Bloodborne Pathogens and Communicable Diseases · PDF file 4 Definitions (From OSHA) •...

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Transcript of Bloodborne Pathogens and Communicable Diseases · PDF file 4 Definitions (From OSHA) •...

  • Bloodborne Pathogens and

    Communicable Diseases


  • 2





  • 3

    Training Objectives

    • Educate CMT employees in bloodborne

    pathogens seen by EMS workers in the field

    • Discuss methods of protecting CMT employees

    from bloodborne pathogens

    • Provide information to allow the CMT employee

    to make an educated decision about the HBV


    • Discuss the OSHA standard on bloodborne


    • Discuss CMT’s methods of compliance with the

    OSHA Standard

  • 4

    Definitions (From OSHA)

    • Bloodborne Pathogen- microorganisms that are

    present in human blood and can cause disease in


    • Exposure Incident- specific eye, mouth, mucous

    membrane, non-intact skin or parenteral contact

    with blood or OPIM that results from the

    performance of a member’s duties

    • Parenteral- piercing mucous membranes or the

    skin barrier through such events as needle sticks,

    human bites, cuts, and abrasions

  • 5

    Definitions (Continued)

    • Personal Protective Equipment (PPE)- specialized

    clothing or equipment worn by a member for protection

    against a hazard. General work clothes (uniforms,

    jumpsuits, etc.) not intended to function as protection

    against a hazard are not PPE.

    • Universal Precautions- an approach to infection control

    where all human blood and certain human body fluids are

    treated as if known to be infectious

    • Body Substance Isolation (BSI)- a form of infection

    control based on the presumption that all body fluids are

    infectious. BSI calls for always using appropriate barriers to

    infection at an emergency scene, such as gloves, goggles,

    face shields, gowns, and protective eyewear.

  • 6

    Definitions (Con’t)

    • Exposure Control Plan (ECP)- agency’s plan to

    eliminate or minimize exposure

    • Other Potentially Infectious Material (OPIM)-

    • the following human body fluids: semen, vaginal

    secretions, CSF, synovial fluid, pleural, pericardial,

    peritoneal, amniotic, saliva (dental procedures), any

    bodily fluids contaminated with blood, any fluid that

    cannot be differentiated between fluid types.

    • Any unfixed tissue or organ from a human (living or


  • 7

    Definitions (Final)

    • Contaminated Laundry- laundry which has been

    soiled with blood or OPIM or may contain sharps

    • Contaminated Sharps- any contaminated object

    that can penetrate the skin including needles,

    scalpels, broken glass, broken capillary tubes, and

    exposed ends of dental wire

  • 8

    OSHA Standard

    • Exposure Control Plan – Identifies job/procedures with identified risks

    – Schedule for implementing provisions

    • All provisions have been implemented

    – Procedure for investigation and follow-up

    – Plan is accessible to all employees

    – Annual review by EHSO

  • 9

    OSHA Standard (Con’t)

    • Initial training upon employment

    • Annual re-training required

    • Training in: – OSHA Standard

    – Bloodborne Diseases and Transmission

    – Exposure Control Plan

    – Work Practices and PPE use

    – HBV Vaccine

    – Exposure recording and follow-up

  • 10

    OSHA Standard (Con’t)

    • Methods of compliance

    – Universal Precautions

    – Engineering and work practice controls

    – Hand washing

    – PPE/BSI

    – Written cleaning schedule

    – Sharps and regulated waste disposal

  • 11

    OSHA Standard (Con’t)

    • Record keeping

    – OSHA mandates

    • Types of records to be kept

    • Duration of storage

    • Disposal of records

    • Hazard Communication

    – Warning labels required (BioHazard) or

    – Red Bio hazard bags instead of labels

  • 12

    Bloodborne Pathogen Standard

    • Effective March 6th, 1992

    • Purpose – Limit the occupational exposure to blood and other

    potentially infectious material (OPIM)

    • Scope – Covers all members who could be “reasonably

    anticipated” as a result of performing their duties to face

    contact with blood and OPIM

    – Everyone who works for CMT or rides as an observer or

    student are “reasonably anticipated” to contact blood

    and OPIM.

  • 13

    BBP Standard (Con’t)

    • Mandates of the standard – Exposure Control Plan (ECP) prevention


    – Work place engineering to prevent exposure

    – HBV vaccine provided by CMT

    – Medical evaluation/follow up

    – Training of employees

    – Record keeping

  • 14

    PPE and BSI

    • Use as little or as much as you feel the

    situation dictates

    • During all patient care EXAMINATION


    • CMT provides all PPE. You do not pay

    for any of it. CMT replaces it when it

    becomes worn or soiled

  • 15

    PPE/BSI (Con’t)

    • CMT provides the following

    – Non-sterile, non-latex exam gloves in

    four sizes

    – Pre-packaged PPE kits containing

    • Golves

    • Mask

    – Hand sanitizer on all ambulances

    – Soap at the bases

  • 16

    A word on hand-sanitizer

    before we continue...

    - For immediate, short term use

    - Not suitable as a substitute for hand washing

    -You still need to wash your hands thoroughly as

    soon as possible

  • 17

    Sharps Disposal


    • CMT uses several types of sharps for

    BLS and ALS purposes – IV Angiocaths

    – Glucose testing lancets

    – Epi-Pens

    • CMT provides sharps containers on

    all ambulances… Use them! – $70,000.00 per improperly disposed sharp

  • 18

    Two Major Definitions

    • Infectious

    – An illness that is caused by the body's

    rejection of a virus, fungi, or parasite

    • Communicable

    – Able to spread from one person to another

    A disease can be infectious and

    not communicable at the same time

  • 19

    Infectious Material

    • Primary Risks

    – Blood

    – Semen

    – Vaginal Secretions

    • Secondary Risks

    – Synovial (joint)


    – Cardiac fluid

    (other than blood))

    – Abdominal and

    stomach fluid

    – Pulmonary fluids

    – Spinal fluid

    – Amniotic fluid

  • 20

    Other Potentially Infectious

    Material (OPIM)

    • Tears

    • Sweat

    • Saliva

    • Urine

    • Stool

    • Vomit

    • Nasal secretions

    • Sputum

  • 21

    Modes of Transmission

    • Direct contact – straight from person to person, exchange of blood or body fluids

    ex: blood splash into the eyes

    • Indirect contact – person to object; infection can spread by touching surfaces that have been contaminated with the bacteria or virus

    ex: Loading stretcher into ambulance and not removing contaminated gloves before touching steering wheel of ambulance

    touching a contaminated needle

  • 22

    Direct Contact

    • Bloodborne

    • Airborne

    • Occult

    – Occult means “hidden”

    – “Occult blood” is blood hidden inside

    some other material

    • Idiopathic

    – Fancy medical word meaning “We

    don’t have a clue!”

  • 23

    Indirect Transmission

    • Vehicle-borne

    – The transfer of an infectious agent to a

    host via contaminated items such as

    water, food, milk, or biological

    products, such as blood, tissues, and


    • Vector-borne

    – The transfer of infectious

    microorganisms from an infected host

    via an insect or arthropod.

  • 24

    Methods to Reduce Exposure

    • Engineering Controls

    – Devices that may be used to eliminate,

    minimize, or reduce occupational

    exposure to bloodborne pathogens.

    • Work Practice Controls

    – Practices and procedures that reduce or

    eliminate the chance of occupational

    exposure to bloodborne pathogens.

  • 25


    • Engineering Controls

    – Sharps containers

    – Self capping needles

    – PPE

    • Work Practice Controls

    – Decontaminating work area

    – Frequent hand washing

    – Consis