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Bloodborne Pathogens

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Jenni Salomon

on 8 February 2016

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Transcript of Bloodborne Pathogens

Bloodborne Pathogens
By: Jenni Salomon, NYS EMT-P

Why do we have to do this? Again?

#1. We have to. OSHA says so.
#2. So that you can know how bloodborne pathogens are spread.
So you know how to help prevent exposure
#4. So that you may know what to do in the event of an exposure.
Bloodborne Pathogens Standard 1910.1030
Federal Needle Stick
Safety and Prevention Act
Bloodborne Pathogens are found in Blood and Other Potentially Infectious Materials.
Human tissue or organs, fluids that surround the lungs, heart, brain or fetus (amniotic fluid), semen, vaginal secretions, any body fluid VISIBLY contaminated with blood, and any body fluid where it may be difficult to determine if it is contaminated with blood can all be considered "other potentially infectious material"
Specifically of concern:

Hepatitis B, Hepatitis C, and HIV.

Also worth mentioning; malaria, syphilis, babesiosis, brucellosis, tuleremia, leptospirosis, arboviruses, dengue, chikungunya, zika, relapsing fever, creutzfeldt-jakob disease and
viral hemorrhagic fever
80% of those infected show no signs or symptoms. Currently there is NO cure or effective vaccine.
Symptoms, when present, may include;
jaundice, fatigue, dark urine, abdominal pain, loss of appetite and nausea.
Hepatitis B
HBV is preventable. A safe and effective vaccine exists and you are entitled to it. For Free.
30% of those infected show NO symptoms.
If symptoms occur, they may appear within 9-21 weeks after exposure.
They may include:
jaundice, dark urine, joint pain, fatigue, loss of appetite, nausea, abdominal discomfort and clay colored bowel movements.
Hepatitis C
Vaccine administration AFTER exposure can provide up to a 75% chance of protection
Hepatitis B can survive outside of the body for 7 days and still be capable of causing infection.
HIV is the virus that causes AIDS
HIV infects cells in the body's immune system, gradually destroying the body's ability to fight off infections and certain types of cancers.
Currently there is no effective or reliable vaccine or cure.
There are vaccines and prophylactic drugs in clinical trials.
Early Signs and Symptoms of HIV include:
Swollen and tender lymph nodes
Sore Throat
Muscle Aches
There exists the risk of infection through occupational exposure to blood and OPIM
A study in 2005 concluded that the expected annual occupational infection of Hepatitis C per 100,000 employee-years for EMT/paramedics is between 5.8 and 118.9, between 3.4 and 33.7 for firefighter/EMTs and up to 3.6 for non-EMT firefighters.
Activities that can carry risk of exposure include:
Extrication of injured persons from vehicles and structures
Clean up of spills of blood and OPIM

Assisting EMS
Response to facilities or environments that work with or store infectious agents
4 conditions must be met for the spread of disease.

A pathogen must be present.

A sufficient quantity of the pathogen to cause disease must be present.

A person must be susceptible to the pathogen.

The pathogen must pass through the correct entry site (for example, eyes, mouth and other mucous membranes or skin pierced or broken by needlesticks, bites, cuts, abrasions and other means).
■ Bloodborne pathogens spread primarily through direct or indirect contact with infected blood or other body fluids.
■ Direct contact occurs when infected blood or body fluid from one person enters another person’s body at a correct entry site.
■ Indirect contact occurs when a person touches an object that contains the blood or other body fluid of an infected person and that infected blood or body fluid enters the body through a correct entry site.
■ Other pathogens can enter the body through droplet transmission, which occurs when a person inhales droplets from an infected person, such as through a cough or sneeze.
■ Vector-borne transmission occurs when an infectious source, such as an animal bite or an insect bite or sting, penetrates the body’s skin.
Bloodborne pathogens do not spread by food or water or by casual contact, such as hugging or shaking hands.
■ Hand washing is the most effective measure to prevent the spread of infection.
■ Wash hands before providing care, if possible, and always after providing care, whether gloves are worn.
■ Use alcohol-based hand sanitizers when soap and water are not available and the hands are not visibly soiled.

