
- May have signs and can transmit disease
- Incubation period
- Time between exposure and appearance of symptoms
79Phases contd
- Seroconversion
- Antibodies created after exposure lab tests are
positive - Window phase
- Time between exposure and seroconversion
- May test negative even though person is
infected - Disease period
- Time from onset of signs and symptoms until
resolution or death
80Preventing Infection
Infectious agent
Means of transmission
Host
Routes of exposure
81Selected Infectious Diseases
- Definition
- Incubation Period
- Transmission Mode
- Signs Symptoms
- Recommended PPEs
- Special Considerations
82HIV
- A fragile virus that attacks the immune system
- Eventually leads to AIDS a collection of signs
and symptoms - Incubation is variable and can be in years
- Transmission
- Sexual contact
- Contact with contaminated blood
- Mother to newborn
83HIV contd
- Signs symptoms
- Fatigue, fever, sore throat, lymphadenopathy,
splenomegaly, rash, diarrhea, secondary
infections, weight loss, dementia, psychosis - No vaccine
- PPE gloves, goggles, mask, gown as needed to
avoid blood contamination - HIV rarely presents life threatening
- Is more often a psychosocial challenge
84Hepatitis B (HBV)
- Viral infection can develop into chronic state
affects the liver - Incubation 4 - 25 weeks
- Transmitted by direct contact with blood or body
fluids - Complaints start as flu-like symptoms
- Dark urine, light colored stools, fatigue, fever,
jaundice - PPEs gloves, goggles, mask, avoidance of
needlesticks
85Hepatitis B Virility
- The CDC states that Hepatitis B Virus can survive
for at least one week in dried blood on
environmental surfaces or on contaminated
instruments.
86Hepatitis B Vaccine
- Must be offered within 10 days of assignment to
task with exposure risk involved - If employee declines, must sign declination form
- Kept on file
- Employee may, at any time, request the hepatitis
B vaccine after initial declination - 3 injection series
- Given IM in deltoid
- Once started, 2nd dose is in 1 month 3rd dose 6
months from 1st dose
87Hepatitis C (HCV)
- Viral infection causing inflammation of liver
- Can lead to cirrhosis and cancer
- Leading reason for liver transplants in the USA
- Incubation 2-25 weeks
- Transmission contact with contaminated blood
- Contagious throughout course of infection
88HCV contd
- Symptom onset slow (up to 20 years for chronic
infection) - Loss of appetite
- Vague abdominal discomfort
- Nausea and/or vomiting
- Jaundice less common than with HBV
- No vaccine is available
- PPEs gloves, mask, goggles, avoidance of
needle sticks
89Tuberculosis (TB)
- Bacterial infection most commonly affecting the
lungs - TB infection
- Person has the bacteria but is not ill cannot
spread disease - TB disease
- Person ill, can spread TB
- Incubation 4 -12 weeks
- Transmission via airborne droplet
- Prolonged exposure increases risk
90TB contd
- Signs and symptoms
- Fever
- Chills
- Weakness. fatigue
- Night sweats
- Weight loss
- Dyspnea
- Productive cough
- Chronic cough
91TB contd
- PPEs
- Respiratory isolation
- Tight fitting surgical mask on patient
- N95 mask for providers
- Obtain periodic skin testing
- If positive, need chest x-ray
- Provide adequate ventilation while caring for and
transporting the patient with suspected or
positive diagnosis
92Chickenpox (Varicella)
- Viral infection
- Transmitted via direct and indirect contact and
airborne droplets - Incubation 10 - 21 days
- Signs and symptoms
- Sudden onset low-grade fever
- Mild feeling of not being well (malaise)
- Rash
93Chickenpox contd
- Contagious about 2 days prior to rash and until
all vesicles have scabbed over - Skin eruptions continue over 3 4 days
- PPEs gloves surgical mask on patient, mask on
healthcare provider - Vaccination added to childhood immunization
schedule
94Bacterial Meningitis
- Bacterial infection causing inflammation of the
