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INFECTIONCONTROL& SAFETY
MRS. STACEY WRIGHT, AAS, EMT-P
DEPUTY CHIEF, SAFETY OFFICER
PENDER EMS AND FIRE, INC.
CONTACT INFORMATION
• Stacey Wright, AAS, EMT-P
• 910-470-0982
• 910-259-4612
• swright@penderems.com
• 910-675-9198
ACCOUNTABILITY
• SOG CO-28
• Purpose:
• The purpose of this guideline is to ensure the location and
safety of all Emergency Personnel working on the Incident
scene.
• To maximize the efficiency of operations used to stabilize the
incident.
• Review the SOG CO-28 that goes in detail the Accountability.
SAFETY FORMS
• Purpose: To provide the employer and employee with
the means to document injuries, exposures, and
unsafe practices.
• Company Safety Forms are located on the Shared
Drive in the 2016 Policy and Guidelines Company
SOG’s --CO 26 Thru CO 26-K
SAFETY
• The safety and health of employees is a
priority. Pender EMS and Fire makes every
effort to comply with all federal and state
workplace safety requirements. All members
are required to have all departmental issued
Personal Protective Equipment (PPE), with
them while at work and/or a departmental
function that may require the use of any or all
of the PPE.
• Each employee is expected to obey safety
rules and exercise caution and common sense
in all work activities.
• Note: See Safety Manual for complete Safety
Guidelines and Policies.
INFECTION / EXPOSURE CONTROL
• GOAL: It is intended to offer you the basic
understanding to protect yourself against such
pathogens as HIV, HBV, and other infectious diseases.
• PLEASE DO NOT let this replace your “COMMON
SENSE”…..If you see a risk, take precautions.
BLOODBORNE PATHOGENS
UNIVERSAL PRECAUTIONS ALSO
KNOWN AS STANDARD PRECAUTIONS
REDUCING RISKS
1. Maintenance Controls
* Equipment maintenance
2. Work Practice Controls
* Proper hand washing (done frequently)
(If water not available, use antiseptic wipe)
* Proper Hygiene
* Keep possible exposure areas free from food items
3. Proper use of Personal Protective Equipment (PPE)
* Gloves are to be used when handling any body fluid
* Careful removal of gloves (not touching outside area)
* Using appropriate equipment in all situations
ISOLATION PRECAUTIONS
 Standard Precautions— used with every patient all the
time that includes but not limited to gloves, goggles, and
gowns.
 Airborne Precautions- use standard precautions and n-
95 or n-100 masks. Patient should have a Surgical mask
on during transport.
Isolation Precautions
 Contact Isolation Level 1- GOWN, GLOVES, and
SURGICAL MASK MUST be worn when entering the room
at a facility or on dealing with patients at home under
home health care Esp. MRSA AND SARS
 Contact Isolation- GOWN and GLOVES This is used for
any Contact Isolation cases esp. VRE, LICE SCABIES,
AND WOUNDS.
 Droplet Isolation- SURGICAL MASK
MRSA
 Methicillin-resistant Staphylococcus
aureus (MRSA) infection is caused
by a type of staph bacteria that's
become resistant to many of the
antibiotics used to treat ordinary
staph infections.
Two Types of MRSA
 First one is MRSA infections that occur in people who've
been in hospitals or other health care settings, such as
nursing homes and dialysis centers. When it occurs in
these settings, it's known as health care-associated
MRSA (HA-MRSA).
 HA-MRSA infections typically are associated with
invasive procedures or devices, such as surgeries,
intravenous tubing or artificial joints.
Two Types of MRSA
 Second type of MRSA infection has occurred in the
wider community — among healthy people. This form,
community-associated MRSA (CA-MRSA), often begins
as a painful skin boil. It's spread by skin-to-skin contact.
 At-risk populations include groups such as high school
wrestlers, child care workers and people who live in
crowded conditions
CAUSES
 Different varieties of Staphylococcus aureus
bacteria, commonly called "staph," exist.
 Staph bacteria are normally found on the
skin or in the nose of about one-third of
the population.
 The bacteria are generally harmless unless
they enter the body through a cut or other
wound, and even then they usually cause
only minor skin problems in healthy
people.
MRSA
 “COLONIZED” VS “INFECTED”
People who carry MRSA are said to be colonized. Many
kinds of bacteria can live in (colonize) your body without
causing an infection. In fact, everyone is colonized by
many kinds of bacteria all the time. Being infected
means bacteria are multiplying and the body is trying to
defend itself against them.
RISK FACTORS of HA-MRSA
 Being hospitalized. MRSA remains a concern in
hospitals, where it can attack those most vulnerable —
older adults and people with weakened immune
systems.
 Having an invasive medical device. Medical tubing —
such as intravenous lines or urinary catheters — can
provide a pathway for MRSA to travel into your body.
 Residing in a long-term care facility. MRSA is prevalent
in nursing homes. Carriers of MRSA have the ability to
spread it, even if they're not sick themselves.
Risk Factors of CA-MRSA
 Participating in contact sports. MRSA can spread easily
through cuts and abrasions and skin-to-skin contact.
 Living in crowded or unsanitary conditions. Outbreaks of
MRSA have occurred in military training camps, child
care centers and jails.
 Men having sex with men. Homosexual men have a
higher risk of developing MRSA infections.
Preventing HA-MRSA
 In the hospital, people who are infected or colonized
with MRSA often are placed in contact precautions as a
measure to prevent the spread of MRSA.
 Visitors and health care workers caring for people in
isolation may be required to wear protective garments
and must follow strict hand hygiene procedures.
 Contaminated surfaces and laundry items should be
properly disinfected
Preventing CA-MRSA
 Wash your hands. Careful hand washing remains your best defense against germs.
Scrub hands briskly for at least 15 seconds, then dry them with a disposable towel
and use another towel to turn off the faucet. Carry a small bottle of hand sanitizer
containing at least 62 percent alcohol for times when you don't have access to soap
and water.
 Keep wounds covered. Keep cuts and abrasions clean and covered with sterile, dry
bandages until they heal. The pus from infected sores may contain MRSA, and
keeping wounds covered will help prevent the bacteria from spreading.
 Keep personal items personal. Avoid sharing personal items such as towels, sheets,
razors, clothing and athletic equipment. MRSA spreads on contaminated objects as
well as through direct contact.
 Shower after athletic games, practices, or workout sessions. Shower immediately
after each game or practice. Use soap and water. Don't share towels.
 Sanitize linens. If you have a cut or sore, wash towels and bed linens in a washing
machine set to the hottest water setting (with added bleach, if possible) and dry
them in a hot dryer. Wash gym and athletic clothes after each wearing.
MRSA
 Because of that, workers comp. will not cover MRSA
exposure’s without direct documentation of exposure at
work but even then it is very hard to get worker
compensation coverage.
 Is a contact spread disease
 WEARING of PPE is essential in the prevention of MRSA.
 CONTACT ISOLATION LEVEL 1: Stands until off antibiotics
and 3 negative cultures have been obtained. If the
negative cultures cannot be obtained YOU MUST follow
CONTACT ISOLATION LEVEL 1 which is Gloves, gowns,
and surgical mask.
Respirator Program
Pender EMS & Fire
RESPIRATOR PROGRAM
 PURPOSE: This is a guideline to help ensure the protection
of all employees from respiratory hazards through proper
selection and use of respirators.
 USAGE: Respirators will be used primarily for the exposure
of Tuberculosis or in emergencies where there are
suspected AIRBORNE health hazards.
Respirator Program Cont.
 Assignment: 1 Respirator per employee
 Training: Once a year
 Selection: N-95/N-100 Sm., Med., Large, Regular
 Inspection: Should be thoroughly inspected
prior wearing and when units are checked off for
any deterioration.
 Medical Evaluations: Done once a year
 Pulmonary Function Test done if required by
Cooperate Health based on Medical Evaluations.
