RPI Ambulance. Annual OSHA Training

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1 RPI Ambulance Annual OSHA Training Updated 30 NOV 2012

2 Training Objectives Educate RPI Ambulance members in bloodborne pathogens seen by EMS workers in the field Discuss methods of protecting RPIA members from bloodborne pathogens Provide information to allow the RPIA member to make an educated decision about the HBV vaccination Discuss the OSHA standard on bloodborne pathogens Discuss RPIA s methods of compliance with the OSHA Standard Updated 30 NOV 2012 OSHA Presentation 2

3 Definitions from the OSHA Standard Bloodborne Pathogen- microorganism that is present in human blood and can cause disease in humans Exposure Incident- specific eye, mouth, mucous membrane, nonintact skin or parenteral contact with blood or OPIM that results from the performance of a member s duties Parenteral- piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions Personal Protective Equipment (PPE)- specialized clothing or equipment worn by a member for protection against a hazard. General work clothes (uniforms, jumpsuits, etc.) not intended to function as protection against a hazard are not PPE. Universal Precautions- an approach to infection control where all human blood and certain human body fluids are treated as if known to be infectious Updated 30 NOV 2012 OSHA Presentation 3

4 Definitions from the OSHA Standard Body Substance Isolation (BSI)- a form of infection control based on the presumption that all body fluids are infectious. BSI calls for always using appropriate barriers to infection at an emergency scene, such as gloves, goggles, face shields, gowns, and protective eyewear. Exposure Control Plan (ECP)- agency s plan to eliminate or minimize exposure Other Potentially Infectious Material (OPIM)- the following human body fluids: semen, vaginal secretions, saliva, cerebrospinal fluid (CSF), synovial fluid, pleural, pericardial, peritoneal, amniotic fluids; any bodily fluids contaminated with blood; any fluid that cannot be differentiated between fluid types. Any unfixed tissue or organ from a human (living or dead) Updated 30 NOV 2012 OSHA Presentation 4

5 Definitions from the OSHA Standard Contaminated Laundry- laundry which has been soiled with blood or OPIM or may contain sharps Contaminated Sharps- any contaminated object that can penetrate the skin including needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wire Updated 30 NOV 2012 OSHA Presentation 5

6 OSHA Standard Exposure Control Plan Identifies job or procedures with increased risk Schedule for implementing provisions All provisions have been implemented Procedure for investigation and follow up Plan accessible to all members Copies located in the Office and the First Aid Rooms (FAR) Annual review by Executive Committee Updated 30 NOV 2012 OSHA Presentation 6

7 OSHA Standard Initial training completed upon joining the agency Annual review training is required All members must be trained in OSHA Standard Bloodborne diseases and their transmission Exposure Control Plan (ECP) Work practices and PPE use HBV Vaccine Exposure recording and follow up Trainer guidelines Updated 30 NOV 2012 OSHA Presentation 7

8 OSHA Standard Methods of compliance Universal Precautions Engineering and work practice controls Hand washing is stressed PPE Written schedule for cleaning Sharps and regulated waste disposal Record keeping Mandates types of records Mandates duration of storage Regulate disposal of records Updated 30 NOV 2012 OSHA Presentation 8

9 OSHA Standard Hazard Communication Warning labels required (BIOHAZARD symbol) Red bags may be used in place of labels RPIA uses red biohazard bags to transport potentially hazardous waste and contaminated linens Updated 30 NOV 2012 OSHA Presentation 9

10 Bloodborne Pathogen Standard Purpose: Limit the occupational exposure to blood and other potentially infectious material (OPIM) Scope: Covers all members who could be reasonably anticipated as a result of performing their duties to face contact with blood and OPIM All members who ride the ambulance or work standby events are reasonably anticipated to contact blood and OPIM. Updated 30 NOV 2012 OSHA Presentation 10

11 Personal Protective Equipment Personal Protective Equipment (PPE) and Body Substance Isolation (BSI) Use as little or as much as you feel the situation dictates Examination gloves will be worn during all patient care RPIA provides all PPE. You do not pay for any of it. RPIA replaces all PPE used by members. Updated 30 NOV 2012 OSHA Presentation 11

12 Personal Protective Equipment RPIA provides all the following Non-sterile nitrile exam gloves in four sizes Pre-packaged Infection Control Kits consisting of Tyvex coveralls Pair of Gloves Hair cover Antiseptic Towelettes Mask Germicidal Soap in the office and FARs Germicidal Towelettes, if handwashing is unavailable PPE is available on the ambulance and in the FARs Updated 30 NOV 2012 OSHA Presentation 12

13 Hepatitis B Virus Hepatitis B Virus (HBV) is a virus that attacks the liver Those with HBV infection are divided into two categories. Both are equally able to infect you Carrier- non-acute patient with virus in blood Acute- virus in blood and is symptomatic HBV can survive outside of the body for quite some time HBV is not airborne You cannot catch HBV from casual contact There is a vaccine to protect you from HBV HBV is a larger risk than HIV to the healthcare provider! Updated 30 NOV 2012 OSHA Presentation 13

