Region 2 Medical Reserve CorpsRegion 2 Medical Reserve Corps

BloodborneBloodbornePathogenPathogenTrainingTraining

Bloodborne Bloodborne PathogensPathogens

Viruses, bacteria and other microorganisms Viruses, bacteria and other microorganisms found in blood that can cause diseasefound in blood that can cause disease

HIVHIV

Hepatitis B

Hepatitis BHepatitis C

Hepatitis C

Modes of TransmissionModes of Transmission

BloodborneBloodborne pathogens (BBP)such as HBV, HCV and HIV pathogens (BBP)such as HBV, HCV and HIV can be transmitted through contact with infected human can be transmitted through contact with infected human blood and other potentially infectious materials (OPIM) blood and other potentially infectious materials (OPIM) such as:such as:

•• SemenSemen•• Vaginal secretionsVaginal secretions•• Cerebrospinal fluidCerebrospinal fluid•• SynovialSynovial fluidfluid•• Pleural fluidPleural fluid•• Amniotic fluidAmniotic fluid•• Saliva (in dental procedures), andSaliva (in dental procedures), and•• All body fluids that are of undetermined nature or where blood iAll body fluids that are of undetermined nature or where blood is s

present.present.

Transmission (Transmission (con’tcon’t))

•• Transmission ofTransmission of bloodbornebloodborne pathogens can occur through pathogens can occur through the following routes:the following routes:

•• ParenteralParenteral exposure exposure -- the pathogen is introduced directly the pathogen is introduced directly into the body through a break in the skin (existing cuts, into the body through a break in the skin (existing cuts, sores, abrasions, dermatitis, sunburn or blisters), bysores, abrasions, dermatitis, sunburn or blisters), byneedlestickneedlestick, or through a cut with a contaminated object. , or through a cut with a contaminated object.

•• Mucous membrane exposure Mucous membrane exposure -- exposure through a mucous exposure through a mucous membrane in the eye, nose or mouth from a splash or spray membrane in the eye, nose or mouth from a splash or spray of contaminated material.of contaminated material.

HBV, HCV & HIV are most commonly HBV, HCV & HIV are most commonly transmitted throughtransmitted through

•• Sexual contactSexual contact•• Sharing of needlesSharing of needles•• Accidental puncture from contaminated Accidental puncture from contaminated

needles,broken glass or other sharpsneedles,broken glass or other sharps•• Contact between broken or damaged skin or Contact between broken or damaged skin or

mucous membranes and infected body mucous membranes and infected body fluids.fluids.

Hepatitis: Hepatitis: Inflammation of the LiverInflammation of the Liver

VirusesViruses

DrugsDrugs

ChemicalsChemicals

Medications

Medications

AlcoholAlcohol

Hepatitis TypesHepatitis Types

BLOODBORNEBLOODBORNE FECAL FECAL -- ORALORAL•• Hepatitis B (HBV)Hepatitis B (HBV)•• Hepatitis C (HCV)Hepatitis C (HCV)•• Hepatitis D (HDV)Hepatitis D (HDV)

•• Hepatitis A (HAV)Hepatitis A (HAV)•• Hepatitis E (HEV)Hepatitis E (HEV)

•• B, C, & D are consonants B, C, & D are consonants --BloodborneBloodborne

•• A & E are vowels A & E are vowels ––fecalfecal--oraloral•• “Bowels and Vowels”“Bowels and Vowels”

HepatitisHepatitis –– Symptoms of B & CSymptoms of B & C

•• FatigueFatigue•• Loss of appetiteLoss of appetite•• FeverFever•• Dark colored urineDark colored urine•• Yellowing of skin and eyes Yellowing of skin and eyes

(jaundice)(jaundice)

•• Nausea / vomitingNausea / vomiting•• Abdominal painAbdominal pain•• Joint and muscle painJoint and muscle pain•• Light colored stoolsLight colored stools

Many people have no recognizable symptomsMany people have no recognizable symptoms