Respirator use under Special Conditions
 Facial Hair: should not interfere
with the seal of the respirator
 All employees should come to
work clean shaven.
 Eye Glasses: Should NOT
interfere with the nose clip of the
mask…..this could cause
interference with the seal
 Facial Deformities: scars, lack of
teeth, dentures, severe acne,
prominent cheek bones
 Communications: Make sure seal
is maintained during conversation
with Patients and Fellow Co-
workers.
FINAL ANALYSIS
 To have a safe and
effective program, the
employees must use
the equipment as they
have been trained!
What is Airborne Pathogens
Is a disease caused by germs that are spread from person to person
through the air.
TUBERCULOSIS
Purpose: Is to provide guidelines and procedures that will
minimize the risk and consequences associated with exposures
to communicable diseases.
BACKGROUND
 Communicable diseases can be transmitted several different
ways:
 Direct>>>Person to Person
 Indirect…..Person to Object
 Inhalation…..unprotected exposure to an airborne pathogen
such as TB
 Ingestion…Eating or drinking contaminated food or water
Indentification of TB
 Transmitted through the air
 Most dangerous indoors……especially areas
with poor air circulation
 Can survive for long periods of time
 Carried through the air in infectious droplets
(1-5 microns in size)
 Generated by infectious persons cough, speach,
sighs, or spits
 EMPLOYEES ARE IN DANGER OF EXPOSURE
WHENEVER THEY TRANSPORT TB – INFECTED
PATIENTS
SIGNS AND SYMPTOMS
INFECTION
VS
ACTIVE TB
 Patients that are infected with TB will have no symptoms
 Will not be contagious
 Only detection is by TB skin test
 Takes months to years to develop TB
 May never develop TB at all
 Patients with active TB will have the S/S as listed in previous
slide
General Measures
 Treatment will be conducted by Local Health Department.
Treatment can last 9-24months.
 Review policy once a year
 TB Skin test every six months or as directed by Medical
Control
 Medical screening as needed
 Pender County Health Department, Safety Officer,& Medical
Direction will assist with all questions and or concerns!
Handling of Suspected TB Patient
**Immediately apply HEPA Respirator issued to you
**Follow policy and procedures for proper donning of
HEPA Mask
**If possible, place mask/face shield on patient
**Gloves, Gowns, & Protective Eye Wear should be worn
**Outside vents should be turned on
Post Exposure Policy
 Treated at PCHD during MONDAY –FRIDAY 8am
to 4pm
 Remember, Treatment will not start
immediately……just PAPERWORK
 Shift supervisor should be notified ASAP
 Safety Officer notified ASAP
 Incident report completed immediately which is
located on the shared drive or assigned Jump
Drive
 Copy of Suspected Patient Run Sheet or Face
Sheet
WORK RESTRICTIONS
 All workers will be out of work until Medically cleared by
Pender County Health Department and or EMS Medical
Direction.
 Workers who are otherwise healthy and receiving preventive
Tx for TB infection may be allowed to work but this is at the
discretion of the Medical Director and EMS Director.
INFECTION / EXPOSURE
CONTROL
• Purpose: As stated by OSHA 1910.1030 Pender EMS
and Fire shall have in place an infection/exposure
control plan that applies to all occupational exposure
to blood or other potentially infectious materials.
• This is includes the following:
• Training….Once a year
• Vaccinations….Hepatitis B, TB Skin Test, and Tetanus.
INFECTION / EXPOSURE CONTROL
GENERAL MEASURES
• Remember, use common sense when it comes to EXPOSURE
CONTROL
• Use gloves at all times when involved in patient care!
• Use gowns and protective eyewear when potential fluid splatter
could take place.
• Use good hand-washing techniques after all patient contact.
GENERAL MEASURES CONTINUED…….
• All blood and or body fluids should be
immediately cleaned with proper supplied
infection control solution
• All contaminated linen should be placed in
proper biohazard bag and placed in storage bins
at stations and/or hospitals.
• Re-usable equipment should be cleaned before
carrying back to the station. If not possible, it
should be RED BAGGED then cleaned at the
station.
GENERAL MEASURES CONTINUED…
• Things you should not do on the Ambulance!!!!!!!!
GENERAL MEASURES CONT…
Sharp Safety
• DO NOT recap needles unless in the process of
Medication Therapy and only use the one handed
technique
• ALL sharps MUST be disposed of in the established
sharps containers, not in the stretchers, bench seats,
floor of the unit, or the trash can.
GENERAL MEASURES
Follow
manufacturer's
directions when it
comes to
cleaning and
washing assigned
Turn Out Gear.
DO NOT DO THIS…..
• Please do not leave
syringes laying around
the units or stations like
this ….NO matter what
they are being used for..
CLEANING AND SANITIZING
• This should be done on each unit
after every call using the proper
disinfectant.
• Do Not leave gloves and/or trash on
the units for the next crew to find.
• Units and equipment should be air
dried when possible.
• All contaminated linen and waste
should be properly disposed of at the
station or hospital.
GENERAL KNOWLEDGE TOPICS….
• Listed below is general knowledge topics with
further discussion in the Infection Control Manual
located at each station.
• IV Cannulation Should be done with
• Patent Airway/Suctioning All PPE in place
to
• Universal Isolation protect each
crew
• Bleeding member involved with
• Emesis, Defecation, Urination the call!!!!
• Labor and Delivery
REGULATED WASTE
• DEFINITION PER OSHA 1910.1030
• Means liquid or semi-liquid 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;
and pathological and microbiological wastes
containing blood or other potentially infectious
materials.
REGULATED WASTE DISPOSAL
• All sharps containers that are ¾ full must be sealed
and replaced.
• SHARPS CONTAINERS must be placed in biohazard
trash once sealed!
• All medical wasted produced as a result of a call must
be collected and placed in a biohazard bag and
removed from the scene.
• Simple Terms: IF YOU TAKE IT IN, YOU
MUST TAKE IT OUT!
REGULATED WASTE DISPOSAL
CONT.
• All waste must be disposed in the proper containers at
each station.
• All regulated waste must be sent to St. 7 for Stericycle to
pick up every 6 weeks.
• Please do not place regular trash in these
containers………this cost Pender EMS and Fire unnecessary
expenses.
• When containers are full Contact Calvin Wright to have it
moved to Station 7.
REGULATED WASTE DISPOSAL CONT.
• All expired drugs must
be put in separate a
container.
• Expired drugs must be
transferred to St. 7 to be
placed in the supplied
WHITE BOX by Stericycle
for proper disposal.
REGULATED
WASTE
DISPOSAL..
HOW NOT TO PROPERLY DISPOSE OF REGULATED
WASTE……
DO NOT DO THIS…..
Not sealing the sharps container
could mean a dirty unknown needle
stick for someone else!
No Sharps Container!!!
Missing Red Bag
#1 RULE
EXPOSURE MANAGEMANT
• Defined as if a parental (i.e. needle stick or cut),
mucous-membrane exposure (i.e. splash to the eyes or
mouth), or cutaneous exposure involving large
amounts of blood or prolonged contact with blood
especially when the exposed skin is chapped, abraded,
or afflicted with dermatitis the provider is to
ASAP………….
EXPOSURE MANAGEMANT
CONT.
• Wash hands/exposed area thoroughly
• Notify Shift Supervisor ASAP
• Notify Safety Officer
• File an exposure/injury form located on the shared
drive.
• Seek Medical attention at PMH or Facility designated
by supervisor.
• File a workman’s compensation form
PATIENT CONFIDENTIALITY
• All patient related information, whether medical or
personal in nature, MUST be kept strictly confidential.
• This is very important to the patient, family members
of the patient, but most of all to YOU and YOUR
COWORKERS.
• Follow Pender EMS and Fire HIPPA Policy
• Also Review Section 3.25 Confidential Information and
Disclosure of the Employee Manual.
