Black Mountain Fire Department Bloodborne /Airborne Pathogen Training

1. Black Mountain Fire Department Bloodborne /Airborne Pathogen Training

2. What are Bloodborne Pathogens • Bloodborne Pathogens are disease-causing micro-organisms present in blood, such as bacteria or viruses, that can cause disease in humans • May be transmitted from one individual to another through exposure to blood or other potentially infectious materials

3. You can be exposed if: • Your skin or mucous membranes come into direct contact with blood, body fluids or other potentially infectious materials • Your skin or mucous membranes come into direct contact with items or surfaces that have been contaminated • You stick yourself with a contaminated needle or bitten by affected person

4. Definitions • Exposure Incident -Occurs when an individual comes in contact with blood or other bodily fluids to which universal precautions apply, through percutaneous inoculation (needle stick), contact with an open wound, non-intact skin, and/or mucous membrane.

5. What is the Standard ? • OSHA - Occupational Safety and Health Administration, under the Department of Labor. North Carolina is an OSHA state and performs its own inspections.

6. Hepatitis • Hepatitis A (HAV) • Hepatitis B (HBV) • Hepatitis C (HCV)

7. Hepatitis A (HAV) • Hepatitis A is found in the stool (poop) of persons with hepatitis A. • Hepatitis A is spread from person to person by putting anything in the mouth that has been contaminated with the stool of a person with hepatitis A. • Casual contact as in the usual office, work, or school setting, does not spread the virus.

8. Who is Likely to Get HAV • Persons who share a household or have sexual contact with someone who has HAV • Persons who use street drugs • Children and employees in child care centers (especially centers that have children in diapers) where a child or an employee has hepatitis A. • Unsanitary practices in food services.

9. Hepatitis A Prevention • Thorough hand washing • Hepatitis A vaccines provide long term protection. • Immuno Globulin: Must be given within two weeks of exposure to HAV in order to work.

10. Spread of Hepatitis • Viral Infection • Takes 2 to 6 months before infected individual feels or looks sick • Individual my be infected and never get sick, but can infect others • Can cause lingering active hepatitis, liver damage, liver cancer and death

11. Signs/Symptoms of Hepatitis A • Flu - like symptoms • Loss of Appetite • Fever • Nausea, vomiting and diarrhea • Stomach ache • Jaundice ( yellow skin tone) • Darkened Urine

12. LONG-TERM EFFECTS • There is no chronic (long-term) infection. • Once you have had hepatitis A you cannot get it again. • About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.

13. Hepatitis B virus (HBV) • Occurs when blood or body fluid from an infected person enters the body of a person who is not infected . • Can be prevented by Vaccine. • Hepatitis B is NOT spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, coughing, sneezing or by casual contact.

14. Signs/Symptoms of Hepatitis B • Flu - like symptoms • Loss of Appetite • Fever • Nausea, vomiting and diarrhea • Stomach ache • Jaundice ( yellow skin tone) • Liver inflamation

15. Hepatitis C virus (HCV) • Occurs when blood from an infected person enters the body of a person who is not infected. • HCV is spread through sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

16. Hepatitis C virus (HCV) • 80% of persons have no signs or symptoms • Chronic infection: 55%-85% of infected persons • Chronic liver disease: 70% of chronically infected persons • Deaths from chronic liver disease: 1%-5% of infected persons may die

17. Hepatitis C virus (HCV) There is no vaccine/treatment to prevent hepatitis C.

18. HIV • Incurable Viral Infection • Can take up to 10 years before infected person feels or looks sick • Infected person who has no symptoms can infect others • HIV infection causes: AIDS, Infections and Cancers • Occurs when blood or body fluid from an infected person enters the body of a person who is not infected .

19. Symptoms of HIV • Flu-like symptoms • Constant fatigue • Fever • Sore throat, swollen lymph nodes in neck and upper arm region • Loss of appetite, weight loss • Diarrhea

20. Characteristics of HBV and HIV • Transmission CAN NOT occur through – Eating Food prepared by an infected person – Drinking Fountains – Toilet Seats – Telephones – Insect bites – Casual Contact

21. SARS- Severe acute respiratory syndrome • Severe Acute Respiratory Syndrome (SARS) is a viral respiratory illness. • In 2003, illness spread to more than two dozen countries in North America, South America, Europe, and Asia

22. SARS- Signs & Symptons • SARS begins with a high fever (temperature greater than 100.4°F [>38.0°C]). • Headache • Overall feeling of discomfort and body aches • Mild respiratory symptoms at the outset • 10 to 20 % of patients have diarrhea • Dry Cough • Most patients develop pneumonia

23. SARS- Prevention • Mask self and patient due to airborne droplets. • Avoid close contact. Examples: • Kissing or hugging • Sharing eating or drinking utensils • Talking to someone within 3 feet • Touching someone directly.

