Skyland Fire Rescue

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Skyland Fire Rescue

• Bloodborne /Airborne Pathogen
• Training

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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

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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

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Definitions

• Exposure Incident -Occurs when an employee comes
  in contact with blood or other bodily fluids to
  which universal precautions apply, through
  percutaneous inoculation, contact with an open
  wound, non-intact skin, and/or mucous membrane

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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.

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Hepatitis

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

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Hepatitis A

• 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.

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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

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HAV Symptoms

• Children who are infected often have no
  symptoms.
  
• 3 of 4 adults who get HAV have symptoms
• A person can spread HAV about one week before
  symptoms appear and during the first week of
  symptoms.
  
• Persons with no symptoms can still spread the
  virus.

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Hepatitis A Prevention

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

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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

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Signs/Symptoms of Hepatitis

• Flu - like symptoms
• Loss of Appetite
• Fever
• Nausea, vomiting and diarrhea
• Stomach ache
• Jaundice ( yellow skin tone)
• Darkened Urine

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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.
  

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Hepatitis B virus (HBV)

• Occurs when blood 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.

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Hepatitis B

• How long does it take for a blood test, such as
  HBsAg, to be positive after exposure to hepatitis
  B virus?HBsAg will be detected in an infected
  persons blood on the average of 4 weeks (range
  1-9 weeks) after exposure to the virus. About 1
  out of 2 patients will no longer be infectious by
  7 weeks after onset of symptoms and all patients,
  who do not remain chronically infected, will be
  HBsAg-negative by 15 weeks after onset of
  symptoms

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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

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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.

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Hepatitis C virus (HCV)

• There is no vaccine/treatment to prevent
  hepatitis C.
  
• Interferon and ribavirin are two drugs licensed
  for the treatment of persons with chronic
  hepatitis C. 
  
• Interferon can be taken alone or in combination
  with ribavirin. Combination therapy, using
  pegylated interferon and ribavirin, is currently
  the treatment of choice.
• Combination therapy can get rid of the virus in
  up to 5 out of 10 persons for genotype 1 and in
  up to 8 out of 10 persons for genotype 2 and 3. 

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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

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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

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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

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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.

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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)

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Airborne Pathogens
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Personal Protective Equipment

• Gloves
• Goggles
• Masks
• Face Shields
• Gowns and body suits

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How Can We Protect Ourselves

• Use gloves and eye protection
• Barrier Devices
• Hand Sanitizer
• Wash your hands

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

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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.

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

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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)

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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

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Failure to use PPE

• Is a violation of the OSHA standard and the
  Skyland Fire Rescue Policy. There are
  
• NO ACCEPTABLE EXCUSES

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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 or
  function of the glove

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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.
  

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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

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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

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Hand washing

• Wash Hands after removing any or all protective
  equipment, you must wash your hands.
  
• You may use antiseptic towelettes and hand
  cleaners , but with soap and warm water as soon
  as possible
  
• Always wash your hands if in doubt

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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

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Exam

• Questions come from PowerPoint info as well as
  Exposure Control Plan.