# Presentation: 182292

## Blood borne Pathogens Training for Ground Team Members & Leaders

- Developed as part of the National Emergency Services Curriculum Project

##    What are Bloodborne Pathogens?

- BBPs are disease causing microorganisms that may be present in  human blood.  They may be transmitted with any exposure to blood or other potentially infectious material.
- Two pathogens of significance are Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV)

##    What is Hepatitis B?

- One of the five viruses that causes illness directly affecting the liver
- Major cause of viral hepatitis which is preventable through immunization

## Hepatitis B Symptoms

- Weakness, Fatigue, Anorexia,  Nausea,  Abdominal pain, Fever, Headache, Possible jaundice( a yellow discoloration of the skin)
- Blood will test positive for the HBV surface antigen with 2 to 6 weeks after symptoms develop
- May show no symptoms, and therefore not be diagnosed

**Notes:**
Is anorexia really a word we want to use?  Anorexia is a condition unto itself.  Do we mean rapid weight loss and loss of appetite?

## HBV Facts	

- 200 out of 8700 health care workers contracting Hepatitis B yearly will die
- HBV is more persistent than HIV in that it is able to survive for at least a week in dried blood on environmental surfaces or contaminated instruments
- Approximately 85% of patients recover in 6 to 8 weeks

##    What is HIV?

- Human Immunodeficiency Virus is a virus that  infects immune system T4 blood cells in humans and renders them less effective in preventing disease
- It is the virus identified as being responsible for Acquired Immunodeficiency Syndrome (AIDS)

## HIV Symptoms

- Night sweats, Weight loss,Fever, Fatigue,   Gland pain or swelling, Muscle or joint pain
- May feel fine and not be aware of exposure to HIV for as much as 8 to 10 years
- Blood tests may not show positive for as long as a year, and therefore multiple tests may be required to determine if the person has been infected

##    HIV Facts

- Estimates in the US say that 1 out of 250 people are infected with HIV
- There are over 100 case reports of health care workers whose HIV infection is associated with occupational exposure
- Over 200,000 AIDS patients have been reported to the CDC, 84 of which are health care workers with no other identified reason for infection

##  Exposure Prevention for Bloodborne Pathogens

- Engineering Controls
- Work Practice Controls
- Personal Protective Equipment
- Universal Precautions

##    Engineering Controls

- Structural or mechanical devices CAP provides for its’ ES personnel
- Hand washing facilities
- Eye wash stations
- Sharps containers
- Biohazard labels

##    Work Practice Controls

- The behaviors necessary to use engineering controls effectively
- Using sharps containers
- Using an eye wash station
- Washing your hands after removal of personal protective equipment

## Work Practice Controls Continued

- Hand washing is considered to be the most effective method of preventing transmission of BBPs
- Alternatives such as hand cleaners and towelettes are acceptable alternatives for those without ready access to wash facilities, but the individual should still wash their hands with soap and warm water after contact with blood or other possible infectious material

- Procedures involving blood or other potentially infectious material will be performed in such a way as to minimize or eliminate splashing, spraying, splattering, and generation of droplets of these substances
- Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses is prohibited in work areas where exposure is likely

-    Work Practice Controls Continued

##    Personal Protective Equipment

- Equipment provided by CAP at no cost to you, which it is to your advantage to use, and should be reported to supervisors when not in working order
- Latex gloves
- Masks
- Aprons,Gowns, or Tyvek suits
- Face shields

## Personal Protective Equipment Continued

- Whenever you need to wear a face mask, you must also wear eye protection
- When wearing personal glasses, you must use side shields and plan to decontaminate your glasses and side shields according to schedule

- Personal protective Equipment is acceptable if it prevents blood or other possible infectious material from contaminating work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes.

-    Personal Protective Equipment Continued

## What is wrong with this picture?

## Use your Personal Protective Equipment!

- Answer: Rubber Gloves were not worn for the patient survey

- Your clothing may be exposed to potentially infectious materials, and must be handled appropriately if that happens
- Clearly label contaminated materials and put them into separate leak proof containers to be sent to a facility following OSHA standard
- Don't handle contaminated clothing more than absolutely necessary

-    Contaminated Clothing

- Remove it in such a way to avoid contact with the outer surface
- Rolling the garment as it is pulled toward removal will decrease chance of contact with the contaminated area
- After rolling it up, carefully pull it off to avoid contact
- If it cannot be removed without contamination, it is recommended that the item be cut off

- Contaminated Clothing Removal

##    Universal Precautions

- The concept that all blood and certain body fluids are to be treated as if contaminated with HIV, HBV, or other BBPs
- Acceptable alternative is Body Substance Isolation: The treating of all fluids and substances as infectious
- Personal protective equipment like gloves and a mask must be used whenever you might be exposed to blood or other potentially infectious materials

## Materials Requiring Universal Precautions

- Blood
- Cerebrospinal fluid
- Synovial fluid
- Pleural fluid
- Any body fluid with visible blood
- Any unidentifiable body fluid
- Saliva from dental procedures

**Notes:**
Theses are all pretty obvious examples of materials requiring universal precautions.

## Materials NOT Requiring Universal Precautions

- Feces
- Nasal secretions
- Sputum
- Sweat
- Tears
- Urine
- Vomitus
- If there is visible blood then all bets are off

**Notes:**
Though, these don’t require use of universal precautions, remember, it just makes sense.  Never mind, if you stop and think, how many of these would you honestly want to touch anyway? 

## BBP Tasks

- General Emergency Services Personnel
- O-0901: Demonstrate knowledge of BBPs
- Ground Team Members
- O-0902: Exercise Universal Precautions
- Ground Team Leaders
- O-0903: Use a BBP Protective Suit

**Notes:**
The instructor should demonstrate each task and then test students as applicable.