WELCOME TO THE FIREEMS TRAINING ACADEMYS INFECTIOUS CONTROL

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WELCOME TO THE FIRE/EMS TRAINING ACADEMY’S INFECTIOUS CONTROL ANNUAL REFRESHER TRAINING PROGRAM • If

WELCOME TO THE FIRE/EMS TRAINING ACADEMY’S INFECTIOUS CONTROL ANNUAL REFRESHER TRAINING PROGRAM • If you have any questions regarding the Infection Control Training Class, please refer to the Infectious Control General Order 5 -16 (‘new’ General Order 08 -07). • If you are still unable to answer your question, please contact the Emergency Operations Center at 301 -583 -2200 to reach the On-Duty Infectious Control Training Instructor. 1

BLOODBORNE PATHOGENS PREVENTING DISEASE TRANSMISSION & INFECTION CONTROL Revised 2008 2

BLOODBORNE PATHOGENS PREVENTING DISEASE TRANSMISSION & INFECTION CONTROL Revised 2008 2

 • Approximately 5. 6 million workers in healthcare and other facilities are at

• Approximately 5. 6 million workers in healthcare 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) • 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 3

Objectives • At the end of this session, the student will be able to:

Objectives • At the end of this session, the student will be able to: – Describe what laws and safety regulations cover Bloodborne Pathogens – List and describe the diseases that cause the greatest concerns for providers – Describe how to prevent disease transmission 4

Objectives – Describe the necessary steps the provider must complete when an exposure occurs

Objectives – Describe the necessary steps the provider must complete when an exposure occurs – Locate and describe the Exposure Control Plans for the Prince George’s County Fire/EMS Department 5

Topics • • • Laws and Safety Regulations How Exposures Occur Diseases that Cause

Topics • • • Laws and Safety Regulations How Exposures Occur Diseases that Cause Concern Preventing Disease Transmission If an Exposure Occurs Exposure Control Plans 6

Laws and Safety Regulations • OSHA Standard 29 CFR 1910. 1030 • MOSH 09.

Laws and Safety Regulations • OSHA Standard 29 CFR 1910. 1030 • MOSH 09. 12. 31, Occupational Safety and Health Act • Prince George’s County Fire/EMS Department’s General Orders – General Order 5 -16, Infection Control Program – General Order 5 -17, Tuberculosis Exposure Control Program – General Order 5 -19, Non-Infectious Occupational Exposure Program 7

Laws and Safety Regulations • OSHA, the Occupational Safety & Health Administration, issued the

Laws and Safety Regulations • OSHA, the Occupational Safety & Health Administration, issued the Occupational Exposure to Bloodborne pathogens, OSHA 29 CFR 1910. 1030, to protect employees by reducing or removing the hazards of bloodborne pathogens from the workplace. – The regulation applies to employers whose employees, as a result of job requirements, have the potential for exposure to bloodborne pathogens. 8

Laws and Safety Regulations OSHA Web Site http: //www. osha. gov/SLTC/bloodbornepathogens/index. html 9

Laws and Safety Regulations OSHA Web Site http: //www. osha. gov/SLTC/bloodbornepathogens/index. html 9

How Exposures Occur • Most common: needlesticks • Cuts from other contaminated sharps (scalpels,

How Exposures Occur • Most common: needlesticks • Cuts from other contaminated sharps (scalpels, broken glass, etc. ) • Contact of mucous membranes (for example, the eye, nose, mouth) or broken (cut or abraded) skin with contaminated blood 10

How Exposures Occur • Disease transmission is a two-way street. It is just as

How Exposures Occur • Disease transmission is a two-way street. It is just as easy for you to infect a person with whom you come in contact as it is for that person to infect you. • A pathogen is a disease-producing organism that enters the body; basically, a germ. • The immune system relies heavily on the skin to keep the amount of pathogens that enter the body to a minimum. 11

