PLNU ATEP Blood Borne Pathogen Training Course

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PLNU ATEP Blood Borne Pathogen Training Course
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Introduction

• Occupational Safety and Health Administration
  (OSHA)Bloodborne Pathogen (BBP) standard (29 CFR
  part 1910.1030) does the following
• Lists safeguards to protect workers against the
  health hazards related to BBPs
• How does this affect me?
• Anyone whose job requires exposure to BBPs is
  required to complete OSHA training
• As ATCs or ATSs you work in a setting where you
  will come into contact with blood and/or other
  potentially infectious materials (OPIM).

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What is a BBP?

• All of the following are disease causing agents
• Viruses
• Hepatitis, measles, mumps, chickenpox,
  meningitis, rubella, influenza, etc
• Bacteria
• Tetanus, staphylococcus, MRSA, Lyme disease,
  meningitis, anthrax, etc
• Fungi
• Athletes foot, ring worm
• Protozoa
• Malaria, dysentery

Staph infection
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What is a BBP? (cont.)

• Rickettsia
• Typhus, Rocky Mountain Spotted Fever
• Parasitic worms
• Stomach worms
• Prions
• Mad cow disease
• Yeasts
• Candidiasis

Rocky Mountain Spotted Fever
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Common Bloodborne Diseases

• Many diseases can be spread by coming into
  contact with another persons body fluids, but
  the three diseases of primary concern for this
  training are
• Methicillin-resistant Staphylococcus aureus
  (MRSA)
• Hepatitis B (HBV)
• Hepatitis C (HCV)
• Human immunodeficiency virus (HIV)

HIV
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MRSA

• MRSA is a type of bacteria that is resistant to
  most of the common forms of antibiotics
• Most MRSA infections occur in immunosuppressed
  hospital or nursing home patients
• MRSA infections that we may see as athletic
  trainers are called Community Acquired MRSA
  infections
• MRSA infections can be life threatening if not
  treated promptly
• MRSA can spread rapidly between teammates,
  healthcare workers, or anyone in contact with the
  infected person

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MRSA

• Signs and Symptoms
• CA-MRSA most often presents as skin or soft
  tissue infection such as a boil or abscess
• Patients frequently recall a spider bite. The
  involved site is red, swollen, and painful and
  may have pus or other drainage
• Staph infections also can cause more serious
  infections, such as blood stream infections or
  pneumonia, leading to symptoms of shortness of
  breath, fever, and chills
• Treatment
• Staph skin infections may be treated by incision
  and drainage
• Antibiotic treatment if indicated
• Some skin infections require hospitalization with
  isolation

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Human Immunodeficiency Virus (HIV)

• HIV is the virus that leads to AIDS
• HIV depletes the immune system by attacking the
  T-cells
• Someone may have HIV for 12 years before symptoms
  surface (Nature Reviews Immunology 2003)
• No vaccine exists
• HIV does not survive well outside the body
• No threat on contracting HIV through casual
  contact
• Did you know?
• Antiretroviral medication now exists that can
  eradicate HIV from your system if action is taken
  within 72 hours of an exposure (VL Brashers 2005)

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Hepatitis B (HBV)

• 11.25 million Americans are chronically infected
• Symptoms include jaundice, fatigue, abdominal
  pain, loss of appetite, intermittent nausea ,
  vomiting
• Once you get it you cant get rid of it

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HBV (cont.)

• May lead to chronic liver disease, liver cancer,
  and death
• Vaccination available since 1982
• By law vaccination must be made available at no
  cost for all at risk employees
• HBV can survive for at least one week (up to a
  month) in dried blood
• Symptoms can occur 1-9 months after exposure

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Hepatitis C (HCV)

• Hepatitis C is the most common chronic bloodborne
  infection in the United States
• Leading cause of liver transplants
• No vaccine is available
• Symptoms include jaundice, fatigue, abdominal
  pain, loss of appetite, intermittent nausea,
  vomiting
• May lead to chronic liver disease and death

A liver ravished by HCV
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How is a BBP Spread?