SAFE WORK PRACTICES FOR THE STATION
• Keep medical equipment out of the kitchen
area
• Food must be dated and labeled
• Do not wear/store protective clothing such as
bunker pants in living areas
• Transport equipment in a sealed equipment
bag when transporting in personal vehicle.
• Clean work areas properly each shift
• Use liquid soap for showers and sink
• Use paper or air drying for hands
• Stations MUST be cleaned each shift
FOUND
UNCLEAN
SITUATIONS…
THINGS LEFT AT STATIONS OR ON UNITS AT THE END OF
SHIFTS FOR OTHERS…….REMEMBER THE STATIONS AND
UNITS MUST BE KEPT CLEANED.
FOUND IN FRONT SEAT OF UNIT ON
FLOOR…
DIRTY GLOVES LEFT ON UNIT………
Something is in the
wrong place!
SUPPLIES SHOULD BE PUT UP AND NOT
LEFT OUT FOR OTHERS TO PUT UP……
HAZARD
COMMUNICATIONS
PENDER EMS & FIRE
HAZARD COMMUNICATIONS
• Mandated by OSHA 1910.1200
• Once Called MSDS but changed to SDS
• It is used to reduce chemical source illness and
injuries through the transmission of hazard
information
• Knowing the risk of chemical involved i.e. physical
or health
• ALL products MUST be LABELED.
• Purchased products must, by law, have warning
labels attached.
HAZARD COMMUNICATIONS
• All new containers are labeled when it is transferred to
another container.
• All portable containers will be labeled with name, date
and initials of person placing chemical in container.
• SDS shall be provided on each hazardous chemicals in
the workplace.
SDS
• MSDS Books
• Newer Books
• SDS
SDS— SAFETY DATA SHEET
• What is a Safety Data Sheet (SDS)?
• A Safety Data Sheet (SDS) is designed to provide both
workers and emergency personnel with the proper
procedures for handling or working with a particular
substance. SDS's include information such as physical
data (melting point, boiling point,flash point etc.), toxicity,
health effects, first aid, reactivity, storage, disposal,
protective equipment, and spill/leak procedures. These
are of particular use if a spill or other accident occurs.
SDS's vary in length depending on their format, content,
and font size. We have seen them from 1 to 10 pages,
with most being 2 to 4 pages.
SDS— SAFETY DATA SHEET
• Who are SDS's for?
• SDS's are meant for:
• Employees who may be occupationally exposed to a hazard at
work.
• Employers who need to know the proper methods for storage
etc.
• Emergency responders such as fire fighters, hazardous material
crews, emergency medical technicians, and emergency room
personnel.
HAZARD COMMUNICATIONS
• SDS’s shall be in English and placed in an area
that all employee’s can access.
• Employee’s should take the time to review SDS’s
to make themselves familiar on how to navigate
them in a time of need……
• Employee’s should have suppliers send them
SDS’s with all chemical orders.
• Training on this is once a year
• All new SDS sheets must be sent to every station
in Pender EMS and Fire System.
FIRE & EMERGENCY PLAN
FIRE & EMERGENCY PLAN
• Mandated by OSHA 1910.35 – 1910.38
• Purpose: Is to provide employees with references to
major workplace fire hazards, proper handling of such,
storage, reference personnel/contacts, housekeeping,
training, and maintaining equipment.
FIRE & EMERGENCY PLAN
• As per PEMS policy NO excess
linen is to be stored at any
station this is to include but not
limited to linen for general use,
personnel linen such as
sleeping gear, uniforms, and
turnouts. All SOG’S concerning
housekeeping issues should be
followed. There should be no
storage of excess materials in
any stations that would
contribute to combustible, fire,
and or smoke hazards. OSHA
1910.38 Subpart E
LINEN COLLECTED FROM
STATIONS
FIRE & EMERGENCY PLAN
Fire Alarms will be placed at each station
Carbon Monoxide detectors will be placed at each
station that has LP gas.
Batteries need to be checked monthly
DO NOT REMOVEBATTERIES
BECAUSE THEY GO OFF AND ANNOY YOU!!!
FIRE & EMERGENCY PLAN
• Please do not take the light bulbs out
of the EXIT lights because they are too
bright at night. We will get Fined by
EM during annual inspections if you
do.
• These lights are in place to help
individuals get out of a burning
building.
FIRE & EMERGENCY PLAN
• Exits routes must be free from
all obstructions and not be
blocked in a way that prevents
the use as an exit.
• Properly Marked with signs
designating exits from the
building with proper lighting
available.
• Evacuation maps at each
station
• All doors must have
functioning locks
FIRE & EMERGENCY PLAN
• Fire Extinguishers
• All buildings will be equipped with
proper type of fire extinguishers by
order of the local Fire Marshall
• Must have annual training
• Use the PASS Method
• P-pull the pin out
• A- aim the hose at the base of the fire
• S- squeeze the handle
• S- sweep the hose or nozzle from
side to side
FIRE & EMERGENCY PLAN
• Inspections will be done once a year by a certified
company.
• Employee’s are responsible to know where all
extinguishers are located at each station and on each
unit.
• If a fire extinguisher is used please have it replaced
ASAP. Also, notify the safety or logistics officer so it
can be checked out.
Post Blood Borne Exposure
Post Blood Borne Exposure
 To offer post exposure treatment to employees
of Pender EMS and Fire.
 Includes but not limited too……..iv sticks,
mucous membrane exposures, and fluid
splatter….
 ALL post blood borne exposure’s will be
handled at Designated Facility by Safety
Officer. This could be Pender Memorial
Hospital, Medac, or a Urgent Care.
Post Blood Borne Exposure
 Purpose:
 All staff members of Pender EMS and Fire know how
to report exposure / injury and what takes place after
the fact.
 Shift supervisor must be notified ASAP
 Shift supervisor and Employee will notify the
Safety Officer
 Injury / Exposure form will be filled out by the
employee at the time of reporting the incident
 A written statement must be submitted ASAP.
Post Blood Borne Exposure
 These forms are located on the Shared Drive or assigned
Jump Drive.
 Located on each unit is a Post Exposure Packet that the
employee should get and follow the directions.
 Do not waste any time when reporting exposures to
proper personnel!
Post Blood Borne Exposure
 Flush or Wash the wound with soap and water and or liquid
sanitizer
 Report to will follow up with all testing with PEMS Safety
Officer.
 If transporting patients to another hospital besides Pender
…you must notify the receiving hospital of the exposure and
request the patient get the necessary testing.
 Safety Officer needs the patient demographics to be able to
follow up on the situation.
 Repeat Lab Work in 6 weeks, 12 weeks, 6 months, and 12
months or as determined by medical direction.
OSHA Required Paperwork
 Sharps Injury Log (located in post
exposure packet)
 Unsafe Practices Notification Form—
this is a log to show that PEMS & Fire
is Following up on all incidence’s of
sharps be left in un-proper locations.
 Hepatitis B Declination Form
General Topics / Knowledge
 Reflective Vest
should be worn
on all roadside
scenes.
 Remember to
wear supplied
EMS gear and or
Turn out Gear
when
Required!!
General Topics / Knowledge
 No Vest is
required if you
are wearing a
company
issued Blauer
or 511 coat.
General Topics / Knowledge
 Please Put Oxygen in its proper place with
chains in place and secured. Each station
has a place for empty and full cylinders.
 At each station, know where the circuit
breaker box is located.
 If an OSHA inspector shows up, allow him to
do his inspection, then contact Supervisor
ASAP.
 Same follows for Fire Inspections by the
local Fire Marshall.
 Be cooperative with the inspectors.
All units have proper place for portable
oxygen tanks to be secured not on the
jump seat.
Needs to be secured!!!
Improper way to store
Oxygen………..
Wrong Way
Both Chains have to be secured around
the Oxygen bottle……
Wrong
Way
Proper Way to store Oxygen…….
 The chains must be
secured at the top and
bottom of the oxygen
tank to keep it in
place.