How Infections Occur Chain of Infection • • • Infectious Agent Reservoir Means of

How Infections Occur Chain of Infection • • • Infectious Agent Reservoir Means of Exit Mode of Transmission Means of Entry Susceptible Host 12

How Infections Occur Infectious Agent Susceptible Host Means of Entry Reservoir Means of Exit

How Infections Occur Infectious Agent Susceptible Host Means of Entry Reservoir Means of Exit Mode of Transmission Chain of Infection 13

How Infections Occur • Routes of Transmission: – Direct contact – Indirect contact –

How Infections Occur • Routes of Transmission: – Direct contact – Indirect contact – Airborne transmission – Vector-borne transmission 14

How Infections Occur • Direct Contact – Touching the body fluids from an infected

How Infections Occur • Direct Contact – Touching the body fluids from an infected person • Indirect Contact – Touching objects that have been in contact with the body fluid of an infected person • Airborne – Breathing in droplets that became airborne when an infected person coughs or sneezes • Vector-borne – Through a bite from an infected animal or insect 15

How Infections Occur • Most infectious diseases are caused by one of five types

How Infections Occur • Most infectious diseases are caused by one of five types of pathogens. The most common are viruses and bacteria. – Viruses – Bacteria – Fungi – Protozoa – Parasites 16

How Infections Occur – Viruses • Hepatitis, Chicken Pox, HIV, etc. – Bacteria •

How Infections Occur – Viruses • Hepatitis, Chicken Pox, HIV, etc. – Bacteria • Meningitis, Tuberculosis, food poisoning – Fungi • Athlete’s foot, ringworm – Protozoa • Malaria, dysentery – Parasites • Abdominal pain, anemia, etc. 17

What are Bloodborne Pathogens? • Bloodborne Pathogens are causative agents of disease that are

What are Bloodborne Pathogens? • Bloodborne Pathogens are causative agents of disease that are carried in blood, blood products and other potentially infectious materials. They can result in severe and deadly disease in healthcare or research personnel. 18

How Infections Occur • Just because pathogens have a means of getting into the

How Infections Occur • Just because pathogens have a means of getting into the body does not mean that disease will be transmitted. • For diseases to be transmitted, all four of the following conditions must be met: – A pathogen is present. – There is sufficient quantity of the pathogen to cause disease. – A person is susceptible to the specific pathogen. – The pathogen enters the body through the correct entry site. 19

Diseases that Cause Concern What Is infectious? • Capable of causing infection • Caused

Diseases that Cause Concern What Is infectious? • Capable of causing infection • Caused by a pathogen • Illness resulting from an invasion of a host by a disease producing organism 20

Diseases that Cause Concern • You should be familiar with diseases that can have

Diseases that Cause Concern • You should be familiar with diseases that can have serious consequences if transmitted. • These include - – Herpes - These viruses cause infections to the skin and mucus membranes. – Meningitis - A severe infection of the coverings of the brain and spinal cord. – Tuberculosis—A disease that predominantly affects the respiratory system. – Hepatitis - A viral infection of the liver. Different forms of hepatitis are transmitted in different ways. 21

Diseases that Cause Concern – HIV: A disease that attacks white blood cells and

Diseases that Cause Concern – HIV: A disease that attacks white blood cells and destroys the body’s ability to fight infections. – Childhood Diseases: Diseases such as measles, mumps and chicken pox pose a serious risk for persons who did not contract the diseases as children or were not immunized against them. 22

Diseases that Cause Concern Bloodborne Pathogens of Special Concern To Health Care Providers –

Diseases that Cause Concern Bloodborne Pathogens of Special Concern To Health Care Providers – HBV: Hepatitis B virus – HCV: Hepatitis C virus – Other emerging viral hepatitis – HIV: Human Immunodeficiency virus 23

