Iowa WingBloodborne Pathogens

andOther Diseases of Concern

Created by: Casey L. C. Schroeder, MLSCaptain, CAPHealth Services Officer

Outline

• Universal Precautions• OSHA Regulations• CAP Regulations• Disease Transmission• Prevention of Transmission• Diseases of Concern• Questions

Universal Precautions

• Infection control procedures to protect members from infectious agents

• Involve the use of protective barriers:– Gloves– Masks– Personal hygiene (hand

washing)

Universal Precautions

• Require that all human blood be considered infectious

• Require other body substances be considered infectious

• Consists of both:– Bloodborne pathogens– Body substance isolation

Universal Precautions

• Must follow UP and safe practices each time you provide care or are near crash sites

• Precautions include:– Personal Hygiene– Personal Protective Equipment– Engineering and work practices– Equipment cleaning and disinfecting

• Required by employees for whom there is “reasonable anticipation” of exposure

• Good Samaritan actions are not covered under this

• Ground Teams and CAP do not fall under this standard

OSHA Regulations

CAP Regulations

• Does not require that you directly care for victims

• If you chose, use universal precautions, safe practice, and common sense at all times

Disease Transmission

• Possible for you to infect someone and vice versa

• Pathogen:– Disease causing organisms such as:• Fungi• Parasites• Viruses• Bacteria

Disease Transmission

• Pathogen can enter the body:– Direct– Indirect– Airborne– Vector-borne

Disease Transmission

• 4 factors required for infection:– Pathogen– Appropriate entry site– Enough of the pathogen– Susceptibility to the pathogen

• Prevent any one of these, infection does not occur

Cross-Contamination

• Form of indirect exposure that poses a particular risk of disease transmission

• Everything touched is considered contaminated

• Common activities:– Pens & Pencils– Eye glasses– Scratching your nose or face– Door knobs or handles– Phones & Radios

Hand Washing

• Single best defense against disease transmission

• Visibly soiled hands use soap and water

• Do not use hand sanitizer if visibly soiled

• Vigorously wash for at least 15 seconds

• A little longer than the birthday song

• Dry hands with unused disposable towel or air blower

• Use towel to turn off faucet and open door

Hand Washing

• Use alcohol-based hand sanitizers (60% to 95%) only when not visibly soiled

• Ensure you apply the amount prescribed on the bottle

• Rub hands thoroughly until product dries

Hand Washing

PPE

• Only works if it does not permit blood or other body fluids to pass

• Should be free of holes, tears, rips, and other defects

• Immediately replace if this is the case

• Should be correct size

• Ensure it is readily available

PPE

• Glove removal– With soiled gloves, start with either hand

– Carefully pinch glove near the wrist, touching only the outside of the glove

– Slowly pull the glove off, which will turn it inside out

– With the gloved hand, ball the dirty glove into the gloved hand

PPE

• Glove removal (cont’d)– Examine cuff of the soiled glove for a clean area

– Slide an ungloved finger under the cuff, touching only the inside of the glove

– Slowly pull the soiled glove off, turning it inside out

– Dispose of soiled gloves

– WASH HANDS with soap and water immediately after

Glove Removal

Disease of Concern

• Some diseases:– HIV– HBV– HCV– HSV– Staphylococcus aureus

• Transmitted by:– Blood– Semen or Vaginal

secretions– Childbirth with an

infected mother– Breast-feeding– Body fluids– CSF

HIV

HIV

• Who can contract this virus:– Every one regardless of age, gender, sexual

orientation, or race

• US rate: >1 million people infected

• Iowa: 102 new HIV cases each year

• No external factors or symptoms

HBV

• Causes hepatitis

• Lifelong infection causing cirrhosis, liver cancer, and death

• Symptoms include:– Jaundice– Loss of appetite– Fatigue– Many others

HBV

• Transmission:– Blood or body fluids– Sharing drug needles– Needle sticks or sharp biohazard exposure– Childbirth from infected mother– Sexual intercourse

• Three shot vaccine

• 43,000 new cases in 2007 for the US

• Approximately 1.4 million people infected in the US

• Iowa: 24 new cases each year

HBV

HCV

• Causes hepatitis

• Lifelong infection causing cirrhosis, liver cancer, and death

• Symptoms include:– Jaundice– Loss of appetite– Fatigue– Dark urine– Many others

HCV

• Transmission:– Blood or body fluids– Sharing drug needles– Needle sticks or sharp biohazard exposure– Childbirth from infected mother– Sexual intercourse

HCV

• No vaccine or treatment

• 43,000 new cases in 2007 for the US

• Approximately 1.4 million people infected in the US

• Iowa: 24 new cases each year

HSV

• Causes cold sores

• Symptoms include:– Pain around mouth and lips– Blister that breaks open and leaks a clear fluid

• Transmission– Touching the sore– Touching saliva that contains the virus

• No vaccine or cure

• Treatment may reduce symptoms by 1 or 2 days

• Approximately 140 million people are infected

HSV

Staphylococcus aureus

• Many species of Staphylococcus

• Considered normal flora on the skin

• Causes:– Skin abscess– Pneumonia– Sepsis– Osteomyelitis– Many More

Staphylococcus aureus

• Transmission– Skin contact– Fomite (towels, bandages, etc)– Contaminated surfaces and items

• Risk factors:– Athletic facilities– Dormitories– Military barracks– Households

Staphylococcus aureus

• Prevention– Proper hygiene

• Treatment through antibiotics

• Estimated 89,785 infections in 2008

• Estimated 15,249 deaths in 2008

Points to Remember

• Proper Hygiene

• Always use PPE

• Infection is both ways

• Always assume blood and other body fluids are infectious

Questions?