 The small oxygen
bottles can be placed
in the plastic drink
holders.
Correct
Way
Worker’s Compensation
 Injury, Exposure, or Possibility of
the 2, must be reported ASAP.
 Notify Immediate Supervisor and
Safety Officer.
 Fill out INJURY/ EXPOSURE form
located on “S” drive.
 Safety Officer and/or Supervisor
will direct you on the next steps.
Worker’s Compensation Cont.
 The First 7 calendar days of LOSS time is the
employee’s responsibility. The 7 calendar days
begins on day of treatment.
 Workers Comp. goes back and covers those 7
days if you miss 21 calendar days or more.
 Also remember when you are out on workers
comp. you must pay your part of insurance
premiums for health care, colonial, and so-
on. You MUST contact Audrea if this situation
comes about.
Worker’s Compensation Cont.
 There will be several forms mailed to your residence
that must be completed by you in a timely matter. Some
have to be returned with 30 days or they can be denied.
I will assist anyone in filling out of these forms but
please complete each form.
Pender EMS & Fire Drug Policy
 Pender EMS and Fire maintains a firm
commitment to provide a safe and productive
work environment for its employees.
 As a company, drug and/or alcohol test are
ordered for pre-employment, post accident,
post injury, random, and reasonable cause.
 Random testing is done 4 times a year. The list
is generated by an outside company.
Pender EMS Drug Policy
 It is policy that all employees, including management,
administrative, part-time, temporary and volunteer employees,
shall not engage in the manufacture, use, possession, sale,
purchase, or transfer of any substance which may impair their
ability to perform assigned duties or otherwise adversely impact
the Company’s business.
 Substances which may impair performance include, but are not
limited to, alcoholic beverages, illegal drugs, or other controlled
substances. This policy applies to all employees during working
time, regardless of location, and at all times on Company
property including worksites and parking lots, or while operating
a company vehicle.
Pender EMS & Fire Drug
Policy
 All employees signed an employee acknowledgement
upon being hired.
 Pender EMS and Fire has a no tolerance policy.
 Copies of the drug testing policy is located at all the
stations, Shared Drive, and or Flash Drive.
Pender EMS and Fire
 Items from Employee Manual
 Located on Shared Drive
 Company Issued Jump/Flash
Drive
Preventing Harassment
 Pender EMS and Fire has adopted a zero-tolerance
policy toward discrimination and all forms of unlawful
harassment, including but not limited to sexual
harassment.
 Review Section 2.05 Preventing Harassment in the
Employee Manual.
Building Security
 Each and every employee must follow the building
security rules and regulations listed here:
 All means of egress/ingress must be closed and
locked when building is vacated.
 All means of egress/ingress must be closed and
locked from 2300 hours to 0900 hours
Health-related Issues
 Employees who
become aware of any
health or safety-related
issue should notify
their supervisor as
soon as possible.
Annual Fire Fighter NFPA Physical
 The medical evaluation of a
member (7.4 -7.7.13) shall
include a medical history,
examination, and any
laboratory tests required to
detect physical or medical
condition(s) that could
adversely affect their ability to
safely perform the essential job
tasks outlined in NFPA 1582
Chapter 9.
 Done at Medac Cooperate
Health
 Must Get TB Skin test read and
returned in time.
 EMS BC’s, Training BC’s, Deputy
and Assistant Chiefs can read
the TB Skin Test.
 Don’t wait till the last minute
before due date to schedule
NFPA exam.
 Go past your due date will mean
suspension until completed.
 Centrelearn sends out
notifications starting 90 days
out.
Employee Requiring Medical
Attention
 Employees should report all work-related
injuries and accidents immediately to their
supervisor, and then follow theses steps:
 Fill out an injury/exposure form.
 Complete an incident report in a Word
Document Format
 Forms can be found on “S” Drive.
 Seek any needed medical attention as
directed by supervisor.
 Notify Safety Compliance Officer as soon
as possible.
 Note: See Policy Manual for details.
Absence and Tardiness
 From time to time, it may be necessary for an employee
to be late or absent from work. Pender EMS and Fire is
aware that emergencies, illnesses, or pressing personal
business that cannot be scheduled outside work hours
may arise. It is the responsibility of all employees to
contact all affected parties if they will be absent or late.
 Note: See Employee Manual Section 3.06 Attendance,
Punctuality and Absenteeism
Unscheduled Absence
 Absence from work for two (2) consecutive days for
Monday through Friday employees or two (2)
consecutive shifts for FWW or non-emergency
transport employees, without notifying your
supervisor will be considered a voluntary
resignation.
Smoking and Tobacco Use
 Smoking on company property is a privilege, not a
right and may be rescinded by management if the
privilege is abused. Smoking is defined as the act of
lighting, smoking or carrying a lighted or smoldering
cigar, cigarette, electronic cigarette or pipe of any
kind.
 Smoking is not permitted inside any Pender EMS and
Fire building with the exception of apparatus bays!!
 All debris should be disposed of in appropriate
provided receptacles.
 When Pender EMS and Fire employees are on the
campus of other companies, they are expected to
comply with that companies smoking policies.
Attire and Grooming
 Section 3.26 of Employee Manual
 It is important to project a professional image while at work by being appropriately
attired and groomed. Pender EMS and Fire employees are expected to be neat,
clean, and well-groomed while on the job, conducting business in or outside of the
office. Uniformed personnel must comply with the dress code.
 Fire/EMS personnel shall wear and maintain their uniforms in such a manner so as to
present a neat, wrinkle free, and clean appearance. Uniforms shall be clean, free of
rips, tears, holes and shall not be faded or missing any required part such as buttons,
patches and accessories.
 Any hairstyle is permissible as long as the style does not allow hair to extend beyond
the coverage of safety equipment. Hair that extends beyond the collar must be
pulled back and tied anytime the employee is engaged in fire suppression or rescue
operations. Hair shall be trimmed so as not to flare out or curl beneath the lower
edge of the dress uniform hat, work cap, or helmet.
Attire and Grooming
Continued
 North Carolina Division of Occupational Safety and Health has determined
that facial hair between the skin and respirator sealing surface is a violation of
the Occupational Safety and Health Administration standards which follows
State and Federal Law 29 CFR-1920 and 34 (E)(5)(I).
 This is true for SCBA and N-95/N-100 Mask.
 A positive quantitative or qualitative fit test is not acceptable by OSHA as
evidence that would allow a respirator to be worn when facial hair could
interfere with the operation of the exhalation valve or seal.
 Based on the above statements, personnel who are required to wear self-
contained breathing apparatus will be free from any facial hair growth, except
for a mustache or center lip growth which will meet the following prescribed
grooming standards:
 Facial hair should be neatly groomed and trimmed
 Shall not extend beyond the lower ridge of the mandible below the corner of
the mouth to impede with the proper sealing of breathing apparatus face
piece
 Sideburns shall not interfere with the proper seal of a breathing apparatus face
piece
Pender Volunteer EMS and Fire Inc.
Standard Operating Guideline
Hurricane Guideline
 Historically, the major natural disaster threat to
the coastal area of North Carolina has been
hurricanes. Accordingly, this plan has been
developed to cope with the emergency response
and recovery efforts that we will face after a land
falling hurricane. The Pender Volunteer EMS and
Fire, Inc. plan provides for guidance to the
employees of this department and other
agencies that we work with. This plan was
developed to coordinate emergency operations,
in the event of a land falling hurricane.
Continue……
Pender Volunteer EMS and Fire Inc.
Standard Operating Guideline
Hurricane Guideline
 It is important that each employee
read and understands this plan.
This plan includes things to do
before, during, and after a
hurricane. Once a storm threatens,
you become an emergency worker.
Your role becomes more vital than
ever. This event might last one day
or for months depending on the
severity of the storm.
Pender Volunteer EMS and Fire Inc.