Diseases that Cause Concern Hepatitis B (HBV) – – – Infection of liver caused

Diseases that Cause Concern Hepatitis B (HBV) – – – Infection of liver caused by HBV Virus is in blood and other body fluids Spread by exposure to blood and body fluids Some people are at higher risk of HBV In 1983 there were 17, 000 new cases among healthcare workers, while in 1995 there were only 400 occupationally acquired infections. With the introduction of the HBV vaccine to healthcare workers, the period from 1983 to 1995 had a 95% decrease in new cases among healthcare workers. 24

Diseases that Cause Concern Hepatitis B (HBV) Symptoms: • • Lethargy Loss of appetite

Diseases that Cause Concern Hepatitis B (HBV) Symptoms: • • Lethargy Loss of appetite Fever Vomiting • Yellow skin & eyes (jaundice) • Dark-colored urine. • Light colored stool DID YOU KNOW? ? ? It is estimated that 4. 9% of all Americans have been infected with HBV 25

Diseases that Cause Concern HBV Treatment • • • NO CURE Fluids Rest Right

Diseases that Cause Concern HBV Treatment • • • NO CURE Fluids Rest Right diet Avoid alcohol & some medicines 26

Diseases that Cause Concern Hepatitis B Prevention • Avoid exposure • A VACCINE IS

Diseases that Cause Concern Hepatitis B Prevention • Avoid exposure • A VACCINE IS AVAILABLE! (Get complete vaccination series) 27

Diseases that Cause Concern Hepatitis C (HCV) • Infection of the liver • Virus

Diseases that Cause Concern Hepatitis C (HCV) • Infection of the liver • Virus is in blood and other body fluid • HCV mainly spread by exposure to blood and blood products • Certain people are at higher risk of getting HCV 28

Diseases that Cause Concern Hepatitis C (HCV) Symptoms: • • Lethargy Loss of appetite

Diseases that Cause Concern Hepatitis C (HCV) Symptoms: • • Lethargy Loss of appetite Abdominal pain Nausea • Vomiting • Yellow skin & eyes (jaundice) • Urine that is dark in color 29

Diseases that Cause Concern Hepatitis C (HCV) Treatment • • NO CURE Treatment limited

Diseases that Cause Concern Hepatitis C (HCV) Treatment • • NO CURE Treatment limited Rest & fluids Avoid alcohol & some medicines 30

Diseases that Cause Concern Hepatitis C (HCV) Prevention • NO effective VACCINE! • Taking

Diseases that Cause Concern Hepatitis C (HCV) Prevention • NO effective VACCINE! • Taking the same precautions that protect you from Hepatitis B and HIV will help prevent transmission of HCV in the workplace. 31

Diseases that Cause Concern Human Immunodeficiency Virus (HIV) • AIDS is caused by the

Diseases that Cause Concern Human Immunodeficiency Virus (HIV) • AIDS is caused by the HIV virus • Some people at higher risk than others • HIV is in blood and other body fluids • HIV is spread by exposure to HIV infected blood and HIV infected body fluids 32

Diseases that Cause Concern • As of 2002, and according to the Centers for

Diseases that Cause Concern • As of 2002, and according to the Centers for Disease Control and Prevention (CDC), there are over 816, 000 reported cases of people with AIDS in the US, and an estimated 5 million people were infected with the Human Immunodeficiency Virus (HIV) worldwide. • In the US, HIV-related illness was the leading cause of death among young adults between the ages of 25 and 44 years old in 1995. 33

Diseases that Cause Concern AIDS annual rates per 100, 000 population United States, January

Diseases that Cause Concern AIDS annual rates per 100, 000 population United States, January - December 1996 4. 0 14. 5 MD. 44. 4 3. 9 6. 1 26. 6 30. 1 D. C. 232. 3 12. . 0 25. 3 13. 4 50. 9 14. 2 34

Diseases that Cause Concern HIV • Certain symptoms & conditions may be associated with