• Disposables protect against blood and fluids
• Normally provide no protection against sharps • Must be changed if soiled or torn
• Must be changed between handling of different people

Masks, Eyewear & Gowns

• Not necessary unless blood or other potentially infectious fluids are or could be present

• Masks & eyewear should be worn together if splashes are anticipated

• Gowns or aprons are worn to avoid soaking of clothes
The Firefighter Cancer Support Network and other organizations have offered many specific suggestions for reducing exposures relative to PPE use and care as well as specific hygiene practices.
Wear SCBA through all stages of the fire, including overhaul.
Remove as much of the bulk contamination as possible while still at the fire scene by performing gross contamination.
Wipe soot from your head, neck, jaw, throat, underarms and hands using wet wipes immediately after the fire.
Change and wash station, work and other clothing right after returning to the station or leaving the fireground.
Shower after the fire.
Ensure that all gear is properly cleaned right after the fire.
Do not transport or take contaminated clothing home or store in a vehicle.
Keep all gear out of living and sleeping areas.
In addition to these recommendations, it is important to always wear gear properly. This includes wearing the hood, deploying ear flaps, extending the collar fully and making sure that all interface areas are properly secured with sufficient overlap.
Take the following steps to clean up spills:

Wear disposable gloves and other PPE.
Take steps to protect others by roping off or placing cones around the area so others are not accidentally exposed by walking through it.
Clean up spills immediately or as soon as possible after the spill occurs.

If the spill is mixed with sharp objects,
such as broken glass and needles, do
not pick these up with your hands. Use
tongs, a broom and dustpan, or similar
Dispose of the absorbent material used to collect the spill in a labeled biohazard container.
Flood the area with a fresh disinfectant solution. Use a commonly accepted disinfectant of approximately 1 1⁄2 cups of liquid chlorine bleach to 1 gallon of water (1 part bleach to 9 parts water, or about a 10% solution) and allow it to stand for at least 10 minutes.
Use appropriate material to absorb the solution, and dispose of it in a labeled biohazard container.
Scrub soiled boots, leather shoes and other leather goods, such as belts, with soap, a brush and hot water. If you were wearing turnout gear, wash and dry it according to the manufacturer’s instructions.
Immediate steps to take following an exposure incident include:
Cleaning the contaminated area thoroughly with soap and water.
Irrigating the eyes, if exposed, with clean water, saline or sterile irrigants for 20 minutes.
Flushing splashes of blood or other potentially infectious materials near the mouth and nose with water.

Seeking immediate follow-up care according to the fire department’s exposure control plan.
Steps to take after an exposure incident include:
Immediately reporting the incident to the appropriate person identified in the fire department's exposure control plan and to the emergency medical services (EMS).
Writing down what happened, including the time, date and circumstances of the exposure, actions taken after the exposure and any other information required by your department.
If it is wet, sticky, and not yours, don't touch it.
Bloodborne pathogens are infectious
like viruses and bacteria
, in human blood that can cause disease in humans.
Viral hemorrhagic fevers refer to a group of illnesses that are caused by several distinct families of viruses.
In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome. Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage; however, the bleeding is itself rarely life-threatening.
While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease.
VHFs are caused by viruses that share a number of features:

Their survival is dependent on an animal or insect host, called the natural reservoir.
The viruses are geographically restricted to the areas where their host species live.
Humans are not the natural reservoir for any of these viruses. Humans are infected when they come into contact with infected hosts. However, with some viruses, after the accidental transmission from the host, humans can transmit the virus to one another.
Human cases or outbreaks of hemorrhagic fevers caused by these viruses occur sporadically and irregularly. The occurrence of outbreaks cannot be easily predicted.

Viruses associated with most VHFs are zoonotic. This means that these viruses naturally reside in an animal reservoir host or arthropod vector.
They are totally dependent on their hosts for replication and overall survival. For the most part, rodents and arthropods are the main reservoirs for viruses causing VHFs. However, the hosts of some viruses remain unknown --
and Marburg viruses are well-known examples.
Some viruses that cause hemorrhagic fever can spread from one person to another, once an initial person has become infected.
Ebola, Marburg, Lassa and Crimean-Congo hemorrhagic fever viruses are examples.
This type of secondary transmission of the virus can occur directly, through close contact with infected people or their body fluids.
It can also occur indirectly, through contact with objects contaminated with infected body fluids. For example, contaminated syringes and needles have played an important role in spreading infection in outbreaks of Ebola hemorrhagic fever and Lassa fever.
You can only get Ebola from
• Touching the blood or body fluids of a person who
is sick with or has died from Ebola.
• Touching contaminated objects, like needles.
• Touching infected fruit bats or primates
(apes and monkeys).
The likelihood of contracting Ebola in the United States is extremely low unless a person has direct contact with the blood or body fluids (like urine, saliva, vomit, sweat, and diarrhea) of a person infected with Ebola virus and showing symptoms. The majority of patients with fever and other non-specific signs and symptoms in the United States do not have Ebola. The transmission risk posed to those in direct contact with patients with Ebola and early symptoms is lower than the risk from a patient hospitalized with severe Ebola.
Although inpatient hospital settings generally present a higher risk of Ebola virus transmission to healthcare personnel, contact with emergency services presents unique challenges because of the uncontrolled nature of the work, the potential for resuscitation procedures being needed, enclosed space during rescue, and a varying range of patient acuity.
Mosquito borne
presents with fever, rash, joint pain, muscle aches, headaches, conjunctivitis and flu like symptoms
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