Standard Operating Guideline
Hurricane Guideline
 It is my hope that this plan will help you begin to
prepare yourself and your families in the event of a
hurricane. Make sure your station is as self-sufficient
as possible. Be as prepared as you can.
Thank you,
Woodrow W. Sullivan III, Chief
Pender Vol. EMS and Fire, Inc.
 Please review guideline on the shared drive.
THE
END!!
• Each station has a
Infection/Exposure Manual
located at each work station.
It is the employees
responsibility to be aware of
all policies and guidelines.
• Pender EMS and Fire Medical
Director Dr. Michael Moulton
and Chief Woody Sullivan III
have reviewed and approved
these policies and guidelines.
It is your responsibility to
follow them.

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Infection Control & Safety Procedures

  • 1. INFECTIONCONTROL& SAFETY MRS. STACEY WRIGHT, AAS, EMT-P DEPUTY CHIEF, SAFETY OFFICER PENDER EMS AND FIRE, INC.
  • 2. CONTACT INFORMATION • Stacey Wright, AAS, EMT-P • 910-470-0982 • 910-259-4612 • swright@penderems.com • 910-675-9198
  • 3. ACCOUNTABILITY • SOG CO-28 • Purpose: • The purpose of this guideline is to ensure the location and safety of all Emergency Personnel working on the Incident scene. • To maximize the efficiency of operations used to stabilize the incident. • Review the SOG CO-28 that goes in detail the Accountability.
  • 4. SAFETY FORMS • Purpose: To provide the employer and employee with the means to document injuries, exposures, and unsafe practices. • Company Safety Forms are located on the Shared Drive in the 2016 Policy and Guidelines Company SOG’s --CO 26 Thru CO 26-K
  • 5. SAFETY • The safety and health of employees is a priority. Pender EMS and Fire makes every effort to comply with all federal and state workplace safety requirements. All members are required to have all departmental issued Personal Protective Equipment (PPE), with them while at work and/or a departmental function that may require the use of any or all of the PPE. • Each employee is expected to obey safety rules and exercise caution and common sense in all work activities. • Note: See Safety Manual for complete Safety Guidelines and Policies.
  • 6. INFECTION / EXPOSURE CONTROL • GOAL: It is intended to offer you the basic understanding to protect yourself against such pathogens as HIV, HBV, and other infectious diseases. • PLEASE DO NOT let this replace your “COMMON SENSE”…..If you see a risk, take precautions.
  • 8. UNIVERSAL PRECAUTIONS ALSO KNOWN AS STANDARD PRECAUTIONS
  • 9. REDUCING RISKS 1. Maintenance Controls * Equipment maintenance 2. Work Practice Controls * Proper hand washing (done frequently) (If water not available, use antiseptic wipe) * Proper Hygiene * Keep possible exposure areas free from food items 3. Proper use of Personal Protective Equipment (PPE) * Gloves are to be used when handling any body fluid * Careful removal of gloves (not touching outside area) * Using appropriate equipment in all situations
  • 10.
  • 11. ISOLATION PRECAUTIONS  Standard Precautions— used with every patient all the time that includes but not limited to gloves, goggles, and gowns.  Airborne Precautions- use standard precautions and n- 95 or n-100 masks. Patient should have a Surgical mask on during transport.
  • 12. Isolation Precautions  Contact Isolation Level 1- GOWN, GLOVES, and SURGICAL MASK MUST be worn when entering the room at a facility or on dealing with patients at home under home health care Esp. MRSA AND SARS  Contact Isolation- GOWN and GLOVES This is used for any Contact Isolation cases esp. VRE, LICE SCABIES, AND WOUNDS.  Droplet Isolation- SURGICAL MASK
  • 13. MRSA  Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a type of staph bacteria that's become resistant to many of the antibiotics used to treat ordinary staph infections.
  • 14. Two Types of MRSA  First one is MRSA infections that occur in people who've been in hospitals or other health care settings, such as nursing homes and dialysis centers. When it occurs in these settings, it's known as health care-associated MRSA (HA-MRSA).  HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints.
  • 15. Two Types of MRSA  Second type of MRSA infection has occurred in the wider community — among healthy people. This form, community-associated MRSA (CA-MRSA), often begins as a painful skin boil. It's spread by skin-to-skin contact.  At-risk populations include groups such as high school wrestlers, child care workers and people who live in crowded conditions
  • 16. CAUSES  Different varieties of Staphylococcus aureus bacteria, commonly called "staph," exist.  Staph bacteria are normally found on the skin or in the nose of about one-third of the population.  The bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they usually cause only minor skin problems in healthy people.
  • 17. MRSA  “COLONIZED” VS “INFECTED” People who carry MRSA are said to be colonized. Many kinds of bacteria can live in (colonize) your body without causing an infection. In fact, everyone is colonized by many kinds of bacteria all the time. Being infected means bacteria are multiplying and the body is trying to defend itself against them.
  • 18. RISK FACTORS of HA-MRSA  Being hospitalized. MRSA remains a concern in hospitals, where it can attack those most vulnerable — older adults and people with weakened immune systems.  Having an invasive medical device. Medical tubing — such as intravenous lines or urinary catheters — can provide a pathway for MRSA to travel into your body.  Residing in a long-term care facility. MRSA is prevalent in nursing homes. Carriers of MRSA have the ability to spread it, even if they're not sick themselves.
  • 19. Risk Factors of CA-MRSA  Participating in contact sports. MRSA can spread easily through cuts and abrasions and skin-to-skin contact.  Living in crowded or unsanitary conditions. Outbreaks of MRSA have occurred in military training camps, child care centers and jails.  Men having sex with men. Homosexual men have a higher risk of developing MRSA infections.
  • 20. Preventing HA-MRSA  In the hospital, people who are infected or colonized with MRSA often are placed in contact precautions as a measure to prevent the spread of MRSA.  Visitors and health care workers caring for people in isolation may be required to wear protective garments and must follow strict hand hygiene procedures.  Contaminated surfaces and laundry items should be properly disinfected
  • 21. Preventing CA-MRSA  Wash your hands. Careful hand washing remains your best defense against germs. Scrub hands briskly for at least 15 seconds, then dry them with a disposable towel and use another towel to turn off the faucet. Carry a small bottle of hand sanitizer containing at least 62 percent alcohol for times when you don't have access to soap and water.  Keep wounds covered. Keep cuts and abrasions clean and covered with sterile, dry bandages until they heal. The pus from infected sores may contain MRSA, and keeping wounds covered will help prevent the bacteria from spreading.  Keep personal items personal. Avoid sharing personal items such as towels, sheets, razors, clothing and athletic equipment. MRSA spreads on contaminated objects as well as through direct contact.  Shower after athletic games, practices, or workout sessions. Shower immediately after each game or practice. Use soap and water. Don't share towels.  Sanitize linens. If you have a cut or sore, wash towels and bed linens in a washing machine set to the hottest water setting (with added bleach, if possible) and dry them in a hot dryer. Wash gym and athletic clothes after each wearing.
  • 22. MRSA  Because of that, workers comp. will not cover MRSA exposure’s without direct documentation of exposure at work but even then it is very hard to get worker compensation coverage.  Is a contact spread disease  WEARING of PPE is essential in the prevention of MRSA.  CONTACT ISOLATION LEVEL 1: Stands until off antibiotics and 3 negative cultures have been obtained. If the negative cultures cannot be obtained YOU MUST follow CONTACT ISOLATION LEVEL 1 which is Gloves, gowns, and surgical mask.
  • 24. RESPIRATOR PROGRAM  PURPOSE: This is a guideline to help ensure the protection of all employees from respiratory hazards through proper selection and use of respirators.  USAGE: Respirators will be used primarily for the exposure of Tuberculosis or in emergencies where there are suspected AIRBORNE health hazards.