Diseases that Cause Concern HIV • Certain symptoms & conditions may be associated with HIV/AIDS • Fever • Weight loss • Swollen lymph nodes • White patches in mouth (thrush) • Certain cancers eg. Kaposi’s sarcoma, certain lymphomas • Infections eg. pneumocystis pneumonia, TB, etc. 35

Diseases that Cause Concern HIV • A blood test may tell if you have

Diseases that Cause Concern HIV • A blood test may tell if you have HIV infection or AIDS HIV treatment • No CURE • A treatment protocol (Zidovudine (AZT) plus lamivudine (3 TC) for 28 days) • Combination therapy with a variety of medications has been developed by the help people with HIV by U. S. Public Health Service slowing the disease and is to be administered process following a high-risk exposure to a known HIVinfected source. 36

Diseases that Cause Concern HIV and AIDS are Preventable • There is NO VACCINE!

Diseases that Cause Concern HIV and AIDS are Preventable • There is NO VACCINE! • Avoid exposure • Follow standard (universal precautions) such as the use of: gloves, eye protection, gowns, etc. DID YOU KNOW? ? ? According to previous reports from the CDC, HIV does not survive well outside the body. The number of infectious HIV particles is reduced by 90 to 99 percent within several hours. However, this natural inactivation can take up to 8 hours or longer! 37

Diseases that Cause Concern A diagnosis of TB should be suspected in any patient

Diseases that Cause Concern A diagnosis of TB should be suspected in any patient with the following: • Productive cough (>2 to 3 wks duration) • Fever - Chills • Night sweats • Easily fatigable • Loss of appetite (anorexia) - weight loss • Hemoptysis (bloody sputum) 38

Diseases that Cause Concern Managing patients who may have TB in ambulatory care setting

Diseases that Cause Concern Managing patients who may have TB in ambulatory care setting and emergency departments: – Attempt to identify any potentially TB infected patient e. g. history, signs & symptoms, any previous positive TB treatment, or any current antituberculosis medications 39

Diseases that Cause Concern • Utilize engineering controls where possible and use of approved

Diseases that Cause Concern • Utilize engineering controls where possible and use of approved PPE when treating and transporting a patient suspected of having TB • TB patients, if medically stable, should remain in the transport unit (with a provider) until receiving facility is notified and ready to accept the patient 40

Diseases that Cause Concern Developing, implementing, maintaining, and evaluating a respiratory protection program: –

Diseases that Cause Concern Developing, implementing, maintaining, and evaluating a respiratory protection program: – Personal Protective Equipment (PPE): Respiratory Protection (NIOSH approved mask e. g. N-99 or HEPA and other PPE as per local protocol) – Meets adequate filtration standards 41

Diseases that Cause Concern Qualitatively or quantitatively fit tested • Respirators available in units

Diseases that Cause Concern Qualitatively or quantitatively fit tested • Respirators available in units • Ability to be checked for face piece fit (OSHA) • Must comply with CFR 1910. 134 (OSHA Respiratory Standard) • 42

Diseases that Cause Concern Use precautions while performing cough-inducing and other high hazard procedures:

Diseases that Cause Concern Use precautions while performing cough-inducing and other high hazard procedures: – Characterized by potential to generate airborne / droplet secretions – Aerosolized medication treatment – Endotracheal Intubation – Suctioning – Transporting a patient with active TB disease in a closed vehicle 43

Diseases that Cause Concern What Is Tuberculosis? • Mycobacterial disease • Caused by the

Diseases that Cause Concern What Is Tuberculosis? • Mycobacterial disease • Caused by the infectious agent: Mycobacterium tuberculosis • Transmitted by infected airborne particles called droplet nuclei 44

Diseases that Cause Concern • TB Infection can result from exposure to infectious droplet

Diseases that Cause Concern • TB Infection can result from exposure to infectious droplet nuclei • Positive PPD but, no clinically apparent signs or symptoms of TB • Negative CXR & negative smears and cultures which means usually not infectious • May develop into TB disease 45