24. TB - Tuberculosis • Tuberculosis, many cases, is a lethal infectious disease. • Usually attacks the lungs. • Is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit their saliva through the air

25. TB – Tuberculosis Symptoms • Chronic cough • Fever • Night Sweats • Weight Loss

26. TB – Tuberculosis Prevention • Vaccine • Mask self and patient due to airborne droplets. • Avoid close contact. Examples: • Kissing or hugging • Sharing eating or drinking utensils • Talking to someone within 3 feet • Touching someone directly.

27. A TB skin test is the only way to find out if you have a TB infection

28. TB Skin Tests • You should get test if you are exposed to a person with active TB • Small amount of tuberculin is injected under skin in lower arm • After 2 to 3 days the result is checked • Test should be given initially after exposure and if negative then 10 weeks after exposure.

29. If you test positive, the Doctor will order another test, Chest x-rays and blood work to confirm the results and begin treatment

30. Exposure Statistics • Risk of Exposure from needle sticks or cut exposure: - HBV 6 to 30% depending on source - HCV 1.8% - HIV 0.3% • Treatment for HBV/HIV exposure should start as soon as possible, preferably 24hrs.

31. Exposure Follow Up • HBV- No follow up unless any symptoms appear • HCV- Antibody and liver enzyme levels as soon as possible after exposure and at 4-6 months after exposure. Check for virus 4-6 weeks after exposure. • HIV- Antibody as soon as possible after exposure (baseline) and periodically for at least 6 months after the exposure (6 weeks,12weeks, 6 months)

32. Airborne Pathogens Any organism that cause disease that spreads throughout the environment via the air.

33. Personal Protective Equipment • Gloves • Goggles • Masks • Face Shields • Gowns and body suits

34. How Can We Protect Ourselves • Use gloves and eye protection • Barrier Devices • Hand Sanitizer • Wash your hands

35. Personal Protective Equipment • Use anytime there is a risk of exposure • Dispose in regular trash if not soiled • Dispose in red biohazard bag if soiled • Disinfect non-disposable with approved disinfectant (Available at Fire Department)

36. Reasons why People fail to use PPE • Not necessary to use all the time • Using it causes work to be slowed down • Using it interferes with ability to do certain things • Just simply forgot to use it • Not available once got out of car or truck

37. Failure to use PPE Is a violation of the OSHA standard and the Riceville Vol. Fire Department Policy. There are NO ACCEPTABLE EXCUSES

38. Gloves • Should be appropriate size • Gloves will deteriorate with use of cleaners and disinfectants • Disposable, single use gloves should not be washed and re-used • Discoloration does not affect the integrity or function of the glove

39. Masks • Primary function is to protect mucous membranes of the mouth, nose and eyes from contamination with blood or other potentially infectious materials • Surgical Masks Filter Out and Respirators filter in.

40. Masks • If you wear a mask to cover you mouth, you must wear and eye shield or goggles • Masks should be worn when blood splashes are likely to occur • If you are using your eyeglasses as eye protection the glasses must have side shields

41. Gowns • Always use a clean gown • Gowns should fit comfortably • If blood soaks thru quickly remove and cleanse skin below it • If clothing is contaminated, DO NOT TAKE HOME TO CLEAN

42. The “Gotchas” • Never blindly reach into any containers • Never assume that any bleeding is under control • Never assume that you know what body fluids are present

43. Clean up • Contaminated items should NOT be cleaned in normal ways. • Special cleaners are used for decontamination. • Always ask for instructions if unsure of clean-up procedures.

44. Reporting Exposures • Always report suspected exposures to the incident commander and/or the Fire Chief. • Exposure Report Forms are located in the radio room filing cabinet.

45. Exam Questions come from PowerPoint info as well as Exposure Control Plan.