Can be Acute or ChronicCan be Acute or Chronic

Hepatitis BHepatitis B VaccineVaccine

EffectivenessEffectiveness Vaccine is 80% Vaccine is 80% -- 100% effective in 100% effective in preventing infection in those who receive preventing infection in those who receive the complete seriesthe complete series

SafetySafety Made from yeast; cannot transmit HBV or Made from yeast; cannot transmit HBV or HIVHIV

Vaccine SeriesVaccine Series Three doses (0,1, and 6 months)Three doses (0,1, and 6 months)

Booster DosesBooster Doses Not routinely recommendedNot routinely recommended

Highly recommended for MRCHighly recommended for MRC(No vaccine for HCV)(No vaccine for HCV)

Human Immunodeficiency Virus Human Immunodeficiency Virus (HIV)(HIV)

•• HIV HIV –– The virus that causes AIDSThe virus that causes AIDS•• HIV is found in:HIV is found in:

BloodBloodSemenSemenVaginal fluidsVaginal fluidsBreast milkBreast milk

Initial infection can be followed by an acute Initial infection can be followed by an acute fluflu--like illness, with symptoms such as:like illness, with symptoms such as:

•• FeverFever•• LymphadenopathyLymphadenopathy•• SweatsSweats•• Muscle achesMuscle aches•• RashRash

Human Immunodeficiency Virus Human Immunodeficiency Virus (HIV)(HIV)

You cannot catch HIV by:You cannot catch HIV by:•• Hugging an infected personHugging an infected person•• Sharing food or drinksSharing food or drinks•• Mosquito bitesMosquito bites•• Coughing or sneezingCoughing or sneezing

HIV is NOT transmitted by:HIV is NOT transmitted by:

•• Casual contactCasual contact•• Toilet seatsToilet seats•• Airborne particlesAirborne particles•• Contaminated food/beveragesContaminated food/beverages•• MosquitoesMosquitoes

Acquired Immunodeficiency Acquired Immunodeficiency Syndrome Syndrome -- AIDSAIDS

•• The disease that develops in the late stages of HIV The disease that develops in the late stages of HIV infection.infection.

•• The virus DESTROYS THE IMMUNE SYSTEMThe virus DESTROYS THE IMMUNE SYSTEM

Engineering ControlsEngineering ControlsSafer Medical DevicesSafer Medical Devices

•• HandwashingHandwashing facilities in patientfacilities in patient--care areas.care areas.•• Sharps disposal containers (closeable, puncture Sharps disposal containers (closeable, puncture

resistant, colorresistant, color--coded or labeled with biohazard warning coded or labeled with biohazard warning label and leaklabel and leak--proof on the sides and bottom).proof on the sides and bottom).

•• Safer needle/medical devices.Safer needle/medical devices.•• Specimen storage and transport containers.Specimen storage and transport containers.•• Resuscitator devices (masks, mouthpieces, etc.)Resuscitator devices (masks, mouthpieces, etc.)•• Red bags for biological waste.Red bags for biological waste.

Work Practice ControlsWork Practice ControlsAltering the Manner in Which a Task is PreformedAltering the Manner in Which a Task is Preformed

•• Standard PrecautionsStandard Precautions –– Are inclusive of all body Are inclusive of all body fluids and substances and recognizes that they are fluids and substances and recognizes that they are capable of transmitting an infection, whether or not a capable of transmitting an infection, whether or not a causative agent has been identified. This method causative agent has been identified. This method defines all body fluids as infectious.defines all body fluids as infectious.

•• Universal PrecautionsUniversal Precautions –– is an infection control is an infection control system that considers blood and other potentially system that considers blood and other potentially infectious material from all persons as containing ainfectious material from all persons as containing abloodbornebloodborne disease, whether or not the person has disease, whether or not the person has been identified as having abeen identified as having a bloodbornebloodborne disease.disease.

Handwashing Handwashing

Wash hands with soap and water:Wash hands with soap and water:

•• Before and after contact with each patient.Before and after contact with each patient.•• After removal of gloves or other protective clothing.After removal of gloves or other protective clothing.•• Before eating or drinking.Before eating or drinking.•• After contact with blood or other potentially infectious After contact with blood or other potentially infectious

materials.materials.•• WhenWhen handwashinghandwashing facilities are not available, use facilities are not available, use

antisepticantiseptic towelettestowelettes or antiseptic hand cleansers along with or antiseptic hand cleansers along with clean paper towels.clean paper towels.

