The document discusses OSHA's Bloodborne Pathogen Standard which requires annual training for employees exposed to blood and other potentially infectious materials. It covers who is covered under the standard, potential pathogens, how pathogens are transmitted, and common precautions to prevent exposure such as use of personal protective equipment, proper handling of sharps and regulated waste, decontamination procedures, and universal precautions to treat all blood and body fluids as potentially infectious. It also provides guidance for immediate treatment in the event of an exposure.

2. What is the OSHA Bloodborne
Pathogen Standard?
• OSHA mandates training annually for all
employees who have the potential to be
exposed to blood and other potentially
infectious materials (OPIM) in the
workplace.
• OSHA Bloodborne pathogens regulation
went into effect on March 6th, 1992.

3. Who is covered under this standard?
• All employees who may reasonably expect
to be exposed to blood and OPIM that may
contain pathogens.
• Anyone whose job involves handling or
possibly being exposed to blood, blood
products, or OPIM.

4. What are OPIM?
Any body fluids , including:
• Saliva
• Semen
• Vaginal Secretions
• Breast Milk
• Amniotic Fluid
• Cerebral spinal fluid
• Synovial Fluid
• Pleural Fluid
• Peritoneal Fluid
• Pericardial Fluid
• Any body fluid that
visibly is contaminated
with blood, such as
vomit or urine.

5. What are Pathogens
A Pathogen: is any disease-producing agent,
especially a virus, bacterium, or other
microorganism.
Examples: HIV, hepatitis B (HBV) and C (HCV),
influenza (flu), tuberculosis (TB), meningitis,
COVID, etc.

6. How are you Exposed to pathogens?
• Persons do not have to come into direct
contact with others who have a disease to be
exposed.
• Pathogens can be spread through exposure to
blood or OPIM that is infected.

7. How are pathogens spread?
• Spilled blood or body fluids
• Clinical specimens
• Biohazardous Trash
• Blood or body-fluid soaked laundry
• Sharps (needles, scalpels, etc.)
• Aerosolized particles (cough or sneeze)

9. Common Pathogens Encountered by
EMS Personnel
• Bloodborne Pathogens
– HIV
– Hepatitis B
– Hepatitis C
• Airborne Pathogens
– Tuberculosis
– Influenza
– Meningitis
– Pneumonia
– COVID

10. Human Immunodeficiency Virus
(HIV and AIDS)

11. Human Immunodeficiency Virus
(HIV and AIDS)

12. Human Immunodeficiency Virus
(HIV and AIDS)

13. Human Immunodeficiency Virus
(HIV and AIDS)

14. Human Immunodeficiency Virus
(HIV and AIDS)

15. Human Immunodeficiency Virus
(HIV and AIDS)
Description: HIV damages cells essential for immune function and results in
AIDS. People with AIDS are more susceptible to opportunistic infections.
Symptoms: many people with HIV have no symptoms. HIV may take up to
10 years or more to develop into AIDS. Symptoms of AIDS include:
• Loss of appetite
• Weight loss
• Skin rashes
• Swollen lymph nodes
• Diarrhea
• Fatigue
• Night sweats
• Inability to fight off infection

16. Human Immunodeficiency Virus
(HIV and AIDS)
How detected: HIV can be detected only through blood tests. The
results are usually positive 12 weeks after exposure. A confirmation
test is recommended six months after exposure.
How Transmitted:
• Through an infected person’s body fluids (blood, semen, vaginal
secretions, breast milk, OPIM if blood is present)
• Sexual activity
• Needle stick or puncture wounds
• Exposure through mucous membranes
Cure / Vaccine: No Cure, however, there are medications that use
antiretroviral treatment and control the virus. There are also
medications that help lower chances of contracting it.

17. Human Immunodeficiency Virus
(HIV and AIDS)
HIV is not transmitted through:
• Casual contact
• Sharing a drinking glass, meal, or fork
• Kissing, hugging or touching
• Sneezes or coughs
• Sharing a phone or bathroom
• Through mosquitoes, fleas, ticks or other
blood sucking vermin

18. Hepatitis B Virus (HBV) and
Hepatitis C Virus (HCV)
Description: viral infection that attacks the liver and can
cause both acute and chronic disease. HCV is usually more
chronic than HBV.
Symptoms: most people do not experience symptoms
during the acute infection phase. However, some people
have acute illness that lasts several weeks including:
• Jaundice
• Dark urine
• Extreme fatigue
• Nausea
• Vomiting
• Abdominal pain

19. Hepatitis B Virus (HBV) and
Hepatitis C Virus (HCV)
How is it Detected: HBV can be detected through blood
tests. The incubation period can be up to 12 weeks.
How is it Transmitted:
• Through an infected person’s body fluids (blood, semen,
vaginal secretions, breast milk, OPIM if blood is present)
• Sexual activity
• Needle stick or puncture wounds
• Exposure through mucous membranes
• Transmitted to child by mother at birth
At room temperature HBV may survive outside the body for
several days.