covering the brain and spinal cord - Transmitted via contact with respiratory droplets
- Incubation 2 10 days
- Sudden onset high fever, headache, stiff neck,
nausea with vomiting, irritability - Infants poor feeding, irritability
95Bacterial Meningitis contd
- PPEs gloves, mask (patient and provider)
- Vaccination provided in childhood immunization
schedule - Postexposure antibiotic prophylaxis provided
after exposure
96Influenza The Flu
- Upper respiratory viral disease
- Transmitted via respiratory droplet or airborne
in crowded, enclosed spaces - Incubation usually 1 5 days
- Adults contagious 3 5 days after symptom onset
- Up to 7 days in children
- Rapid onset high fever, headache, muscle aches,
sore throat, dry cough
97Flu contd
- PPE Mask the patient and provider
- Frequent handwashing
- Daily cleaning of environment
- Phones, door handles, steering wheels, counter
tops, computers - Best protection annual flu vaccine
98H1N1 Influenza Swine Flu
- A new strain of influenza virus
- Transmitted person to person primarily via
droplets - Coughing
- Sneezing
- Contact with contaminated objects
- Contaminated hands touch the nose and mouth and
introduce the virus - Incubation could range 1 7 days
- Considered contagious up to 7 days from symptom
onset
99H1N1 contd
- Symptoms similar to regular flu
- Fever
- Cough
- Sore throat
- Body aches
- Chills
- Fatigue
- Critical situation
- Respiratory difficulty
- Cyanosis
- Pain, pressure in chest or abdomen
100H1N1 contd
- PPE
- Gloves
- HANDWASHING
- Disinfecting surfaces after each call
- Frequently disinfect surfaces likely to have hand
contact
101General Advice
- Get vaccinated
- Cover mouth and nose when coughing or sneezing
- Use elbow not hand
- Throw tissue away after one use
- Wash hands often
- Avoid touching eyes, nose, mouth with hands
- Practice good personal health
- Get plenty of rest
- Eat healthfully
- Manage stress
- Stay physically active
1023 Cs To Stay Healthy
- CLEAN COVER CONTAIN
- Wash your hands
- Cover your cough and sneeze
- Contain your germs
- Stay home if sick
103Pertussis Whooping Cough
- Highly contagious bacterial disease
- Incubation 7 10 days
- Range total 4 21 days
- Transmitted most commonly respiratory droplet and
airborne - Most at risk
- Infants prior to vaccination
- Aging population with lost immunity
- Those never vaccinated
104Whooping Cough contd
- Signs and symptoms in phases
- 1st phase sneezing, watery eyes, loss of
appetite, listless, noticeable night cough - 2nd phase in 10 -14 days paroxysms of coughing,
thick mucous coughed up - 3rd phase in 4 weeks coughing decreases in
frequency can last for months - Vaccination DTaP
- Immunity not life long need repeat vaccination
105Whooping Cough contd
- PPE gloves, surgical mask patient and provider,
goggles, possible gown - Complications often from the spasmodic forceful
coughing - Pneumothorax
- Rib fractures
- Hypoxia during coughing spells
106Staph Infections
- Staphylococcus aureus, often referred to simply
as "staph," are bacteria commonly carried on the
skin or in the nose of healthy people - Approximately 25 to 30 of the population is
colonized (bacteria are present, but not causing
an infection) in the nose with staph bacteria - One of the most common causes of skin infections
in the United States - Most of these skin infections are minor (such as
pimples and boils) and can be treated without
antibiotics - Staph bacteria can also cause serious infections
107MRSA Methicillin-Resistant Staphylococcus Aureus
- Type of bacteria that is resistant to common
antibiotics such as methicillin, oxacillin,
penicillin and amoxicillin. - Consequently, MRSA infections can be far more
difficult to treat quickly than traditional staph
infections. - Occurs most frequently among persons in hospitals
and healthcare facilities who have weakened
immune systems.
