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Slide 2 Infectious Disease Training Bloodborne & Airborne Pathogens Toggenburg Ski Patrol 2011 - 2012 Narrated by: Beau Blair Slide 3 2011-2012 Infectious Disease Training Review Applicable Standards Review Infection Control Policy & Procedures Review Engineering Controls and Work Practices Identify PPE Discuss Body Substance Isolation Review Bloodborne Pathogens Review Airborne Pathogens Slide 4 OSHA Standards CFR 1910.1030 Bloodborne Pathogens CFR 1910.134 Respiratory Protection Airborne Pathogens Slide 5 Infection Control Policy & Procedure Toggenburg Ski Patrol Infection Control Policy For Protection of the Members of TSP Universal Precautions Some Body Fluids of Some Patients Potentially Infectious Redefined as Body Substance Isolation (BSI) ALL Body Fluids of ALL Patients Potentially Infectious Airborne Pathogens Respiratory Protection Controls Slide 6 What can you be exposed to ? Bloodborne Hepatitis B & C HIV SyphilisAirborne Tuberculosis Meningitis Influenza Measles Mumps Chicken Pox Small Pox SARS Slide 7 How can you be exposed? Bloodborne Needle stick Blood or other body fluids contacting non intact non intact skin, eyes, or mucus membranes. Airborne Inhalation of droplets from a person coughing, sneezing, or breathing in close proximity or in an enclosed area. (Patrol Room) Inhalation of droplets from an aerosolized source. Slide 8 Bloodborne Pathogens HIV Hepatitis B, C, D, G? Syphilis Slide 9 Hepatitis Hepatitis Viral Infection A - Food or contaminated water / Poor hygiene B - Bloodborne C - Bloodborne D - Bloodborne - must have HBV E - Food or contaminated water / Poor hygiene G - Not a lot known currently under research Slide 10 Hepatitis B (HBV) Viral Infection Virulent Lives outside of body for weeks Dried blood No known cure Destroys the liver Usually Fatal Slide 11 HIV Cause : HIV Virus Very Fragile Not Many Virus / Unit of blood Cannot live outside the body for very long Transmission: Blood and many body fluids Incubation: 8 to 11 years Onset: Mild flu-like, fever, headache, rash, swollen glands, then remission and dormant illness Slide 12 HIV (cont.) Course: AIDS is end-stage of HIV; complications from damaged immunity, infections, pneumonias, cancers; fatal Treatment: Drug treatment to delay onset of AIDS; Post-exposure prophylaxis may be an option within 36 hours of exposure. No cure Prevention: Body Substance Isolation; safe sex Will not live outside the body. Slide 13 Airborne Pathogens Tuberculosis Meningitis Influenza Measles Mumps Chicken Pox Small Pox SARS Slide 14 Tuberculosis (TB) Cause : Mycobacterium Tuberculosis Transmission: Airborne droplets Incubation: 1 to 8 weeks - maybe longer Symptoms: Persistent productive cough, weight loss, fever, night sweats, coughing up blood, shortness of breath, fatigue Slide 15 Tuberculosis (cont.) Treatment: INH, Rifampin, Pyrazinamide Prevention: Respiratory BSI precautions; post- exposure medications can be offered to prevent infection. T.B. test A surveillance form shall be completed annually for those employees who have previously tested positive. Slide 16 Tuberculosis High risk Groups Homeless people in shelters Alcoholics Prisoners IV drug users HIV infected individuals Residents of long-term care facilities People with previous positive skin tests Slide 17 Tuberculosis High Risk Groups Contacts of known TB patients Elderly; chronically ill Immunosuppressed Foreign born, especially Asian, African, or Latin America Healthcare ProvidersHealthcare Providers Ski Patrollers Slide 18 Signs & Symptoms of TB Frequent Cough Coughing up blood Night Sweats Fever Fatigue Weight loss Slide 19 SARS Severe Acute Respiratory Syndrome These diseases are grouped in a category know as Febrile (fever causing) Respiratory Illness Infectious Slide 20 Febrile Respiratory Illness Signs and symptoms of febrile respiratory illness are: Fever of at least 100.5 degrees F o One or more clinical findings of respiratory illness, such as cough, shortness of breath, difficulty breathing, hypoxia; Slide 21 Respiratory Etiquette Strategy Implement the use of N95 Respirator masks by healthcare personnel, during the evaluation of patients with respiratory symptoms Provide N95 respirator masks to all patients with symptoms of a respiratory illness. Provide instructions on the proper use and disposal of N95 masks. Slide 22 Respiratory Etiquette Strategy (Cont) For patients who cannot wear a respirator mask: (in addition to medical treatment being provided) Provide tissues and instructions on proper use when coughing, sneezing, or controlling nasal secretions How and where to dispose of them And the importance of hand hygiene Slide 23 Respiratory Etiquette Strategy (Cont) Continue to use respiratory precautions to manage patients with respiratory symptoms Until it is determined that the cause of symptoms is not an infectious agent Slide 24 What is an Exposure?: Direct or indirect contact of blood or other body fluids with non-intact skin or mucous membranes