Diseases that Cause Concern • TB disease develops in a person with tuberculosis infection

Diseases that Cause Concern • TB disease develops in a person with tuberculosis infection • Usually is infectious if not treated • Signs and symptoms apparent with positive lab test 46

Diseases that Cause Concern Develop and implement a program for routine periodic counseling and

Diseases that Cause Concern Develop and implement a program for routine periodic counseling and screening of HCWs for active and latent TB infection: • PPD skin testing is used to detect TB infection 47

Diseases that Cause Concern • Skin test conversion from negative to positive indicates a

Diseases that Cause Concern • Skin test conversion from negative to positive indicates a new infection with TB • A person with a positive PPD should be clinically evaluated for active tuberculosis • A person with a positive PPD should be evaluated for preventive therapy if no active disease is present • If TB disease is detected, begin treatment per local policy 48

Diseases that Cause Concern Interpretation of TB Skin Test Indurations of: – 5 mm

Diseases that Cause Concern Interpretation of TB Skin Test Indurations of: – 5 mm or larger considered positive after close personal contact, abnormal CXR or in known HIV infected persons – 10 mm or larger considered positive in persons with other known risk factors (HCW) – 15 mm or larger considered positive in all other populations 49

Diseases that Cause Concern Promptly evaluate possible episodes of tuberculosis transmission in your healthcare

Diseases that Cause Concern Promptly evaluate possible episodes of tuberculosis transmission in your healthcare setting – An exposure to TB is defined as: – Potential exposure to the exhaled air of an individual with suspected or confirmed TB disease – Exposure to high hazard procedure performed on persons with suspected or confirmed TB disease 50

Diseases that Cause Concern Risk Factors for TB Disease Development – Only about 1

Diseases that Cause Concern Risk Factors for TB Disease Development – Only about 1 in 10 people infected ever suffer active disease – Reactivation of TB is likely if the host has impaired immunity, including diabetes, chronic renal failure, malnourished, high-dose corticosteroid therapy, some hematologic disorders, or HIV infection 51

Diseases that Cause Concern Treatment of Tuberculosis • Drug susceptibility testing should be performed

Diseases that Cause Concern Treatment of Tuberculosis • Drug susceptibility testing should be performed on all initial isolates from patients with TB • Until results are known, two basic principles of therapy apply: 1) Start with the four primary drugs used in the treatment of TB until sensitively and resistance are known 2) Continue treatment regimen with at least two drugs known to be effective on the isolate 52

Diseases that Cause Concern Drug Resistant Tuberculosis – Where therapy is not continuous or

Diseases that Cause Concern Drug Resistant Tuberculosis – Where therapy is not continuous or incomplete, multi-drug resistant tuberculosis can develop (MDR-TB). – MDR-TB can be treated but, treatment is with second line drugs that are less effective. – MDR-TB requires longer treatment regimens: 18 to 24 months (due to lower efficacy) 53

Diseases that Cause Concern TB Surveillance & Reporting – Skin test conversions among personnel

Diseases that Cause Concern TB Surveillance & Reporting – Skin test conversions among personnel – PPD done at time of employment and (annually) periodic re-testing thereafter – Evaluation of exposure incidents – Evaluations & management of positive PPD skin tests or symptoms of TB – Follow-up of personnel with positive PPD skin test 54

Diseases that Cause Concern Follow-up After TB Exposure – Clinically evaluate for active TB

Diseases that Cause Concern Follow-up After TB Exposure – Clinically evaluate for active TB – Negative PPD in preceding 3 months - repeat 12 weeks after exposure – Negative PPD longer than 3 months ago, repeat baseline and if this one is negative, repeat in 12 weeks – A positive PPD requires clinical evaluation and management 55

Diseases that Cause Concern Tuberculosis Prevention & Control – Unit ventilation: keep adequate ventilation

