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2. Chapter 11 Infection Control

3. Primary survey

4. overview • Bloodborne pathogens are transmitted through contact with blood or other bodily fluids. • Hepatitis B and the Human Immunodeficiency Virus are of serious concern.

5. overview • A heath care facility must be maintained as clean and sterile to prevent the spread of disease and infection. • Precautions must be made to minimize the risk of transmission.

6. bloodborne pathogens • Pathogenic microorganisms that can potentially cause disease • Transmitted by human blood, semen, vaginal secretions, CSF, & synovial fluid

7. bloodborne pathogens • Three main concerns: • HBV, HCV, and HIV • Additional viruses • HAV, HDV, HEV • Make host cells ill by reducing cellular activity • Redirect cell activity to create more viruses

8. Hepatitis b virus • Signs and Symptoms • Swelling, soreness, & loss of normal liver function • Flu-like symptoms, abdominal pain, fever, headache, jaundice • May test positive 2-6 weeks after symptoms develop • 85% recover in 6 to 8 weeks

9. Hepatitis b virus • Prevention • Good personal hygiene • Avoid high risk activities • Virus may survive 7 dayson contaminated surfaces • Management • Vaccination – required for AHC • 3 dose vaccination over 6 months

10. Hepatitis C virus • Acute and chronic liver disease • Most common chronic bloodborne infection in USA • Signs & Symptoms • ~80% do NOT have signs and symptoms • Jaundiced, abdominal pain, nausea, loss of appetite, joint/muscle pain, fatigue, dark urine

11. Hepatitis C virus • Prevention • Spread through contact w/ infected blood • Usually needles or tools with blood on them • Rarely through sexual contact • Management • No vaccine; drug management

12. Human immunodeficiency virus • Signs & Symptoms • Fatigue, weight loss, muscle/joint pain, painful or swollen glands, night sweats, fever • May not develop symptoms for up to 8-10 years • Will eventually develop AIDS

13. Human immunodeficiency virus • Management • No vaccine, but there are drugtherapies • Prevention • Safe-sex choices • Avoid body fluids & sharing needles

14. Disease transmission • Athletics involve skin-to-skin contact • Some can cause breaks in the skin • Lacerations • Abrasions • Punctures • Limited risk of on-field transmission of HIV • Est. risk in football <1:1,000,000 games

15. Disease transmission • Some sports may have higher risk • Boxing, wrestling, rugby, martial arts • Basketball, football, hockey, soccer • Non-contact sports have lowest risk

16. But… • The risk of transmitting a disease exists • Must be aware of surroundings • Know the chain of infection

17. Chain of infection pathogen

18. The Infection Cycle • Infection cycle: chain of events allowing a pathogen to infect a host: • Pathogen is present • Reservoir host • Portal of exit • Route of transmission • Portal of entry • Susceptible host

19. Breaking the chain • The spread of disease can be stopped by removing any link in the chain • Two ways to remove a link • Kill the bacteria before it enters the host • Change the environment the bacteria lives in • Moist  dry • Increase temperature

20. Help Prevent the Spread of Infection! • Wash hands frequently • Wear gloves and other protective clothing • Gowns, goggles, and masks • Exposure to blood or other body fluids exists • Working with clients who may be infectious

21. Help Prevent the Spread of Infection! • Keep your immunizations up-to-date • Especially hepatitis vaccinations

22. Breaking the Chain pathogen

23. Medical Asepsis(Clean Technique) • Practices and procedures designed to ensure a clean environment • Removing or destroying disease-causing microorganisms

24. Handwashing:The Key to Medical Asepsis • Handwashing is done at the following times: • When first arriving at work • Before performing each procedure on a client • During a procedure if hands become contaminated

25. Handwashing:The Key to Medical Asepsis • Handwashing is done at the following times: • Between each client when a procedure is performed • After using the restroom • After removing gloves from your hands • Before eating

26. Universal precautions • Use Personal Precautions • Wash hand & skin surfaces • Proper Hand Washing

27. Using Gloves • The athletic trainer: • Should always wear gloves whenever blood or body fluids are present • Even when the potential for such fluids are present, gloves must be worn

28. Universal precautions • Use Personal Precautions • Extreme care must be used with glove removal • Glove Removal

29. Contaminated Sharps • A serious risk exists when punctured by a needle or other sharp object • Dispose of all needles, scalpel blades, and other sharp objects in the proper puncture-resistant container

30. Reducing the Risk of Puncture Wounds • Never recap, bend, or manually remove a dirty needle • Always deposit the entire syringe and needle or sharp object in puncture-resistant container

31. Reducing the Risk of Puncture Wounds • Immediately clean a puncture wound with alcohol and Betadine and cover the wound • Report this to your supervisor

32. Reducing the Risk of Puncture Wounds • Never carry needles or sharp objects from one location to another with the tips pointing toward other people or yourself • Point them toward the floor

33. The Risk of Hepatitis • Handwashing is critical for reducing hepatitis spread • Often transmitted through the fecal-oral route due to not washing one’s hands after using the bathroom

34. AIDS • Incurable (at present) disease • Great care must be taken to avoid contact with this virus • Wash hands • Wear protective eyewear, gloves, and a mask to prevent exposure to splattering blood or other body fluids

35. Universal Precautions • Health care workers must be familiar with these precautions: • Wear gloves when one has contact with blood, body secretions, or broken skin • Do not reuse gloves

36. Universal Precautions • Health care workers must be familiar with these precautions: • Wear protective eyewear and a mask during any procedures that may expose you to splattering blood or other body fluids

37. Universal Precautions • Health care workers must be familiar with these precautions: • Wear disposable gowns if blood or body fluids may splatter • Thoroughly wash hands and other skin surfaces immediately following contamination

38. Universal Precautions • Health care workers must be completely familiar with these precautions: • Avoid giving direct mouth-to-mouth resuscitation • Use mouth-to-mask method, resuscitator bags, and other available equipment

39. Universal Precautions • Health care workers must be completely familiar with these precautions: • Keep an airway nearby when working in a health care environment • Avoid direct patient contact if you have open wounds or other skin conditions

40. Universal Precautions • Healthcare workers must be completely familiar with these precautions: • Wash your hands after each patient contact and after removing gloves • Carefully dispose of all sharp objects in appropriate puncture-resistant containers

41. Body Secretions for which Standard Precautions Are Used • Urine • Sputum • Fecal material • Wound drainage • Semen • Vaginal secretions

42. Body Secretions for which Standard Precautions Are Used • Tissues • Synovial fluid • Around a joint • Cerebrospinal fluid • Around brain and spinal cord

43. Body Secretions for which Standard Precautions Are Used • Pleural fluid • Lung • Peritoneal fluid • Abdominal cavity • Pericardial fluid • Around the heart • Amniotic fluid

44. Universal precautions • Protect Coaches & ATs • Policy for OSHA training • Purchase proper supplies • Protect Athletes • Use mouthpieces in high-risk sports • Shower immediately • Immunizations • Postexposure Procedures • Confidential medical evaluation

45. Take home message… • Minimize risks by not eating/drinking, applying cosmetics/lip balm, handling contact lenses, and touching face before washing hands in athletic training room