20. Hepatitis B Virus (HBV) and
Hepatitis C Virus (HCV)
Cure / Vaccine :
• Hepatitis C Virus (HCV)
– There is no cure for chronic Hepatitis B, however there are
treatments to help repress the symptoms and slow the attack
on the liver.
– For acute cases of Hepatitis B you doctor will determine the
best coarse of action, normally this is bed rest.
– There is a vaccination available in a series of three injections
over the course of several weeks.
• Hepatitis C Virus (HCV)
– Anti Viral Medications

21. Influenza
Description: viral infection that infects the respiratory tract.
Symptoms:
• Cough
• Running or stuffy nose
• Muscle pain
• Stiffness
• Fatigue
• Headache
• Sore throat
• Shaking / chills
• Fever
• Dehydration
• Difficulty breathing

22. Influenza
How Detected: diagnosis based on symptoms and/or Rapid influenza
diagnostic test (RIDT)
How Transmitted: virus enters the body via mucous membranes
(eye, nose, mouth). Most often contracted via airborne droplets or
by hand to eye / hand to nose / hand to mouth contact.
• Hands (after touching contaminated objects)
• Air (in the vicinity of coughing or sneezing)
• Contaminated objects (steering wheels, stretcher, used linen)
Influenza may survive outside the body for several days.
Cure / Vaccine: There is no cure, but a vaccine is available. The yearly
vaccine only protects against a few strains of the flu expected for
that season. Does not always protect against all Flu strains and
variants. Tamiflu can be taken to help reduce the symptoms.

23. COVID
Description: viral infection that infects the respiratory tract.
Symptoms:
• Cough
• Running or stuffy nose
• Muscle pain
• Stiffness
• Fatigue
• Headache
• Sore throat
• Shaking / chills
• Fever
• Dehydration
• Difficulty breathing

24. COVID
How Detected: diagnosis based on symptoms and/or Nasal Swab and/or
Rapid nasal test
How Transmitted: virus enters the body via mucous membranes (eye,
nose, mouth). Most often contracted via airborne droplets or by hand to
eye / hand to nose / hand to mouth contact.
• Hands (after touching contaminated objects)
• Air (in the vicinity of coughing or sneezing)
• Contaminated objects (steering wheels, stretcher, used linen)
Cure / Vaccine: Anti viral treatments, sometimes a patient may experience
little to no symptoms all they way to needing hospitalization. A vaccine has
became available and it is expected in the coming months more
manufactures will be FDA approved. It is expected to take about a year to
reach “Herd” immunity. Also it should be noted that it is unknown if the
vaccine will protect against the new strands that are coming out.

25. COVID
IT IS VERY IMPOPRTANT TO NOTE
THAT THERE ARE STILL A LOT OF
UNKNOWNS WITH COVID. WHEN IN
DOUBT REACH OUT TO YOUR CHAIN
OF COMMAND TO ATTEMPT TO GET
ANSWERS TO HELP YOU.

27. Tuberculosis (TB)
Description: bacterial infection that often infects the lungs.
Symptoms: many people with TB infection have no symptoms.
Those who have TB disease (active) will experience:
• Weight loss
• Fever
• Night sweats
• Weakness
In the lung infection can cause:
• Coughing
• Chest pain
• Production of sputum
• Coughing up blood

28. Tuberculosis (TB)
How is it Detected: ppd, blood tests, and chest X-ray (if you
have been exposed, you will always test positive on a ppd).
People can be infected (no symptoms / not contagious)
meaning they have the bacterial antibodies present. A
person with active TB is said to have TB disease
(symptomatic / contagious)
How is it Transmitted: aerosolized particles from the cough
or sneeze of an infected person.
Cure / Vaccine: TB has no vaccine, but TB disease is curable
with antibiotics. Those with TB infection are at high risk to
develop the disease again in the future.

29. Tuberculosis (TB)
How TB is NOT Transmitted:
• Clothing
• Drinking glass
• Eating utensils
• Shaking hands
• Toilet
• Other surfaces

30. What is Exposure Prevention?
Exposure Prevention – the means by which
you can isolate yourself from pathogens, and
protect yourself from exposure.
Exposure: when a specific eye, mouth, other
mucous membrane, non-intact skin, or
parenteral (piercing mucous membranes or
skin) contact with blood or OPIM that results
from the performance of an employee’s
duties.

31. What are Engineered Controls?
Engineered Controls – Are controls that isolate or
remove the bloodborne pathogen hazard from
the workplace.
• Sharps disposal containers
• Self – sheathing needles
• Needleless IV systems
• Handwashing
• Eye wash stations
• Biohazard labels

32. Sharps Containers
Must be present for safe disposal of used
sharps.
Containers must be:
• Puncture resistant
• Leak-proof on sides and bottom
• Clearly labeled with orange/red biohazard
warning label
• Closable and sealable for shipping or
transport

33. Handwashing / Eye-washing stations
• Handwashing stations must
be supplied whenever
possible.
– Waterless antiseptic hand
cleanser may be provided when
handwashing is not possible.
• Eye-wash stations must be
provided whenever possible.
– Any equipment or fixture which
allows for flushing of eyes with
water for at least 20 minutes.