• All four of the following conditions must be met
• A pathogen in present
• There is enough of the pathogen to cause disease
• The pathogen passes through the correct entry
  site
• A person is susceptible to the pathogen
• Modes of transmission
• Direct Infected blood or other body fluid from
  one person enters another persons body
• Indirect a person touches an objects that
  contains the blood or body fluid of another person

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Potentially Infectious Bodily Fluids

• Skin tissue, cell cultures
• Any other bodily fluid

• Blood
• Saliva
• Vomit
• Urine
• Semen or vaginal secretions

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Transmission Potential

• Contact with another persons blood or bodily
  fluid that may contain blood
• Mucous membranes eyes, mouth, nose
• Non-intact skin
• Contaminated sharps/needles

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Your Exposure Potential

• Administering first aid
• Close contact with athletes
• Needle stick
• Janitorial or maintenance work
• Handling of any waste products
• Handling biohazard waste

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Universal Precautions

• Use of proper Personal protective equipment (PPE)
• Treat all blood and bodily fluids as if they
  are contaminated
• Proper cleanup and decontamination
• Disposal of all contaminated material in the
  proper manner

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Personal Protective Equipment (PPE)

• Anything that is used to protect a person from
  exposure
• Latex or Nitrile gloves, goggles, CPR mouth
  barriers, aprons, respirators

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PPE Rules to Remember

• Always check PPE for defects or tears before
  using
• If PPE becomes torn or defective remove and get
  new
• Remove PPE before leaving a contaminated area
• Do not reuse disposable equipment

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Decontamination

• When cleaning up surfaces use Sanizide spray
• Spray and allow it to stand for ten minutes then
  wipe up
• Dispose of all wipes in biohazard containers
• PPE should be removed and disposed of in
  biohazard containers

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Hand Washing

• Wash hands immediately after removing PPE
• Use a soft antibacterial soap
• A hand sanitizer can be used but wash with soap
  and water as soon as possible.

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Other ways to control risk

• Engineering controls
• Sharps disposal containers
• Self-sheathing needles
• Biohazard bags and labels
• PPE

• Work practice controls
• Place sharp items in sharps container at point of
  use
• Disinfecting equipment ASAP
• Wash hands thoroughly
• Do not re-sheath needles

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Regulated Medical Waste

• Liquid or semi-liquid blood or other potentially
  infectious material(OPIM)
• Contaminated items that would release blood or
  OPIM when compressed
• Contaminated sharps
• Pathological and microbiological waste
  containing blood or OPIM

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Signs Labels

• Labels must include the universal biohazard
  symbol, and the term Biohazard must be attached
  to
• containers of regulated biohazard waste
• refrigerators or freezers containing blood or
  OPIM
• containers used to store, transport, or ship
  blood or OPIM

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Exposure Incident

• A specific incident of contact with potentially
  infectious bodily fluid
• If there are no infiltrations of mucous membranes
  or open skin surfaces, it is not considered an
  occupational exposure
• Report all accidents involving blood or bodily
  fluids to the director of the athletic training
  clinic
• Post-exposure medical evaluations are offered by
  the school

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What to do if an exposure occurs

• Wash needlestick injuries, cuts, and exposed skin
  with soap and water
• Flush splashes of blood of OPIM to the nose and
  mouth with water
• Irrigate eyes with clean water, saline, or
  sterile irrigants
• Follow the procedures in the athletic training
  clinic exposure control plan (see the policies
  and procedures manual).

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Post-exposure Evaluation

• Confidential medical evaluation
• Document route of exposure
• Identify source individual
• Test source individuals blood (with individuals
  consent)
• Provide results to exposed employee

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Hepatitis B Vaccination

• Strongly endorsed by medical communities
• No evidence of harmful effects
• Offered to all potentially exposed employees
• Provided at no cost to employees

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Recordkeeping

• Medical records include
• Hepatitis B vaccination status
• Post-exposure evaluation and follow-up results
• Training records include
• Training dates
• Contents of the training
• Signature of trainer and trainee

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Conclusion

• After completing this training you know more
  about
• How exposures occur
• What causes disease
• How to control the spread of BBPs
• What to do if an exposure occurs
• By following the simple guidelines outlined in
  this training you will reduce your risk of BBP
  exposure and disease transmission
• In order to complete the training please log onto
  your eclass page for the clinical class you are
  currently in and complete the quiz