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Blood borne pathogen

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Blood Borne Pathogen Training

Blood Borne Pathogen Training

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  • 1. New Richland Fire Department Training & Safety 2007 Pathogens Blood Borne
  • 2.
    • Approximately 5.6 million workers in health care and other facilities are at risk of exposure to bloodborne pathogens such as human immunodeficiency virus (HIV – the virus that causes AIDS), the hepatitis B virus (HBV), and the hepatitis C virus (HCV)
    • OSHA’s Bloodborne Pathogens standard prescribes safeguards to protect workers against the health hazards from exposure to blood and other potentially infectious materials, and to reduce their risk from this exposure
    Introduction
  • 3. Who is Covered by the Standard?
    • All employees who could be “reasonably anticipated” as the result of performing their job duties to face contact with blood and other potentially infectious materials
    • “ Good Samaritan” acts such as assisting a co-worker with a nosebleed would not be considered occupational exposure
  • 4. Some Workers Who are at Risk
    • Physicians, nurses and emergency room personnel
    • Orderlies, housekeeping personnel, and laundry workers
    • Dentists and other dental workers
    • Laboratory and blood bank technologists and technicians
    • Medical examiners
    • Morticians
    • Law enforcement personnel
    • Firefighters
    • Paramedics and emergency medical technicians
    • Anyone providing first-response medical care
    • Medical waste treatment employees
    • Home healthcare workers
  • 5. Mode of Transmission
    • Communicable diseases are most often caused by either viruses or bacteria
      • Viruses cannot reproduce outside of a cell
      • Bacteria can reproduce outside of a cell, meaning that they can reproduce on any inanimate object
  • 6. Two ways of transmission
    • 1. Direct Transmission
    • 2. Indirect Transmission
  • 7. Direct Transmission
    • Passage of a disease from one person to another through direct contact with infected body fluids
      • Across placenta (from mother to child)
      • Sexual contact
      • Airborne
      • Bloodborne
  • 8. Indirect Transmission
    • Passage of a disease from one person to another without direct personal contact
      • Food
      • Water
      • Airborne
      • Bloodborne
      • Insect
  • 9. Chain of Transmission
    • Certain conditions must be met in order for a communicable disease to be transmitted
    • You need the following conditions to exist…
      • Causative agent
      • Mode of transmission
      • Portal of entry
      • Receiving host
  • 10. Causative Agents
    • Bacteria
    • Virus
    • Fungi
    • Protozoa
  • 11. Mode of Transmission
    • Efficient mode of transmission
      • (ex: Injection directly into the bloodstream)
    • Inefficient mode of transmission
      • (ex: Splash onto mucous membrane of eye or nose)
  • 12. Portal of Entry
    • Respiratory tract
    • Mucous membranes
    • Parenteral
    • Gastrointestinal tract
    • Genitourinary tract
    • Transplacental
    • Non-intact skin
  • 13. Receiving Host
    • The receiving host is the person who has been…
    • Don’t Let this be YOU!
    EXPOSED!
  • 14. Breaking the Chain of Transmission
    • Only you can break the chain by following your services…
    INFECTION / EXPOSURE CONTROL PLAN
  • 15. How does exposure Occur?
    • Most common: needle sticks
    • Cuts from other contaminated sharps (scalpels, broken glass, ect.)