Diseases that Cause Concern Tuberculosis Prevention & Control – Unit ventilation: keep adequate ventilation in the treatment area of the transport vehicle e. g. , windows, exhaust fans, air out vehicle after run – Work practices to prevent the spread of airborne droplets – When treating and transporting HIV infected patients, IVDAs, foreign born, and other high risk groups for TB, PPE should routinely include airborne protection 56

Diseases that Cause Concern TB Prevention & Control - Continued – Face & eye

Diseases that Cause Concern TB Prevention & Control - Continued – Face & eye protection during exposure prone activities, e. g. endotracheal intubation, suctioning, positive pressure demand valve ventilation – Decontamination with E. P. A. approved hospital grade detergent disinfectant – Tuberculosis screening program – Preventive therapy or treatment – Documentation 57

Diseases that Cause Concern • Review procedures in the Prince George’s County Fire/EMS Department’s

Diseases that Cause Concern • Review procedures in the Prince George’s County Fire/EMS Department’s General Order 5 -17, Tuberculosis Exposure Control Program 58

Preventing Disease Transmission Identify tasks and other activities that may involve exposure to blood

Preventing Disease Transmission Identify tasks and other activities that may involve exposure to blood or other potentially infectious body materials 59

Preventing Disease Transmission • Patient assessment • Airway management • Assisting respirations • Bleeding

Preventing Disease Transmission • Patient assessment • Airway management • Assisting respirations • Bleeding control • Contact with body fluids • Clean-up of scene & equipment • Establishing an IV • Emergency childbirth • Other patient care activities where contact with blood or body fluids occur 60

Preventing Disease Transmission To reduce the risk of infection: • Wear gloves • Minimize

Preventing Disease Transmission To reduce the risk of infection: • Wear gloves • Minimize contact with body fluids • Wash hands or any exposed area immediately and thoroughly after you provide care or clean a spill 61

Preventing Disease Transmission • Precautions taken to prevent exposure to blood or other body

Preventing Disease Transmission • Precautions taken to prevent exposure to blood or other body fluids containing visible blood are known as Universal Precautions. – Precautions taken to prevent exposure to any other type of body fluids or substances are known as Body Substance Isolation (BSI). Since August 1987, the Centers for Disease Control and Prevention have defined Universal Precautions as: "Since medical history and examination cannot reliably identify all patients infected with HIV or other blood-borne pathogens, blood and body- fluid precautions should be consistently used for ALL patients. " 62

Preventing Disease Transmission Preventing disease transmission involves following basic precautions: • Personal hygiene: Personal

Preventing Disease Transmission Preventing disease transmission involves following basic precautions: • Personal hygiene: Personal habits or practices such as hand washing and proper grooming • Protective equipment: Protects a person from direct contact with infected material (i. e. , gloves, masks, etc. ) 63

Preventing Disease Transmission Engineering and work practice controls. Help eliminate or reduce the risk

Preventing Disease Transmission Engineering and work practice controls. Help eliminate or reduce the risk of exposure in the workplace. • Engineering controls isolate or remove the hazard (i. e. , containers for sharp items such as needles) • Work practice controls reduce the likelihood of exposure by changing the way a task is carried out (i. e. , washing hands before and after giving first aid) 64

Preventing Disease Transmission Equipment cleaning and disinfecting • Careful handling of all soiled equipment,

Preventing Disease Transmission Equipment cleaning and disinfecting • Careful handling of all soiled equipment, supplies, or other materials until properly taken care of (i. e. , placing soiled clothing in properly marked plastic bags for disposal or washing) 65

Preventing Disease Transmission The following steps shall be followed when cleaning-up a contaminated area/scene:

Preventing Disease Transmission The following steps shall be followed when cleaning-up a contaminated area/scene: • Isolation of Containments – Isolate the area where the material is located to prevent accidental contamination. • Personal Protective Equipment – Before attempting to clean the contaminated area, apply appropriate Personal Protective Equipment (may include Gloves, protective eye wear, footwear, and clothing). 66