Sharps Sharps –– Handling and DisposalHandling and Disposal

•• Do notDo not recap, cut or bend needles.recap, cut or bend needles.•• Contaminated sharps should be discarded Contaminated sharps should be discarded

immediately or as soon as feasible into labeled immediately or as soon as feasible into labeled sharps containers.sharps containers.

•• Do NotDo Not overfill sharps containers; never exceed the overfill sharps containers; never exceed the manufacturers “fill to” line located on the sharps manufacturers “fill to” line located on the sharps container.container.

•• Reusable containers shall not be opened, emptied, Reusable containers shall not be opened, emptied, or cleaned in any manner that would expose an or cleaned in any manner that would expose an employee to the risk ofemployee to the risk of percutaneouspercutaneous injury.injury.

How To Protect YourselfHow To Protect YourselfInfectious Waste DisposalInfectious Waste Disposal

•• Universal Symbol for Biohazard MaterialUniversal Symbol for Biohazard Material•• Affixed to containers Affixed to containers •• Used to STORE, SHIP, OR TRANSPORT, Used to STORE, SHIP, OR TRANSPORT,

blood or OPIM blood or OPIM

Personal Protective Equipment Personal Protective Equipment (PPE)(PPE)

•• GlovesGloves•• Goggles, surgical mask, face Goggles, surgical mask, face

shield, eye protection and/or shield, eye protection and/or gowngown

•• To protect yourself, it is To protect yourself, it is essential to have a barrier essential to have a barrier between you and the potentially between you and the potentially infectious material.infectious material.

HousekeepingHousekeeping

Decontamination will be accomplished by using:Decontamination will be accomplished by using:•• 10% solution of chlorine bleach, or 10% solution of chlorine bleach, or •• EPAEPA--registered disinfectant.registered disinfectant.

When cleaning up a spill of blood:When cleaning up a spill of blood:Cover the spill with paper towels then, pour a 10% bleach Cover the spill with paper towels then, pour a 10% bleach solution or EPAsolution or EPA--registered disinfectant over the towels, and registered disinfectant over the towels, and leave it for at least 10 minutes. This will help ensure that anleave it for at least 10 minutes. This will help ensure that anyybloodbornebloodborne pathogens are killed before the material is cleaned pathogens are killed before the material is cleaned or wiped up. Wear gloves during cleanup; wash hands or wiped up. Wear gloves during cleanup; wash hands afterwards.afterwards.

PostPost--Exposure EvaluationExposure Evaluation& Follow& Follow--UpUp

•• All exposure incidents shall be reported, All exposure incidents shall be reported, investigated, and documented.investigated, and documented.

•• Provide first aidProvide first aid•• Be referred immediately to the local Be referred immediately to the local

medical facility equipped to handle medical facility equipped to handle exposuresexposures

The PostThe Post--Exposure FollowExposure Follow--UpUp

The followThe follow--up includes:up includes:•• Documentation of the route(s) of exposure;Documentation of the route(s) of exposure;•• A description of the circumstances under which the exposure A description of the circumstances under which the exposure

occurred;occurred;•• Identification and documentation of the source individual if posIdentification and documentation of the source individual if possible;sible;•• Collect and test the Collect and test the sourcesource individual’s blood if possible for HBV, individual’s blood if possible for HBV,

HCV, and HIV as soon as consent is obtainedHCV, and HIV as soon as consent is obtained•• Collect and test the Collect and test the volunteer’svolunteer’s bloodblood•• Administer postAdminister post--exposure prophylaxis, when medically indicated, as exposure prophylaxis, when medically indicated, as

recommended by the U.S. Public Health Servicerecommended by the U.S. Public Health Service•• Provide counseling and evaluation for any reported illness.Provide counseling and evaluation for any reported illness.

The EndThe End