Bloodborne Pathogens

Avoiding Infectious Diseases

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Training Topics 1
Where to find compliance documents Signs & symptoms of diseases How diseases are spread
Blood to blood Blood/opim to mucous membranes All patient care CPR BVM/Combitube use Active bleeding/bleeding control See SOP ADM01-infection control Draft Medical Waste SOP Workplace controls:
Universal precautions-Assume all patients to be contagious
mask//gown/goggles Gloves Biohazard bags

Recognizing tasks with exposure risk

Our specific Exposure Control Plan

How our agency has limited exposures

How workers must limit their exposures

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Training Topics 2
Hepatitis B vaccinations Personal Protective Equipment (PPE)
Chose the right PPE for the situation

How to report an exposure

Notify your immediate supervisor ASAP

Post-exposure medical evaluations

FF will be sent to same hospital as source patient.

Cleaning and disinfecting

1:100-1:10 bleach solution

Signs, labels, color-coding An opportunity to ask questions

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Dont Get it On You Dont Get it In You!

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Occupational Exposure to Bloodborne Pathogens

29 CFR 1910.1030

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Relative Risk for Contracting Bloodborne Disease

unprotected sexual contact contaminated puncture human bite mucous membranes non-intact skin

no contact
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Regulated Body Fluids:

Blood and Other Potentially Infectious Materials Human blood, blood components, and products made from human blood Semen, vaginal secretions Cerebrospinal fluid Amniotic fluid Other internal fluids
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Regulated Body Fluids:

Blood and Other Potentially Infectious Materials Saliva in dental procedures Any body fluid visibly contaminated with blood Any body fluid which is not identified Unfixed human tissues or organs
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Regulated Body Fluids:

Blood and Other Potentially Infectious Materials
HIV-containing cell or tissue cultures, organ cultures HIV or HBV-containing culture media or solutions Blood, organs or tissues from experimental animals infected with HIV or HBV
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Hepatitis
Viruses attack the liver A, B, C, D, E, B is most serious C also highly infectious Transmitted through blood, body fluids, sexual contact
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Hepatitis Signs & Symptoms

abdominal discomfort muscle/joint aches weakness, fever, nausea loss of appetite yellowish skin tone lighter stool, darker urine
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Hepatitis B
survives 7-10 days outside the body in dried state found mainly in blood, semen, vaginal secretions incubation 6 weeks to 6 months, average 2-3 months 30% have no symptoms
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Hepatitis B: Annual Estimates

1980s: 450,000 new HBV infections each year Now about 80,000/year ~ 1% of all infected persons die from acute hepatitis B ~ 1,000,000 hepatitis B carriers in U.S.

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Hepatitis B Cases in Connecticut 1980-1999

Cases

600 500 400 300 200 100 0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5,026 total cases

1980
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1995

2000

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Hepatitis C (HCV)
transmitted mainly through contaminated punctures, human bites, transfusions 40-60% of acute viral hepatitis cases in U.S. incubation 2-26 weeks, average 6-7 weeks 80% have no signs or symptoms
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HCV Annual Estimates

3.9 million infected Americans 2.7 million are chronic, most are age 30-39 75-85% develop chronic HCV infection 1980s: 240,000 new infections per year Now ~ 40,000/year
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HIV/AIDS
Human Immunodeficiency Virus

Acquired Immune Deficiency Syndrome

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Signs & Symptoms of AIDS

Night sweats Swollen glands Weight loss Fatigue Purple spots on skin Persistent infections

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Progression of AIDS
End stage

Diagnosis
Symptoms

HIV Positive
Exposure

Pre-exposure
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Cumulative U.S. AIDS Cases as of 2/83 N~1,000

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cases

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Cumulative U.S. AIDS Cases as of 9/97 N~626,334

Each point = 30 cases

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Avoid Bloodborne Diseases

Standard Precautions Recognize risks Avoid spraying, splashing, spattering
Especially with CPR and other airway procedures

Dont recap needles Dont touch if you dont have to!

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Universal Precautions Apply to

Blood and all other body fluids, secretions, and excretions except sweat nonintact skin mucous membranes

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Latex Allergy
local redness, itching runny nose, watery eyes, sneezing or hayfever symptoms difficulty breathing anaphylactic reaction cross allergies to foods
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Barriers to Infections
Administrative Controls Engineering Controls:
Gloves, masks, goggles, etc. Biohazard storage bags and containers

Work Practice Controls

Hand washing Antimicrobial gel/wipes after Pt. contact

Personal Protective Equipment (barriers) Vaccinations

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Hepatitis B Vaccinations
free of charge 3 shots over 6 months 85-97% are protected sign waiver if you refuse; change your mind any time titer testing to verify seroconversion
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Cleaning & Disinfection

Wear PPE Wipe up, clean surface thoroughly Disinfect (10 min., room temp)
bleach & water, 1:100 1:10 commercial disinfectants NOT ON KEVLAR

Rinse, air dry Wash your hands!

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Sharps container

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Post-Exposure: Reporting
First Aid first, then notify supervisor Non-significant exposure
clothing, intact skin

Significant
eyes/nose/mouth contaminated puncture non-intact skin human bite
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Post-Exposure: Procedure
report to supervisor, determine significance referral to health care professional (ER) bring paperwork (report of initial exposure) medical evaluation, blood testing notification of all results written opinion to employer document on OSHA 200 log
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Confidentiality
you cannot disclose the source patients infectivity or HIV status

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Comments? Questions?

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