Transcript Bloodborne Pathogens/TB

Bloodborne Pathogens/TB
An OSHA Mandated Drill
Introduction
OSHA mandates that upon hire each
individual who works in a high-risk
environment must received bloodborne
pathogens training.
 OSHA also mandates that this topic be
reviewed annually
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Objectives
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Identify the pathogens that are transmitted via
blood
Identify modes of transmission of BBP
Identify risks of transmission in the workplace
Identify appropriate use of PPE
Identify correct procedure to follow if exposed
Identify requirements of HBV series
Understand importance of infectious waste
disposal
Identify locations at both companies for
decon and infectious waste disposal
Objectives (cont’d)
Identify those at risk for development of
TB
 Differentiate between TB Disease and TB
Infection
 Identify methods of diagnosing TB
 Understand treatment of TB
 Understand risks of rabies exposure to
emergency responders
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Bloodborne Pathogens
Hepatitis B,C,D,E,F,G
 HIV
 Viral Hemorrhagic Fevers (Ebola,
Marburg)
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Hepatitis
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Hepatitis is an infection that occurs in the liver
after exposure to the virus through blood.
Symptoms of hepatitis include: jaundice,
fever, weight loss, loss of appetite, fatigue,
dark urine, joint pain, abdominal pain,
diarrhea, nausea, and vomiting.
Incubation periods vary depending on the
type.
HBV average is 120 days (ranges from 45160 days)
HCV average is 45 days (ranges from 14180)
Hepatitis (cont’d)
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Death from chronic liver disease occurs in 1525% of chronically infected persons.
People with chronic HBV infection have a much
greater risk of developing liver failure & liver
cancer
Chronic infection with HCV occurs in 55-85% of
infected persons and 70% of chronically infected
persons go on to develop chronic liver disease
Those with chronic HCV have a much higher risk
of suffering from liver failure and liver cancer
Hepatitis Vaccine
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HBV series is a series of 3 shots over a period of
6 months
OSHA mandates that all employees in a highrisk setting must be offered the vaccine free of
charge.
If you decline the vaccine, you must sign a
waiver.
31-60 days after receiving the 3rd shot you
should have a titre drawn to check for immunity.
There is no vaccine for HCV
Transmission of Hepatitis
HBV is found in blood and certain body
fluids. It is spread through these fluids
from an infected person to a non-immune
person.
 Spread via unprotected sex, sharing
needles, exposure to needlesticks/sharps
in the workplace, and from an infected
mother to her child during birth
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HIV
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Human Immunodeficiency Virus is a retrovirus
that causes Acquired Immune Deficiency
Syndrome (AIDS).
The Immune system progressively deteriorates
leading to opportunistic infections that ultimately
leads to death.
There is no vaccine for HIV
Antiretroviral medications are used to treat HIV
and have been shown to prolong the lifespan of
those with HIV. There is no cure.
HIV (cont’d)
HIV was first discovered on December 1,
1981. Since that time the World Health
Organization (WHO) estimates that AIDS
has killed more than 25 million people.
 In 2005 AIDS claimed 2.4-3.3 million lives
of which, more than 570,000 were
children.
 It is one of the most destructive pandemics
in recorded history.
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HIV Transmission
The three major routes of transmission of
HIV are:
 Unprotected sexual intercourse
 Contaminated needles
 Infected mother to unborn child /breast
milk to nursing infant
 Screening of blood products has virtually
eliminated transmission via that route
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HIV Symptoms (Early)
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Many people do not develop symptoms when
first infected.
Some people develop flu-like symptoms within
3-6 weeks of exposure (Acute HIV Syndrome).
There may also be enlargement of lymph nodes
during this phase of illness.
This phase usually lasts a week to a month & is
often mistaken for another viral infection
HIV Symptoms (Late)
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Lack of energy, swelling or hardening of
glands
Weight loss, long bouts of diarrhea
Frequent fevers & sweats
Thrush accompanied by sore throat
Severe or recurring yeast infections
Chronic pelvic inflammatory disease
Periods of extreme & unexplained fatigue
Headaches, lightheadedness, dizziness
Bruising easily
What are the Chances?
HBV –5-30 out of 100
 HIV – 1 in 300
 HCV – 1.8 in 100
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Precautions
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Standard Precautions- combines major
features of universal precautions and body
substance isolation (BSI). Applies to all
body fluids, secretions, and excretions
regardless of whether or not they
contain visible blood.
Transmission-Based
Precautions
Airborne – TB, Chickenpox
 Droplet – Whooping cough, measles,
SARS, flu
 Contact – MRSA, VRE, C-Diff
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Personal Protective Equipment
PPE
 Gloves
 Goggles
 Masks (N95 and surgical)
 Gowns/Aprons
 Tyvek suits
 BVM
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Post Exposure Follow up
Report your exposure immediately to OIC
 Complete Incident report
 You will be sent for a confidential medical
evaluation (You have the right to refuse
testing)
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Disposal of Infectious Waste &
Decontamination Procedures
Work area to be kept clean & sanitary
 Use appropriate disinfectants and mix
according to manufacturer’s directions
 All dressings & disposables must be
bagged per infection Control policy in
red biohazard bags.
