Mc Fatter Technical Center Emergency Medical Technician Basic

Mc. Fatter Technical Center Emergency Medical Technician - Basic Health Science Core Infectious Disease

Exposure Types Non-Significant – Occupational exposure that have little to no risk of transmission of disease known at the time. Significant – Occupational exposure that has increased risk transmission and acquiring of disease

Significant Exposure based on contact with bodily fluid and injury Fluids • Blood, serum, or plasma • Pleural, amniotic, pericardial, peritoneal, syovial, or cererospinal fluid • Vaginal secretions or semen • Saliva Injuries • Percutaneous – needle stick, laceration, abrasion, or bites • Mucous membrane – eyes, nose, or mouth • Skin – cut or abraded skin (not intact)

Significant Air or Droplet Exposure Combination of a subject showing signs or symptoms of suspected airborne illness and performing activity that exposed the EMT to droplet or airborne contaminants. Activity • Gag/cough reflex • Manual suctioning of naso -pharyngeal airway • Insertion of nasogastric, supraglottic, or intubation tube

Post Exposure • Provide first aid (if necessary, for example) – Remove contaminated clothing – Flush site contaminated fluid – Clean site with soap/water or antiseptic • Notification and relief of duty • Obtain medical attention at medical facility • Document • Possible need to do follow-up testing months later

HIV/AIDS

HIV Human Immunodeficiency Virus A virus that attacks and destroys the immune system making the patient vulnerable to any infection.

AIDS Acquired Immune Deficiency Syndrome A specific group of diseases or conditions which are indicative of severe immunosuppress ion related to the HIV infection.

HIV/AIDS • Normal T-cell count for a healthy adult is between 8001000 T-cells per cubic millimeter of blood. • A patient infected with the HIV virus usually has a T-cell count less than 200 T-cells per cubic millimeter of blood. • HIV then attacks, enters, and destroys these T-4 cells. • Without T-4 helper cells, the elimination process cannot occur. • The patients defense system known as the immune system, is now destroyed and unable to prevent further illnesses.

HIV/AIDS • America’s first case was diagnosed in 1981 • Many cases are just not reported • 50% of those that are infected with HIV will generally develop some signs and symptoms within 5 years • The most recent reports of AIDS/HIV cases suggest that: • ½ cases are among men who have sex with other men • ¼ cases are among intravenous drug use

HIV/AIDS • Mortality is high upon progression of disease. • 80 -90% of patients diagnosed with AIDS, will die within 3 -5 years of diagnosis due to complications associated with the disease. • With advancements in medications and treatments, early intervention can increase the quality of life and possibly increase the longevity of those infected.

HIV/AIDS Transmission • Sexual contact with an infected person • Blood to blood • intravenous drug use (IDU) • Pregnancy and breastfeeding • Transfusions, but since blood screening in the early 90’s, risk has been greatly diminished.

Bodily Fluids with HIV • Transmittable amounts: • Blood • Semen • vaginal secretions • breast milk • Non-transmittable amounts: • Saliva • Urine • tears

HIV/AIDS Not Transmitted by: • casual contact • handshaking • hugging • kissing • animals • insects

HIV/AIDS Signs / Symptoms • fatigue • continuos flu-like symptoms • weight loss • night sweats • grayish-purple lesions called Karposi’s Sarcoma

HIV/AIDS Protection • Gloves • Double gloves to prevent cross contamination. • Mask due to possible associated airborne diseases • Isolation gown for rescue personnel that have any open wounds • Hands washed with a anti-microbial agent.

Tuberculosis

Tuberculosis • A bacterium that infects the alveoli • Not everyone infected develops the full-blown disease, latent TB infection is most common. • However, one in ten latent infections will progress to active TB disease, which, if left untreated, kills more than half of its victims.

Multiple Drug Resistant Tuberculosis • A form of TB resistant to antibiotics. • Strain developed from patients that did not finish taking the antibiotics and not killing off all of the bacteria

Tuberculosis Transmission Droplets are so small, they remain airborne for extended periods of time and breathed into the lungs

Tuberculosis Signs and Symptoms • • cough for greater than 2 weeks unexplained weight loss night sweats loss of appetite fever coughing of blood (hemoptysis) fatigue

Tuberculosis Protection • TB/Hepa protective masks on both the patient and yourself • open all windows to enhance ventilation and reduce exposure of airborne particles

Tuberculosis Testing • • PPD SKIN TESTING Mantoux PPD (Purified Protein Derivative) skin test is an injection of a small amount of fluid under the skin. results 48 to 72 hours possible exposure - bubble swells and hardens verify infection - 6 months chest x-rays and re-

Hepatitis

Hepatitis • Effects the liver by inflammation • Viral Hepatitis refers to several common diseases that lead to the swelling and tenderness of the liver which includes: • Hepatitis A (HAV) • Hepatitis B (HBV) • Hepatitis C (HCV)

Hepatitis Signs and Symptoms • jaundice, especially in the eyes • fatigue • abdominal pain • loss of appetite • intermittent nausea • diarrhea

Hepatitis A Transmission: • Infection contracted by food or water contaminated by human waste Prevention: • Hepatitis A vaccine • Proper hygiene and sanitation

Hepatitis B Transmission: • bloodborne pathogens • sexual contact with an infected person • perinatal • contaminated needles Prevention: • Hepatitis B vaccine

Hepatitis C Transmission: • bloodborne pathogens • sexual contact with an infected person • perinatal • contaminated needles Prevention: • No vaccine

Influenza

Influenza • Other names: – Flu – seasonal Flu – pandemic Flu • Transmission: – airborne • Cause mild to severe illness and/or death • Symptoms 1 -3 days after exposure • Prevention: – Yearly vaccination

MRSA – Methicillin-resistant Staphylococcus Aureus

MRSA • Transmission: – skin to skin contact with infected person – Skin contact with object that was exposed to bacteria • Cause minor infection to fatal bloodstream infection • Prevention: – Gloves and washing hands

Meningitis

Meningitis Inflammation of the protective membranes covering the central nervous system know as meninges. Cause can be from infectious agent, physical injury, cancer, or certain drugs

Meningitis Signs and Symptoms • Most common symptom headache (87%) • Stiffness of the neck (83%) – unable to flex neck forward • High fever • Altered mental status • Photophobia – intolerance to bright light • Phonophobia – intolerance to loud noise • Irritability and delirium in small children • Swelling of fontanelle in infants

Meningitis – Bacterial Meningitis • Medical emergency and high mortality rate • Causes are typically microorganisms of meningococcus and pheumococcus • Treatment various antibiotics depending on age and type of bacterium • Transmission – respiratory and throat secretions from coughing or kissing • Prevention: – Certain strain have vaccines

Meningitis – Viral Meningitis • Serious but rarely fatal with patients with normal immune systems • Antibiotics have no effect on virus • Causes - enteroviruses • Treatment – none • Prevention: – Washing hands – Cleaning contaminated surfaces

Reference • Florida Regional Common EMS Protocols. Jones and Bartlett. Boston: 2004. • www. cdc. gov • www. wikipedia. com