    • Contact of mucous membranes (for example, the eye, nose, mouth) or broken (cut or abraded) skin with contaminated blood
  • 16. Exposure Control Plan
    • Identifies jobs and tasks where occupational exposure to blood or other potentially infectious material occurs
    • Describes how the employer will:
      • Use engineering and work practice controls
      • Ensure use of personal protective equipment
      • Provide training
      • Provide medical surveillance
      • Provide hepatitis B vaccinations
      • Use signs and labels
  • 17. Exposure Control Plan
    • Written plan required
    • Plan must be reviewed at least annually to reflect changes in:
      • Tasks, procedures or assignments which affect exposure, and technology that will eliminate or reduce exposure
    • Annual review must document employer’s consideration and implementation of safer medical devices
    • Must solicit input from potentially exposed employees in the identification, evaluation and selection of engineering and work practice controls
    • Plan must be accessible to employees
  • 18. Universal Precautions
    • Treat all human blood and certain body fluids as if they are infectious
    • Must be observed in all situations where there is a potential for contact with blood or other potentially infectious materials
  • 19. Engineering and Work Practice Controls
    • These are the primary methods used to control the transmission of HBV and HIV
    • When occupational exposure remains after engineering and work practice controls are put in place, personal protective equipment (PPE) must be used
  • 20. Engineering Controls
    • These controls reduce employee exposure by either removing the hazard or isolating the worker
      • Sharps disposal containers
      • Self-sheathing needles
      • Safer medical devices
        • Needleless Systems
        • Sharps with engineered sharps injury protections
  • 21. Safer Medical Devices
    • Needless Systems: a device that does not use needles for the collection or withdrawal of body fluids, or for the administration of medication or fluids
    • Sharps with Engineered Sharps Injury Protections: a non-needle sharp or a needle device used for withdrawing body fluids, accessing a vein or artery or administering medications or other fluids, with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident
  • 22. Work Practice Controls
    • These controls reduce the likelihood of exposure by altering how a task is performed. Examples:
      • Wash hands after removing gloves and as soon as possible after exposure
      • Do not bend or break sharps
      • No food or smoking in work areas
  • 23. B S I
    • Body Substance Isolation
  • 24. BSI Protective Measures
    • Wear gloves
    • Wash hands
    • Use masks and eyewear
    • Do not do mouth-to-mouth CPR
    • Wear gowns
    • Handle and dispose of all sharps properly
    • Cover all non-intact skin
    • Personal Protective Equipment (PPE)
  • 25. Personal Protective Equipment
    • Specialized clothing or equipment worn by an employee for protection against infectious materials
    • Must be properly cleaned, laundered, repaired, and disposed of at no cost to employees
    • Must be removed when leaving area or upon contamination
  • 26. Examples of PPE
    • Gloves
    • Gowns
    • Face Shields
    • Eye Protection
    • Mouthpieces and Resuscitation Devices
  • 27. Housekeeping
    • Must develop a written schedule for cleaning and decontamination at the work site based on the:
      • Location within the facility
      • Type of surface to be cleaned
      • Type of soil present
      • Tasks or procedures being performed
  • 28. Housekeeping
    • Work surfaces must be decontaminated with an appropriate disinfectant:
      • After completion of procedures,
      • When surfaces are contaminated, and
      • At the end of the work shift
  • 29. Decontamination Methods and Procedures
    • Low-level disinfection
    • Intermediate level disinfection
    • High-level disinfection
    • Sterilization
  • 30. Low-level Disinfection
    • Destroys most bacteria and fungi
    • Used for routine housekeeping
    • NOT used to remove visible body fluid
    • EPA registered disinfectants
  • 31. Intermediate Level Disinfection
    • Used for stethoscopes, BP cuffs, and splints
    • Use a 1:10 bleach solution or EPA disinfectant
  • 32. High-level Disinfection
    • Destroys all forms of microorganisms except some bacterial spores
    • Used for airway adjuncts
    • Uses EPA chemical sterilizing agent for 10-45 seconds
    • Can also immerse in hot water (176-212 degrees) for 30 minutes
  • 33. Sterilization
    • Destroys all microorganisms
    • Used in autoclave
    • Used for all contaminated invasive equipment
  • 34. Regulated Waste
    • Must be placed in closeable leak-proof containers built to contain all contents during handling, storing, transporting or shipping and be appropriately labeled or color-coded
  • 35. Laundry
    • Handle contaminated laundry as little as possible and use PPE
    • Must be bagged or containerized at location where used
    • No sorting or rinsing at locations where used
    • Must be placed and transported in labeled or color-coded containers
  • 36. So what can I be exposed to?