34. What are Work Practice Controls?
Work Practice Controls – are controls that reduce the
likelihood of exposure by altering the manner in which
a task is performed.
• Use of personal protective equipment (PPE)
• Handwashing
• Decontamination and sterilization of equipment /
areas
• Safely handling sharps
• Correctly disposing of wastes
• Safely handling laundry
• Work area restrictions

35. Personal Protective Equipment (PPE)
Personal Protective Equipment – is specialized clothing
or equipment worn by an employee for protection
against a hazard.
General work clothes (uniforms, pants, shirts, or
blouses) not intended to function as protection against
a hazard are not considered to be personal protective
equipment.
The following are considered PPE:
• Gloves
• Tyvek suits / aprons
• Eye shields and goggles
• Face masks / face shields / N95

36. Personal Protective Equipment
(PPE) (cont.)
• PPE is to be provided at no cost to the
employee
• Training on how to properly use equipment
is to be provided to employees
• PPE must be cleaned, repaired, or replaced
as needed

37. Medical Exam Gloves
• Normal exam gloves are non-latex
• P2 (Heavy gloves) are latex
• Sterile gloves are latex
• Make sure gloves are intact
– If not, replace glove
– Do not attempt to repair gloves with tape, etc.
– Petroleum based hand lotions can weaken
gloves, do not use them!

38. Removal and Disposal of Gloves
• Remove contaminated gloves carefully
without touching any part of the outside of
the glove.
• Dispose of gloves in a container clearly
marked for biohazardous wastes.

39. Other PPE
• Tyvek suits – protect clothing (available in
different thicknesses and materials)
• Goggles, Eye Shields, Safety glasses with
side shields, and face shields: protect eyes
from exposure to blood / OPIM
– Personal eyewear (sunglasses / prescription
glasses) do not normally count as PPE for eye
protection?

40. Handwashing Guidelines
• Immediately wash any exposed skin, ideally
with soap.
• Be gentle with any scabs or sores.
• Wash all surfaces including the back of the
hands, wrists, between the fingers and
under the fingernails.
• Wash hands immediately after removing
gloves or other PPE.

41. Waterless Handwashing
• Waterless antibacterial handwashing liquid can be
used when soap and running water are not
available.
• After a potential exposure a thorough scrubbing
with soap and water is still recommended as soon
as possible.

43. Decontamination / Sterilization
• Clean and sterilize all reusable equipment after
use.
• Clean and disinfect working surfaces such as
bench seats, shelves, floors, and ambulance
floors, walls, and ceilings.
– Use 10% bleach solution or acceptable pre-mixed
commercial solutions
– Clean surfaces as they become contaminated
– Clean surfaces after any spill of blood or OPIM
• Ideally, ambulances should be decontaminated
after every call.

44. Decontamination / Sterilization

45. Handling Sharps
• Sharps containers must be placed in easily
accessible areas where sharps are used
• Contaminated sharps must be placed into
sharps containers immediately or as soon as
possible after use
• Contaminated sharps shall not be bent, re-
capped, sheared, or broken, and sharps
should not be disassembled prior to disposal

46. What is Regulated Waste?
• Liquid or semi-liquid blood or OPIM
• Contaminated items which would release blood or
OPIM in a liquid or semi-liquid state if compressed
• Items with dried blood or OPIM that could be spread
by handling
• Contaminated sharps
• Pathological or microbiological waste containing
blood or OPIM
• Waste should be placed into an appropriate
receptacle container such as a red bag or clearly
labeled sharps container.

47. Safely Handling Laundry
Anyone handling contaminated laundry must
be trained to handle bloodborne pathogens

48. Safely Handling Laundry (cont.)
• Uniforms, clothing and cloth supplies should
be kept free from contamination when
possible.
• Laundry contaminated by blood or OPIM
shall be placed in a labeled hazardous
materials bag.
– DO NOT TAKE CONTAMINATED LAUNDRY
HOME, you can wash it at Station in the
machines provided to you.

49. How to clean turn out gear
• For extreme contamination of products from combustion,
fire debris, or body fluids, removal of the contaminants by
flushing with water as soon as possible is necessary,
followed by appropriate cleaning.
• In the case of blood-borne pathogens, recommended
decontamination procedures include using a 0.5% to 1%
concentration of Lysol, or a 3%–6% concentration of
stabilized hydrogen peroxide. Liquid glutaraldehyde,
available through commercial sources, will also provide
high to intermediate levels of disinfectant activity.

50. Universal Precautions
All blood and OPIM is treated as if it were
infected with HIV, HBV, and other bloodborne
pathogens.

51. Dealing With Exposure
If blood or OPIM splashes in your eyes or other mucous
membranes:
• Flush area with running water for twenty minutes
• Wash any exposed area well with antibacterial soap
• Gently treat any scabs or sores
• Get treatment IMMEDIATELY and as soon as possible
report the exposure to any chief
• DO NOT DELAY TREATMENT FOR ANY REASON
• Treatment should be done at the source patients hospital
destination if at all possible.
• Save any potentially contaminated objects for testing
purposes

53. Post-Exposure
Treatment and medical care depend on:
• The type of exposure
• Substance involved
• Route of transmission
• Severity of the exposure
A confidential exposure report will be placed
in the employee's personnel file.