  • 25. Respirator Program Cont.  Assignment: 1 Respirator per employee  Training: Once a year  Selection: N-95/N-100 Sm., Med., Large, Regular  Inspection: Should be thoroughly inspected prior wearing and when units are checked off for any deterioration.  Medical Evaluations: Done once a year  Pulmonary Function Test done if required by Cooperate Health based on Medical Evaluations.
  • 26. Respirator use under Special Conditions  Facial Hair: should not interfere with the seal of the respirator  All employees should come to work clean shaven.  Eye Glasses: Should NOT interfere with the nose clip of the mask…..this could cause interference with the seal  Facial Deformities: scars, lack of teeth, dentures, severe acne, prominent cheek bones  Communications: Make sure seal is maintained during conversation with Patients and Fellow Co- workers.
  • 27.
  • 28.
  • 29.
  • 30. FINAL ANALYSIS  To have a safe and effective program, the employees must use the equipment as they have been trained!
  • 31. What is Airborne Pathogens Is a disease caused by germs that are spread from person to person through the air.
  • 32. TUBERCULOSIS Purpose: Is to provide guidelines and procedures that will minimize the risk and consequences associated with exposures to communicable diseases.
  • 33. BACKGROUND  Communicable diseases can be transmitted several different ways:  Direct>>>Person to Person  Indirect…..Person to Object  Inhalation…..unprotected exposure to an airborne pathogen such as TB  Ingestion…Eating or drinking contaminated food or water
  • 34. Indentification of TB  Transmitted through the air  Most dangerous indoors……especially areas with poor air circulation  Can survive for long periods of time  Carried through the air in infectious droplets (1-5 microns in size)  Generated by infectious persons cough, speach, sighs, or spits  EMPLOYEES ARE IN DANGER OF EXPOSURE WHENEVER THEY TRANSPORT TB – INFECTED PATIENTS
  • 36. INFECTION VS ACTIVE TB  Patients that are infected with TB will have no symptoms  Will not be contagious  Only detection is by TB skin test  Takes months to years to develop TB  May never develop TB at all  Patients with active TB will have the S/S as listed in previous slide
  • 37. General Measures  Treatment will be conducted by Local Health Department. Treatment can last 9-24months.  Review policy once a year  TB Skin test every six months or as directed by Medical Control  Medical screening as needed  Pender County Health Department, Safety Officer,& Medical Direction will assist with all questions and or concerns!
  • 38. Handling of Suspected TB Patient **Immediately apply HEPA Respirator issued to you **Follow policy and procedures for proper donning of HEPA Mask **If possible, place mask/face shield on patient **Gloves, Gowns, & Protective Eye Wear should be worn **Outside vents should be turned on
  • 39. Post Exposure Policy  Treated at PCHD during MONDAY –FRIDAY 8am to 4pm  Remember, Treatment will not start immediately……just PAPERWORK  Shift supervisor should be notified ASAP  Safety Officer notified ASAP  Incident report completed immediately which is located on the shared drive or assigned Jump Drive  Copy of Suspected Patient Run Sheet or Face Sheet
  • 40. WORK RESTRICTIONS  All workers will be out of work until Medically cleared by Pender County Health Department and or EMS Medical Direction.  Workers who are otherwise healthy and receiving preventive Tx for TB infection may be allowed to work but this is at the discretion of the Medical Director and EMS Director.
  • 41. INFECTION / EXPOSURE CONTROL • Purpose: As stated by OSHA 1910.1030 Pender EMS and Fire shall have in place an infection/exposure control plan that applies to all occupational exposure to blood or other potentially infectious materials.
  • 42. • This is includes the following: • Training….Once a year • Vaccinations….Hepatitis B, TB Skin Test, and Tetanus. INFECTION / EXPOSURE CONTROL
  • 43. GENERAL MEASURES • Remember, use common sense when it comes to EXPOSURE CONTROL • Use gloves at all times when involved in patient care! • Use gowns and protective eyewear when potential fluid splatter could take place. • Use good hand-washing techniques after all patient contact.
  • 44. GENERAL MEASURES CONTINUED……. • All blood and or body fluids should be immediately cleaned with proper supplied infection control solution • All contaminated linen should be placed in proper biohazard bag and placed in storage bins at stations and/or hospitals. • Re-usable equipment should be cleaned before carrying back to the station. If not possible, it should be RED BAGGED then cleaned at the station.
  • 45. GENERAL MEASURES CONTINUED… • Things you should not do on the Ambulance!!!!!!!!
  • 46. GENERAL MEASURES CONT… Sharp Safety • DO NOT recap needles unless in the process of Medication Therapy and only use the one handed technique • ALL sharps MUST be disposed of in the established sharps containers, not in the stretchers, bench seats, floor of the unit, or the trash can.
  • 47. GENERAL MEASURES Follow manufacturer's directions when it comes to cleaning and washing assigned Turn Out Gear.
  • 48. DO NOT DO THIS….. • Please do not leave syringes laying around the units or stations like this ….NO matter what they are being used for..
  • 49. CLEANING AND SANITIZING • This should be done on each unit after every call using the proper disinfectant. • Do Not leave gloves and/or trash on the units for the next crew to find. • Units and equipment should be air dried when possible. • All contaminated linen and waste should be properly disposed of at the station or hospital.
  • 50. GENERAL KNOWLEDGE TOPICS…. • Listed below is general knowledge topics with further discussion in the Infection Control Manual located at each station. • IV Cannulation Should be done with • Patent Airway/Suctioning All PPE in place to • Universal Isolation protect each crew • Bleeding member involved with • Emesis, Defecation, Urination the call!!!! • Labor and Delivery
  • 51. REGULATED WASTE • DEFINITION PER OSHA 1910.1030 • Means liquid or semi-liquid 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; and pathological and microbiological wastes containing blood or other potentially infectious materials.
  • 52. REGULATED WASTE DISPOSAL • All sharps containers that are ¾ full must be sealed and replaced. • SHARPS CONTAINERS must be placed in biohazard trash once sealed! • All medical wasted produced as a result of a call must be collected and placed in a biohazard bag and removed from the scene. • Simple Terms: IF YOU TAKE IT IN, YOU MUST TAKE IT OUT!
  • 53. REGULATED WASTE DISPOSAL CONT. • All waste must be disposed in the proper containers at each station. • All regulated waste must be sent to St. 7 for Stericycle to pick up every 6 weeks. • Please do not place regular trash in these containers………this cost Pender EMS and Fire unnecessary expenses. • When containers are full Contact Calvin Wright to have it moved to Station 7.
  • 54. REGULATED WASTE DISPOSAL CONT. • All expired drugs must be put in separate a container. • Expired drugs must be transferred to St. 7 to be placed in the supplied WHITE BOX by Stericycle for proper disposal.
  • 55. REGULATED WASTE DISPOSAL.. HOW NOT TO PROPERLY DISPOSE OF REGULATED WASTE……
  • 56. DO NOT DO THIS….. Not sealing the sharps container could mean a dirty unknown needle stick for someone else!
  • 60. EXPOSURE MANAGEMANT • Defined as if a parental (i.e. needle stick or cut), mucous-membrane exposure (i.e. splash to the eyes or mouth), or cutaneous exposure involving large amounts of blood or prolonged contact with blood especially when the exposed skin is chapped, abraded, or afflicted with dermatitis the provider is to ASAP………….
  • 61. EXPOSURE MANAGEMANT CONT. • Wash hands/exposed area thoroughly • Notify Shift Supervisor ASAP • Notify Safety Officer • File an exposure/injury form located on the shared drive. • Seek Medical attention at PMH or Facility designated by supervisor. • File a workman’s compensation form
  • 62. PATIENT CONFIDENTIALITY • All patient related information, whether medical or personal in nature, MUST be kept strictly confidential. • This is very important to the patient, family members of the patient, but most of all to YOU and YOUR COWORKERS. • Follow Pender EMS and Fire HIPPA Policy • Also Review Section 3.25 Confidential Information and Disclosure of the Employee Manual.