108Community Associated MRSA
- MRSA infections acquired by persons who have not
been recently hospitalized or had a medical
procedure (such as dialysis, surgery, catheters)
are known as CA-MRSA (Community Associated MRSA)
infections. - CA-MRSA infections can be transmitted in settings
such as workout facilities or locker rooms - Are usually manifested as skin infections such as
pimples and boils
109Results Of Contracting MRSA
- Skin infections, pimples, boils
- Pneumonia
- Bloodstream infections
- Potentially death
110Transmission of MRSA
- Spread of MRSA skin infections is direct and
indirect - Close skin-to-skin contact
- Cuts or abrasions
- Poor hygiene
- Methods of Contraction
- Crowded living conditions
- Contaminated items or surfaces
- Weakened immune system
111MRSA
- PPE
- Gloves
- Transport patient with a clean sheet
- Do not use the sheet from the bed the patient was
lying in, if possible - Avoid placing laundry in contact with uniform
wear gown if contact made with uniform - Handwashing
112Vancomycin-resistant Enterococcus - VRE
- Bacteria normally found in intestines
- Produces disease when bacteria invade other areas
- Urinary tract, wounds, blood
- Healthy individuals rarely at risk
- Healthy individuals can transmit VRE via indirect
methods - Those at most risk weakened immune systems and
other health issues
113VRE
- Spread via contact
- Feces
- Contaminated equipment
- Healthcare workers hands
- PPE
- Gloves
- Gown if clothing contact anticipated
- Handwashing single most important process to
control spread of VRE - Disinfect equipment after calls
- Prevents indirect spread of VRE
114Content Review
- Review the following questions
- After determining an answer, click the mouse to
check your knowledge - Complete the course with a 10 questions quiz
115Question 1
- Who does the OSHA's Bloodborne Pathogens standard
cover? - 1. All employees, regardless of occupation or
workplace - 2. All employees in jobs where occupational
exposure to bloodborne pathogens can be
"reasonably anticipated - 3. Only employees who work in health care
settings, such as hospitals or clinics - 4. Only employees who use needles on the job
116Question 2
- Which label indicates that a biohazard is
present? -
117Question 3
- Which of the following is not an example of an
other potentially infectious material (OPIM)? - 1. Blood from experimental animals infected with
HIV or HBV2. Cerebrospinal fluid - 3. Urine
- 4. Unfixed body organs going to the lab for
analysis
118Question 4
- Which of the following is a true statement
concerning handwashing after occupational
exposure to blood or other potentially infectious
materials? - 1. If your gloves are still intact when you
remove them, there is no need to wash your hands
afterwards.2. Strong abrasive soaps are most
effective in removing contamination from
hands.3. Using an antiseptic towelette is always
an acceptable alternative to washing your hands
with soap and water. - 4. The best practice is to thoroughly wash
your hands with soap and water after any
potential exposure.
119Question 5
- How often should work surfaces, such as counters
or cabinet surfaces, be decontaminated? - 1. Whenever procedures involving blood or other
potentially infectious materials are completed - 2. At the end of each work shift, if the surface
may have become contaminated since the last
cleaning - 3. Immediately or as soon as feasible following
a spill of blood or other potentially infectious
material - 4. All of the above
120Question 6
- Are gloves required when giving an injection?
- YES or NO
- Gloves are not required to be worn when giving an
injection as long as hand contact with blood or
other potentially infectious materials is not
reasonably anticipated. - Source USDOL FAQs
121Resources
- www.lakecountyil.gov/Health/H1N1.htm
- Ready.illinois.gov
- www.flu.gov
- LCHD Flu Hotline 847-377-8350
122Bibliography
- Condell Medical Center EMS System Operational
Guidelines Infield Policy Manual. January 2001 - Environmental Health Safety On-line Training
Module. BBP. 2010. - Region X SOPs March 2007. Amended May 1, 2008.
- www.cdc.gov
- www.cdc.gov/ncidod/hip/Blood/Exp to blood.pdf
- www.cdc.gov/sharpsafety/
- www.Illinoispoisoncenter.org
- www.osha.gov/OshDoc/data_BloodborneFacts/
- www.osha.gov/SLTC/bloodbornepathogens/index.html