Preventing Disease Transmission • Clean-Up Contaminated Area – If the area has been contaminated

Preventing Disease Transmission • Clean-Up Contaminated Area – If the area has been contaminated with blood or other bodily fluids, clean the area immediately. – Retrieve Bio-Hazard Clean-Up Kit. – Wipe up any excess fluids with disposable towels, you may also use the absorbent powder to solidify any excess fluids and then scoop-up the material and place it into the Red Bio-Hazard Bag. – Place contaminated towels in a Red Bio-Hazard Bag. 67

Preventing Disease Transmission Clean-Up Contaminated Area • A 1: 10 dilution of 5. 25%–

Preventing Disease Transmission Clean-Up Contaminated Area • A 1: 10 dilution of 5. 25%– 6. 15% sodium hypochlorite (i. e. , household bleach) or an EPA-registered tuberculocidal disinfectant has been recommended for decontaminating blood spills. • Let the mixture stand for at least 15 minutes. • Wipe area with disposable towels and let area air dry. • Place all exposed/contaminated materials in the Red Bio-Hazard Bag. • Contact your vendor for proper disposal of your Red Bio-Hazard Bag, it is considered Medical Waste and it must be disposed of properly. 68

Preventing Disease Transmission • Disinfect / Wash Hands – As soon as possible, wash

Preventing Disease Transmission • Disinfect / Wash Hands – As soon as possible, wash hands to reduce the risk of infection / contamination. If you are not able to disinfect / wash hands within a reasonable amount of time, you may use a commercial waterless hand cleanser. 69

Exposure Control Plans • Preventing disease transmission begins with preparation and planning. • The

Exposure Control Plans • Preventing disease transmission begins with preparation and planning. • The Exposure Control Pan creates a system to protect people from infection. • The Plan requires the employer to identify who will receive training, protective equipment and vaccination. 70

Exposure Control Plans • An Exposure Control Plan should contain the following elements: –

Exposure Control Plans • An Exposure Control Plan should contain the following elements: – Exposure determination – Schedule and method of implementing other parts of the OSHA Standard – Procedures for evaluating details of an exposure incident 71

If an Exposure Occurs • An exposure may include contact with potentially infectious blood

If an Exposure Occurs • An exposure may include contact with potentially infectious blood or other body fluids through a needle stick, broken skin, or membranes of the eyes, nose, or mouth. • If it is believed that an exposure has occurred, clean the area of contact thoroughly, write down what happened, and notify your supervisor immediately. • Necessary follow-up care should be secured. • Follow your worksite’s post-exposure policies and procedures. 72

If an Exposure Occurs • Review procedures in the Prince George’s County Fire/EMS Department’s

If an Exposure Occurs • Review procedures in the Prince George’s County Fire/EMS Department’s General Order 5 -16, Infection Control Program 73

If an Exposure Occurs General Post Exposure Evaluation & Follow-Up Guidelines: • Document route

If an Exposure Occurs General Post Exposure Evaluation & Follow-Up Guidelines: • Document route of exposure & circumstances under which the exposure occurred • Identification & documentation of source individual information 74

Prevention and Vigilance is Your Only Cure 75

Prevention and Vigilance is Your Only Cure 75

Summary • • • Laws and Safety Regulations How Infections Occur Diseases that Cause

Summary • • • Laws and Safety Regulations How Infections Occur Diseases that Cause Concern Preventing Disease Transmission If an Exposure Occurs Exposure Control Plans 76

STILL HAVE QUESTIONS? • Please refer to the Infectious Control General Order 5 -16

STILL HAVE QUESTIONS? • Please refer to the Infectious Control General Order 5 -16 (‘new’ General Order 08 -07). • If you are still not able find an answer, please contact the Emergency Operations Center at 301583 -2200 to reach the on duty Infectious Control Training Instructor. 77