  • 63. SAFE WORK PRACTICES FOR THE STATION • Keep medical equipment out of the kitchen area • Food must be dated and labeled • Do not wear/store protective clothing such as bunker pants in living areas • Transport equipment in a sealed equipment bag when transporting in personal vehicle. • Clean work areas properly each shift • Use liquid soap for showers and sink • Use paper or air drying for hands • Stations MUST be cleaned each shift
  • 64. FOUND UNCLEAN SITUATIONS… THINGS LEFT AT STATIONS OR ON UNITS AT THE END OF SHIFTS FOR OTHERS…….REMEMBER THE STATIONS AND UNITS MUST BE KEPT CLEANED.
  • 65. FOUND IN FRONT SEAT OF UNIT ON FLOOR…
  • 66. DIRTY GLOVES LEFT ON UNIT………
  • 67. Something is in the wrong place!
  • 68.
  • 69. SUPPLIES SHOULD BE PUT UP AND NOT LEFT OUT FOR OTHERS TO PUT UP……
  • 71. HAZARD COMMUNICATIONS • Mandated by OSHA 1910.1200 • Once Called MSDS but changed to SDS • It is used to reduce chemical source illness and injuries through the transmission of hazard information • Knowing the risk of chemical involved i.e. physical or health • ALL products MUST be LABELED. • Purchased products must, by law, have warning labels attached.
  • 72. HAZARD COMMUNICATIONS • All new containers are labeled when it is transferred to another container. • All portable containers will be labeled with name, date and initials of person placing chemical in container. • SDS shall be provided on each hazardous chemicals in the workplace.
  • 73. SDS • MSDS Books • Newer Books • SDS
  • 74. SDS— SAFETY DATA SHEET • What is a Safety Data Sheet (SDS)? • A Safety Data Sheet (SDS) is designed to provide both workers and emergency personnel with the proper procedures for handling or working with a particular substance. SDS's include information such as physical data (melting point, boiling point,flash point etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill/leak procedures. These are of particular use if a spill or other accident occurs. SDS's vary in length depending on their format, content, and font size. We have seen them from 1 to 10 pages, with most being 2 to 4 pages.
  • 75. SDS— SAFETY DATA SHEET • Who are SDS's for? • SDS's are meant for: • Employees who may be occupationally exposed to a hazard at work. • Employers who need to know the proper methods for storage etc. • Emergency responders such as fire fighters, hazardous material crews, emergency medical technicians, and emergency room personnel.
  • 76. HAZARD COMMUNICATIONS • SDS’s shall be in English and placed in an area that all employee’s can access. • Employee’s should take the time to review SDS’s to make themselves familiar on how to navigate them in a time of need…… • Employee’s should have suppliers send them SDS’s with all chemical orders. • Training on this is once a year • All new SDS sheets must be sent to every station in Pender EMS and Fire System.
  • 78. FIRE & EMERGENCY PLAN • Mandated by OSHA 1910.35 – 1910.38 • Purpose: Is to provide employees with references to major workplace fire hazards, proper handling of such, storage, reference personnel/contacts, housekeeping, training, and maintaining equipment.
  • 79. FIRE & EMERGENCY PLAN • As per PEMS policy NO excess linen is to be stored at any station this is to include but not limited to linen for general use, personnel linen such as sleeping gear, uniforms, and turnouts. All SOG’S concerning housekeeping issues should be followed. There should be no storage of excess materials in any stations that would contribute to combustible, fire, and or smoke hazards. OSHA 1910.38 Subpart E
  • 81. FIRE & EMERGENCY PLAN Fire Alarms will be placed at each station Carbon Monoxide detectors will be placed at each station that has LP gas. Batteries need to be checked monthly DO NOT REMOVEBATTERIES BECAUSE THEY GO OFF AND ANNOY YOU!!!
  • 82. FIRE & EMERGENCY PLAN • Please do not take the light bulbs out of the EXIT lights because they are too bright at night. We will get Fined by EM during annual inspections if you do. • These lights are in place to help individuals get out of a burning building.
  • 83. FIRE & EMERGENCY PLAN • Exits routes must be free from all obstructions and not be blocked in a way that prevents the use as an exit. • Properly Marked with signs designating exits from the building with proper lighting available. • Evacuation maps at each station • All doors must have functioning locks
  • 84. FIRE & EMERGENCY PLAN • Fire Extinguishers • All buildings will be equipped with proper type of fire extinguishers by order of the local Fire Marshall • Must have annual training • Use the PASS Method • P-pull the pin out • A- aim the hose at the base of the fire • S- squeeze the handle • S- sweep the hose or nozzle from side to side
  • 85. FIRE & EMERGENCY PLAN • Inspections will be done once a year by a certified company. • Employee’s are responsible to know where all extinguishers are located at each station and on each unit. • If a fire extinguisher is used please have it replaced ASAP. Also, notify the safety or logistics officer so it can be checked out.
  • 86. Post Blood Borne Exposure
  • 87. Post Blood Borne Exposure  To offer post exposure treatment to employees of Pender EMS and Fire.  Includes but not limited too……..iv sticks, mucous membrane exposures, and fluid splatter….  ALL post blood borne exposure’s will be handled at Designated Facility by Safety Officer. This could be Pender Memorial Hospital, Medac, or a Urgent Care.
  • 88. Post Blood Borne Exposure  Purpose:  All staff members of Pender EMS and Fire know how to report exposure / injury and what takes place after the fact.  Shift supervisor must be notified ASAP  Shift supervisor and Employee will notify the Safety Officer  Injury / Exposure form will be filled out by the employee at the time of reporting the incident  A written statement must be submitted ASAP.
  • 89. Post Blood Borne Exposure  These forms are located on the Shared Drive or assigned Jump Drive.  Located on each unit is a Post Exposure Packet that the employee should get and follow the directions.  Do not waste any time when reporting exposures to proper personnel!
  • 90. Post Blood Borne Exposure  Flush or Wash the wound with soap and water and or liquid sanitizer  Report to will follow up with all testing with PEMS Safety Officer.  If transporting patients to another hospital besides Pender …you must notify the receiving hospital of the exposure and request the patient get the necessary testing.  Safety Officer needs the patient demographics to be able to follow up on the situation.  Repeat Lab Work in 6 weeks, 12 weeks, 6 months, and 12 months or as determined by medical direction.
  • 91. OSHA Required Paperwork  Sharps Injury Log (located in post exposure packet)  Unsafe Practices Notification Form— this is a log to show that PEMS & Fire is Following up on all incidence’s of sharps be left in un-proper locations.  Hepatitis B Declination Form
  • 92. General Topics / Knowledge  Reflective Vest should be worn on all roadside scenes.  Remember to wear supplied EMS gear and or Turn out Gear when Required!!
  • 93. General Topics / Knowledge  No Vest is required if you are wearing a company issued Blauer or 511 coat.
  • 94. General Topics / Knowledge  Please Put Oxygen in its proper place with chains in place and secured. Each station has a place for empty and full cylinders.  At each station, know where the circuit breaker box is located.  If an OSHA inspector shows up, allow him to do his inspection, then contact Supervisor ASAP.  Same follows for Fire Inspections by the local Fire Marshall.  Be cooperative with the inspectors.
  • 95. All units have proper place for portable oxygen tanks to be secured not on the jump seat. Needs to be secured!!!
  • 96. Improper way to store Oxygen……….. Wrong Way
  • 97. Both Chains have to be secured around the Oxygen bottle…… Wrong Way
  • 98. Proper Way to store Oxygen…….  The chains must be secured at the top and bottom of the oxygen tank to keep it in place.  The small oxygen bottles can be placed in the plastic drink holders. Correct Way
  • 99. Worker’s Compensation  Injury, Exposure, or Possibility of the 2, must be reported ASAP.  Notify Immediate Supervisor and Safety Officer.  Fill out INJURY/ EXPOSURE form located on “S” drive.  Safety Officer and/or Supervisor will direct you on the next steps.