  • 37. Childhood Diseases – Measles
    • Uncommon due to widespread vaccination
    • Cause by rubella virus, transmitted through the respiratory tract
    • Initial high fever, followed by reddish rash
    • Highly self-limited
    • Symptomatic treatment
  • 38. Childhood Diseases – Mumps
    • Uncommon due to widespread vaccination
    • Caused by mumps virus, transmitted through saliva
    • Fever, followed by salivary gland swelling
    • Self-limited, treatment is symptomatic
  • 39. Childhood Diseases – Varicella (Chicken Pox)
    • Herpes infection
    • Transmitted through respiratory tract
    • Begins as a fever followed by reddish skin eruptions and itching
    • Self-limited treatment is symptomatic
  • 40. Meningitis
    • Common CNS infection
    • Can be life threatening
    • Infects lining of brain and spinal cord
    • Caused by bacteria, virus, or fungi
    • Often begins as a cold, sinus infection, or middle ear infection
    • Transmitted by airborne droplets
  • 41. Tuberculosis
    • Bacterial infection
    • Spread through water droplets from respiratory tract
    • Present with a cough, fever, chills
    • May cough up blood
  • 42. Skin Infections - Scabies
    • Highly communicable disease caused by mite species
    • Mites burrow into skin causing intense pain and itching
  • 43. Skin Infection - Lice
    • Slightly larger parasites than mites
    • Lay their eggs in hair follicles
    • Severe itching and small white specks in hair
    • Highly communicable
  • 44. Gastroenteritis
    • Common food poisoning
    • Infection of the stomach and intestines
    • Occurs within minutes or hours after eating infected food
  • 45. HIV Infection
    • Today worldwide epidemic
    • Transmitted through blood, vaginal secretions and semen
    • Theoretically through tears, CSF, saliva, breast milk, amniotic fluid, and urine
    • Enters body through non-intact skin, eyes, placenta and mucous membranes
  • 46. Hepatitis A (HAV)
    • Most common
    • Infected by eating food contaminated with stool from infected person
    • Initial phase is malaise with weakness
    • Dark colored urine and stools
  • 47. Hepatitis B (HBV)
    • Transmitted through blood and body fluids
    • Presents identically to Hepatitis A
    • More pronounced jaundiced and longer lasting illness
    • Disease can progress to cirrhosis of the liver and death
  • 48. Hepatitis B Vaccination Requirements
    • Must make available, free of charge at a reasonable time and place, to all employees at risk of exposure within 10 working days of initial assignment unless:
      • Employee has had the vaccination
      • Antibody testing reveals immunity
    • The vaccination must be performed by a licensed healthcare professional
  • 49. Hepatitis B Vaccination Requirements
    • Must be provided even if employee initially declines but later decides to accept the vaccination
    • Employees who decline the vaccination must sign a declination form
    • Employees are not required to participate in antibody prescreening program to receive vaccination series
    • Vaccination booster doses must be provided if recommended by the U.S. Public Health Service
  • 50. Hepatitis C, D, & E
    • Bloodborne diseases
    • C: May present similar to A & B
    • D: Signs and symptoms may be severe with a poor prognosis
    • E: Fecal oral route that may present similar to other forms of Hepatitis
  • 51. What to do if an Exposure Occurs?
    • Wash exposed area with soap and water
    • Flush splashes to nose, mouth, or skin with water
    • Irrigate eyes with water or saline
    • Report the exposure
    • Direct the worker to a healthcare professional
  • 52. Post-Exposure Follow-Up
    • Document routes of exposure and how exposure occurred
    • Record injuries from contaminated sharps in a sharps injury log, if required
    • Obtain consent from the source individual and the exposed employee and test blood as soon as possible after the exposure incident
    • Provide risk counseling and offer post-exposure protective treatment for disease when medically indicated in accordance with current U.S. Public Health Service Guidelines
    • Provide written opinion of findings to employer and copy to employee within 15 days of the evaluation
  • 53. Biohazard Warning Labels
    • Warning labels required on:
      • Containers of regulated waste
      • Refrigerators and freezers containing blood and other potentially infectious materials
      • Other containers used to store, transport, or ship blood or other potentially infectious materials
    • Red bags or containers may be substituted for labels
  • 54. New Richland Fire Department Training & Safety 2007 Portions of this PowerPoint were taken from the South Central EMS Joint Powers Board Bloodborne Pathogen Training Program and the OSHA Bloodborne Pathogen Training Program THANK YOU

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