Slide 25 Body Fluids Requiring Precautions Blood Blood Components Serum Plasma Vitreous fluid (eyes) Synovial Fluid (joints) Semen Pleural Fluid (lungs) Cerebral-spinal Fluid Pericardial Fluid (heart) Peritoneal Fluid (belly) Saliva Vaginal secretions Amniotic Fluid Wound Drainage Respiratory Droplets Slide 26 Body Fluids that may contain blood: Breast milk Tears Nasal Secretions Urine Stool Emesis Sweat CSF Slide 27 Engineering Controls Reduce the risk by removing the hazard or isolating the worker from the hazard Slide 28 Engineering Controls PPE (G3) Gloves Goggles Gowns Disposable suction components and catheters Disposable BVM Resuscitators Pocket masks Self sheathing needles (Patients may have own) Needle less syringes and medication systems Slide 29 Work Practice Controls Reduce the hazard the by changing the manner in which the task is performed Slide 30 Accepted Work Practice Controls Washing hands Use of PPE Not breaking off or recapping needles (SHARPS) No eating, drinking, smoking, applying cosmetics or touching contact lens in work areas. Limit the number of people contacting patient Use of Pocket Mask or BVM to ventilate patients Slide 31 Body Substance Isolation Body Substance Isolation Wash hands before and after patient contact Wash hands immediately when soiled with blood or body fluids. Use Waterless Gel hand cleaner if soap and running water are not available. Wash hands immediately after removing gloves Wear protective eyewear and mask whenever splashing is possible Slide 32 Body Substance Isolation Wear protective clothing when soiling is likely Use pocket masks and/or Bag-valve-masks (BVMs) to resuscitate Avoid direct patient care when your skin is not intact Follow procedures for handling sharps Slide 33 Body Substance Isolation Use red bag procedures for contaminated articles Use approved decontamination and cleaning procedures Wear gloves for all contact with blood and body fluids including during cleaning and decon Slide 34 Personal Protective Equipment Gloves Gowns Protective eyewear Masks: approved N-95 PPE should be worn during treatment of patients when there is any risk of exposure to blood Body fluids or airborne pathogens. Slide 35 Hepatitis B Vaccine Hepatitis B vaccination (3-shot) series is highly recommended. However, since we are not employees by NSP rules & regulations, the Hep-B series would be at your own expense, through your own physician. Slide 36 What is a Reportable Exposure? Needle sticks Blood or body fluid splash to: Non-intact skin Mucous membranes Eyes Nose Mouth Slide 37 What to do if youve been exposed. Thoroughly cleanse the area of exposure. Report the Exposure to the Infection Control Officer. Patrol Leader or Designated Representative Complete the Exposure Report Form The IC Officer will immediately determine exposure classification & contact Patrol Leader Referrals for any necessary post-exposure treatment or follow-up Slide 38 Post Exposure Evaluation and Follow up Slide 39 Testing Infection Control Officer or Patrol Leader will seek existing information on the source individual. Have the source individuals blood tested for HIV and Hepatitis B & C, as allowed by law. Exposed employee should be tested for base line HIV and Hepatitis status and antibody level. Subsequent HIV testing should be performed at 6 weeks, 12 weeks, 6 months and 1 year Slide 40 Work Related Illnesses Failure to comply with baseline testing, recommendations and or treatments of the physician or infectious disease professional may jeopardize your right to further medical care. Slide 41 Counseling Test results reviewed with the exposed employee Post exposure counseling Health status Treatment options. Information on prophylactic medications. Slide 42 Treatment Options HIV Post-Exposure Prophylaxis can be offered to those assessed to have suffered a high risk exposure. Prophylaxis medications should be administered Optimally within 2-3 hours of exposure Can be provided up to 36 hrs after exposure The risk of transmission of Hepatitis B or Hepatitis C is much greater than the risk of transmission of HIV Slide 43 Treatment Options (cont) Hepatitis B infection can be prevented Pre-exposure Prophylactic Hepatitis B vaccine series No known effective prophylaxis for Hepatitis C Post-exposure Administration of Hepatitis B immune globulin May not be as effective as prophylactic vaccine Slide 44 Labeling Methods for Contaminated Articles Bright fluorescent orange or orange-red colored stickers which contain the biohazard symbol and the word BIOHAZARD in a contrasting color Red biohazard waste bags with the biohazard symbol and the word BIOHAZARD in a contrasting color Slide 45 The following items shall be labeled: Containers of regulated waste Sharps disposal containers Laundry bags and containers Contaminated equipment for repair or cleaning Containers used to store, transport, or ship blood or other potentially infectious materials Slide 46 Q & A Beau Blair 692-4344 Slide 47 Please fill-out, Sign & Return BBP/ABP Training Forms