  • 100. Worker’s Compensation Cont.  The First 7 calendar days of LOSS time is the employee’s responsibility. The 7 calendar days begins on day of treatment.  Workers Comp. goes back and covers those 7 days if you miss 21 calendar days or more.  Also remember when you are out on workers comp. you must pay your part of insurance premiums for health care, colonial, and so- on. You MUST contact Audrea if this situation comes about.
  • 101. Worker’s Compensation Cont.  There will be several forms mailed to your residence that must be completed by you in a timely matter. Some have to be returned with 30 days or they can be denied. I will assist anyone in filling out of these forms but please complete each form.
  • 102. Pender EMS & Fire Drug Policy  Pender EMS and Fire maintains a firm commitment to provide a safe and productive work environment for its employees.  As a company, drug and/or alcohol test are ordered for pre-employment, post accident, post injury, random, and reasonable cause.  Random testing is done 4 times a year. The list is generated by an outside company.
  • 103. Pender EMS Drug Policy  It is policy that all employees, including management, administrative, part-time, temporary and volunteer employees, shall not engage in the manufacture, use, possession, sale, purchase, or transfer of any substance which may impair their ability to perform assigned duties or otherwise adversely impact the Company’s business.  Substances which may impair performance include, but are not limited to, alcoholic beverages, illegal drugs, or other controlled substances. This policy applies to all employees during working time, regardless of location, and at all times on Company property including worksites and parking lots, or while operating a company vehicle.
  • 104. Pender EMS & Fire Drug Policy  All employees signed an employee acknowledgement upon being hired.  Pender EMS and Fire has a no tolerance policy.  Copies of the drug testing policy is located at all the stations, Shared Drive, and or Flash Drive.
  • 105. Pender EMS and Fire  Items from Employee Manual  Located on Shared Drive  Company Issued Jump/Flash Drive
  • 106. Preventing Harassment  Pender EMS and Fire has adopted a zero-tolerance policy toward discrimination and all forms of unlawful harassment, including but not limited to sexual harassment.  Review Section 2.05 Preventing Harassment in the Employee Manual.
  • 107. Building Security  Each and every employee must follow the building security rules and regulations listed here:  All means of egress/ingress must be closed and locked when building is vacated.  All means of egress/ingress must be closed and locked from 2300 hours to 0900 hours
  • 108. Health-related Issues  Employees who become aware of any health or safety-related issue should notify their supervisor as soon as possible.
  • 109. Annual Fire Fighter NFPA Physical  The medical evaluation of a member (7.4 -7.7.13) shall include a medical history, examination, and any laboratory tests required to detect physical or medical condition(s) that could adversely affect their ability to safely perform the essential job tasks outlined in NFPA 1582 Chapter 9.  Done at Medac Cooperate Health  Must Get TB Skin test read and returned in time.  EMS BC’s, Training BC’s, Deputy and Assistant Chiefs can read the TB Skin Test.  Don’t wait till the last minute before due date to schedule NFPA exam.  Go past your due date will mean suspension until completed.  Centrelearn sends out notifications starting 90 days out.
  • 110. Employee Requiring Medical Attention  Employees should report all work-related injuries and accidents immediately to their supervisor, and then follow theses steps:  Fill out an injury/exposure form.  Complete an incident report in a Word Document Format  Forms can be found on “S” Drive.  Seek any needed medical attention as directed by supervisor.  Notify Safety Compliance Officer as soon as possible.  Note: See Policy Manual for details.
  • 111. Absence and Tardiness  From time to time, it may be necessary for an employee to be late or absent from work. Pender EMS and Fire is aware that emergencies, illnesses, or pressing personal business that cannot be scheduled outside work hours may arise. It is the responsibility of all employees to contact all affected parties if they will be absent or late.  Note: See Employee Manual Section 3.06 Attendance, Punctuality and Absenteeism
  • 112. Unscheduled Absence  Absence from work for two (2) consecutive days for Monday through Friday employees or two (2) consecutive shifts for FWW or non-emergency transport employees, without notifying your supervisor will be considered a voluntary resignation.
  • 113. Smoking and Tobacco Use  Smoking on company property is a privilege, not a right and may be rescinded by management if the privilege is abused. Smoking is defined as the act of lighting, smoking or carrying a lighted or smoldering cigar, cigarette, electronic cigarette or pipe of any kind.  Smoking is not permitted inside any Pender EMS and Fire building with the exception of apparatus bays!!  All debris should be disposed of in appropriate provided receptacles.  When Pender EMS and Fire employees are on the campus of other companies, they are expected to comply with that companies smoking policies.
  • 114. Attire and Grooming  Section 3.26 of Employee Manual  It is important to project a professional image while at work by being appropriately attired and groomed. Pender EMS and Fire employees are expected to be neat, clean, and well-groomed while on the job, conducting business in or outside of the office. Uniformed personnel must comply with the dress code.  Fire/EMS personnel shall wear and maintain their uniforms in such a manner so as to present a neat, wrinkle free, and clean appearance. Uniforms shall be clean, free of rips, tears, holes and shall not be faded or missing any required part such as buttons, patches and accessories.  Any hairstyle is permissible as long as the style does not allow hair to extend beyond the coverage of safety equipment. Hair that extends beyond the collar must be pulled back and tied anytime the employee is engaged in fire suppression or rescue operations. Hair shall be trimmed so as not to flare out or curl beneath the lower edge of the dress uniform hat, work cap, or helmet.
  • 115. Attire and Grooming Continued  North Carolina Division of Occupational Safety and Health has determined that facial hair between the skin and respirator sealing surface is a violation of the Occupational Safety and Health Administration standards which follows State and Federal Law 29 CFR-1920 and 34 (E)(5)(I).  This is true for SCBA and N-95/N-100 Mask.  A positive quantitative or qualitative fit test is not acceptable by OSHA as evidence that would allow a respirator to be worn when facial hair could interfere with the operation of the exhalation valve or seal.  Based on the above statements, personnel who are required to wear self- contained breathing apparatus will be free from any facial hair growth, except for a mustache or center lip growth which will meet the following prescribed grooming standards:  Facial hair should be neatly groomed and trimmed  Shall not extend beyond the lower ridge of the mandible below the corner of the mouth to impede with the proper sealing of breathing apparatus face piece  Sideburns shall not interfere with the proper seal of a breathing apparatus face piece
  • 116. Pender Volunteer EMS and Fire Inc. Standard Operating Guideline Hurricane Guideline  Historically, the major natural disaster threat to the coastal area of North Carolina has been hurricanes. Accordingly, this plan has been developed to cope with the emergency response and recovery efforts that we will face after a land falling hurricane. The Pender Volunteer EMS and Fire, Inc. plan provides for guidance to the employees of this department and other agencies that we work with. This plan was developed to coordinate emergency operations, in the event of a land falling hurricane. Continue……
  • 117. Pender Volunteer EMS and Fire Inc. Standard Operating Guideline Hurricane Guideline  It is important that each employee read and understands this plan. This plan includes things to do before, during, and after a hurricane. Once a storm threatens, you become an emergency worker. Your role becomes more vital than ever. This event might last one day or for months depending on the severity of the storm.
  • 118. Pender Volunteer EMS and Fire Inc. Standard Operating Guideline Hurricane Guideline  It is my hope that this plan will help you begin to prepare yourself and your families in the event of a hurricane. Make sure your station is as self-sufficient as possible. Be as prepared as you can. Thank you, Woodrow W. Sullivan III, Chief Pender Vol. EMS and Fire, Inc.  Please review guideline on the shared drive.
  • 119. THE END!! • Each station has a Infection/Exposure Manual located at each work station. It is the employees responsibility to be aware of all policies and guidelines. • Pender EMS and Fire Medical Director Dr. Michael Moulton and Chief Woody Sullivan III have reviewed and approved these policies and guidelines. It is your responsibility to follow them.