Blood borne pathogen


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Blood Borne Pathogen Training

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Blood borne pathogen

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