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Company One
White biohazard containers located by
EMS room.(Lids must be on at all times)
 Contaminated equipment cleaned in
decon shower at far end of bay in decon
shower.
 Contaminated gear & clothing washed in
machines under stairwell at far end of bay
 Biohazard shed kept locked at all times.
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Company Two
White biohazard containers located next to
bay storage doors.
 Medical waste transported back to
Company 1 medical waste shed
 Contaminated gear & clothing transported
to Company 1 for proper handling.
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Protecting Yourself On Scene
USE YOUR HEAD!!!
 Take an extra few seconds to
survey the scene for potential exposure
hazards & choose your PPE accordingly.
 Be efficient but don’t rush. (Fools rush in!)
 You are ultimately accountable for your
own protection.
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Tuberculosis
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Tuberculosis is spread by the
airborne route.
Primarily associated with the lungs,
but can be found in other parts of
the body such as the kidney and
the bone.
It is reportable to the CT DPH by
law.
There are specific laws that dictate
how it should be managed.
Symptoms of TB
•Feeling weak or sick
•Weight loss
•Fever
•Night Sweats
•Persistent Cough
•Chest Pain
•Coughing Up Blood
Who is at Risk?
•People who share the same breathing space as someone with TB
disease.
•Poor people
•Homeless People
•Foreign born people from countries with high incident of TB
•Nursing Home Residents
•Prisoners
•Alcoholics and IV Drug abusers
•People with diabetes, certain types of cancer, and being underweight
•People with HIV
TB Disease vs. TB Infection
TB Disease:
•Person is sick with germs that are active in the body
•Usually have one or more symptoms of TB
•Can pass disease on
•Permanent body damage and death can occur
•Medicine is prescribed that can cure TB
TB Infection:
•Person is healthy
•Strong immune system
•No Symptoms
•Cannot spread the infection
•Can develop TB disease in the future
•Medicine prescribed to prevent development of TB disease
Diagnosis of TB
•Skin Test
•Doctors Office or local Health Department
•If positive other tests will be done to see if you have infection vs. disease
•Small needle used to implant tuberculin under the skin
•Usually done inside of your forearm
•Test is read in 48 to 72 hours to check for reaction
•Size of reaction is measured
•Less than 10mm is negative
Negative vs. Positive
Negative Test:
•Usually means person is not infected
•Maybe falsely negative if person has been recently infected
•Usually takes 2 to 10 weeks after exposure for test to become positive
Positive Test:
•Usually means the person has been infected with the TB germ
•Does not necessarily mean person has TB disease
•Other testing such as X-Ray or Sputum testing will be ordered
Treatment of TB
•Compliance with medications is mandatory
•Common medications include INH and
Rifampin
•Routine follow up Chest X-Rays
•Routine follow up with Physician
Rabies
Virus spread by warm blooded mammals
(raccoons, skunks, foxes, coyotes,
woodchucks and bats.
 A Bat’s teeth & claws are so small that a
bite may not bleed or even hurt
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People sleeping in a room where a
bat is found, or children who may
have been alone in a room with a
bat, should see a doctor. If possible
the bat should be saved for testing,
but never handle it without
protective gloves.
Domestic Pets
Dogs, cats, ferrets & farm animals can act
as a bridge between wild animals and
people.
 If pets appear to have been in a fight, use
caution, and handle with gloves. Cover
pet with fluid impervious material & see
Vet.
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How Does Rabies Work?
Attacks brain cells & nerves
 Slowly & painfully kills its victim if not
treated quickly.
 Prevention vaccine available for bite
victims
 Incubation period is 4-6 weeks
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Rabies Vaccine
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Involves a total of 5 shots over several
days & 1 shot of Human Rabies Immune
Globulin (HRIG) which is given
immediately.
On Scene
Fire & EMS personnel should be wary of
stray or roaming animals
 If bitten, you must report it immediately &
seek medical attention…untreated rabies
can be & usually is fatal.
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Transmission
Transmitted through a bite, scratch, lick,
and even petting.
 The virus is in the animal’s saliva.
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Myths
All Rabid dogs froth at the mouth.
 A rabid dog will be vicious & snap at
everything
 A rabid dog will not drink water & will
exhibit fear of water
 If a suspected dog acts friendly, its not
rabid.
 The dog had his shots, it doesn’t have
rabies
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Avoiding Rabies
Avoid being bitten
 Treat any animal bite as a potential rabies
exposure.
 If bitten, immediately wash area with soap
& warm water then
wash wound with 1%
providone-iodine.
 Capture/confine the animal
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Avoiding Rabies cont’d
Suspect strays should be destroyed &
tested by health officials.
 Pets who’s owner can’t provide proof of
vaccine should be confined for 10 days.
 All animal corpses should be treated as
HIV contaminated (Use PPE when
handling)
 Notify proper authorities of any suspected
rabid animal
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Remember Who’s Number 1!
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