14 Hepatitis B Vaccination Vaccinations available to all members at risk Vaccine provided within ten (10) days of first shift RPIA provides vaccine free through the RPI Student Health Center Can be received at any time if initially declined (notify Captain in writing) Series of three (3) IM injections at day one, one month later, and then six months from day one A declination form is required if declining Updated 30 NOV 2012 OSHA Presentation 14

15 Hepatitis B Vaccination The vaccine is created through genetic engineering. No live or dead virus is injected into you. You cannot catch HBV from the vaccine Some side effects include About 1% of individuals will have a sore arm (like a tetanus shot), fatigue, and/or headache Itchiness or bump at the injection site Allergic reaction- contraindicated if you allergic to yeast Updated 30 NOV 2012 OSHA Presentation 15

16 Human Immunodeficiency Virus (HIV) HIV is the virus that causes Acquired Immunodeficiency Syndrome (AIDS) Those with HIV Infection may have no symptoms, some symptoms, or may have full AIDS symptoms HIV destroys the body s immune system, causing death by other diseases that the body would naturally fight off HIV cannot survive outside the body for a long period of time. When the virus contacts a dry environment, it loses the ability to infect you HIV is not airborne and cannot infect you through everyday contact Updated 30 NOV 2012 OSHA Presentation 16

17 Human Immunodeficiency Virus (HIV) Antibodies are formed six to twelve (6-12) weeks after infection. The AIDS test looks for these antibodies, not the virus itself You can test negative for three (3) months while being infected There is currently no cure for HIV. All HIV patients will eventually die of the disease There are a very small number of healthcare providers who have contracted HIV infection through their duties Updated 30 NOV 2012 OSHA Presentation 17

18 HBV and HIV Some similarities and differences Both HBV and HIV are found in blood, semen, and vaginal secretions HBV is also found in saliva. HIV is not HBV attacks the liver. HIV attacks the immune system There is a vaccine available for HBV but not HIV Updated 30 NOV 2012 OSHA Presentation 18

19 Risk Factors You are at risk for infection if you Have sexual intercourse with an infected person Share infected needles Are the newborn baby of an infected mother Neither of the viruses are airborne. You cannot contract either through routine contact You can contract the virus if You suffer a needle stick from an infected sharp (0.4% for HIV, 6-30% for HBV) Infected material comes in contact with your broken or non-intact skin (chapped, abraded, etc.) Infected material comes in contact with your mucous membranes of the eyes, nose, and mouth Updated 30 NOV 2012 OSHA Presentation 19

20 Risk Factors To reduce your chances of becoming infected Wear Personal Protective Equipment Avoid contact of broken skin and mucous membranes Practice Safe Sex Only condoms can prevent viral transmission Don t have sex in RPIA vehicles or property! Updated 30 NOV 2012 OSHA Presentation 20

21 General Practices All infectious materials go into a red biohazard bag. No one is to remove anything from a biohazard bag All infectious sharps go into a red sharps container. No one is to remove anything from a sharps container. Sharps containers are located on the ambulance and in the FARs Hand-washing is required after the completion of all patient care. Hand-washing is the best way to avoid infection No food, drink, smoking, application of cosmetics, or handling of contact lenses is permitted in any patient care area Suctioning by mouth is prohibited Updated 30 NOV 2012 OSHA Presentation 21

22 General Practices Disinfecting materials are provided on the Ambulance and in the FARs. These materials include LpH One Step Germicidal Disinfectant in a 1:256 solution with water (always wear double gloves when handling this cleaner) Disposable paper towels (toss into a red bag when done) Cavi-Wipe disinfecting wipes (toss into a red bag when done) Annual retraining to refresh memory on pathogens and avoidance measures Updated 30 NOV 2012 OSHA Presentation 22

23 Post Exposure Evaluation Available to all exposed members Confidential medical evaluation Incident Report filed with Captain as soon as possible after exposure May include Several office visits Re-vaccination Prophylactic bolus of Hepatitis B Immune Globulin (HBIG) Provided through RPI Student Health Center for RPI Students Provided by the hospital or physician of member s choice for non- RPI students Updated 30 NOV 2012 OSHA Presentation 23

24 Record Keeping RPIA is required by law to maintain certain records The records that we are permitted access to are Dates of HBV Injections Training records RPIA does not have access to your health records. Only you and the RPI Student Health Center (SHC) have access. The following items are kept in the records Name Medical tests SSN Follow-up procedures HBV Vaccine: Date and Status Health Care Provider opinions Exam results Information given to HCP Updated 30 NOV 2012 OSHA Presentation 24

25 Conclusion IN SUMMARY: IF IT S WET, STICKY AND NOT YOURS DON T TOUCH IT. IF YOU MUST, WEAR GLOVES. USUALLY, AN EXPOSURE IS A PREVENTABLE ACCIDENT. BE CAREFUL. THE END. THANK YOU FOR YOUR ATTENTION! Updated 30 NOV 2012 OSHA Presentation 25

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