Clearwater USD #264 Bloodborne Pathogen Training Information

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1 BLOODBORNE PATHOGENS DISEASES Bloodborne Pathogens are defined as pathogenic microorganisms that are present in human blood and can cause disease in humans. Bloodborne Pathogen exposure from hepatitis B virus, hepatitis C virus and/or human immunodeficiency virus (HIV) can occur as an occupational hazard. Blood is the main source of these viruses in the workplace. Because your contact with blood is infrequent, your risk of contracting one of these viruses at school is low. The following information will help you prepare to deal with any possible blood exposure safely. Hepatitis B (HBV) Facts: Hepatitis means inflammation of the liver. HBV is a virus that can cause serious liver disease. Symptoms may include: Jaundice Fatigue Abdominal pain Loss of appetite Occasional nausea or vomiting, or No symptoms at all. Most people infected with HBV do recover and clear the infection, but some become chronically infected. More than 5,000 people per year die from chronic liver disease and liver cancer that has been linked to hepatitis B. Hepatitis B virus poses the greatest risk to you at school than either hepatitis C virus or HIV, because it is more easily transmitted. Fortunately, there is a vaccine that can prevent HBV infection. Hepatitis C (HCV) Facts: HCV has symptoms similar to HBV and can also cause serious liver disease; however, the two liver diseases have important differences. According to the Centers for Disease Control and Prevention (CDC), people infected with HCV have a higher percentage (85%) of chronic liver disease than those infected with HBV (10%). About 3 million people in the United States are chronically infected with HCV versus 1 and ¼ million infected with HBV. Also, people infected by HCV that have no symptoms are about 75% compared to those infected with HBV without symptoms, 50%. Individuals who are chronically infected by hepatitis C may have no symptoms for more than 20 years, but the infection may slowly be damaging the liver. Liver transplants from chronic hepatitis C infection are the leading indicator. Up to 10,000 people die each year from hepatitis C-related chronic liver disease. No vaccine is currently available to prevent hepatitis C, but there are newly approved antiviral drugs that have shown effectiveness in some people who have contracted the infection.

2 HIV Facts: HIV is a virus that attacks the immune system, and it can cause Acquired Immune Deficiency Syndrome (AIDS). AIDS is characterized by a defect in natural immunity against disease. People who have AIDS are vulnerable to serious illness that would not be a threat to anyone whose immune system was functioning normally. These illnesses are referred to as opportunistic infections or diseases. AIDS is considered one of the most devastating public health problems in recent history. In 1996, the Centers for Disease Control and Prevention (CDC) estimated that one million persons in the United States are HIV-positive, and 223,000 are living with AIDS. Most individuals infected with HIV have no symptoms and feel well. Some develop symptoms that may include: fatigue fever loss of appetite and weight diarrhea night sweats swollen glands (lymph nodes) usually in neck, armpits, or groin. BLOODBORNE PATHOGENS TRANSMISSION All human blood and certain human body fluids are to be treated as though infected with HBV, HCV, HIV and other blood borne pathogens. Although exposure to body fluids other than blood is unlikely in a school, the following body fluids are also to be treated as being infectious: semen and vaginal secretions amniotic fluid cerebrospinal fluid all body fluids or tissue containing visible blood Body fluids not included unless containing visible blood (but may contain other diseases) nasal secretions sweat tears saliva vomit urine & feces. HIV and HBV are most commonly transmitted through: sexual contact needle sharing blood transfusions direct skin or mucous membrane contact with infected blood Unbroken skin forms a barrier against bloodborne pathogens. However, infected blood can enter your system through: open sores, cuts, abrasions, acne and any sort of damaged or broken skin such as sunburn or blisters. Bloodborne pathogens may also be transmitted through the mucous membranes of the eyes, nose and mouth. Bloodborne diseases can also be transmitted indirectly. This can happen when you touch a surface contaminated with blood or other infectious materials.

3 TO PROTECT YOURSELF: Follow your school s Exposure Control Plan which details safety guidelines to help protect yourself from exposure. These safety measures are based on The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard and CDC guidelines. These safety precautions have been shown to decrease the number of exposures on the job. UNIVERSAL PRECAUTIONS Universal precautions are a set of practices and procedures designed to prevent transmission of HIV, HBV, HCV and other bloodborne pathogens when providing first aid or health care. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious. They are the best protection against HBV, HCV, HIV and other infectious agents. Universal Precautions provide the first line of defense against the risks of exposure to bloodborne pathogens. Personal Protective Equipment (PPE) When an exposure potentially exists, even with engineering controls in place, PPE should be used. There is a large range of PPE in the use of infectious control, but the main consideration in choosing and using such equipment is to restrict blood or other potentially infectious materials from contact with skin or other mucous membranes. Disposable vinyl gloves: Used for first aide, clean up, handling of sharps, and when in contact with any blood or other potentially infectious materials. After you have put on the gloves, check for proper fit and punctures. Gloves should fit snugly. Be sure to use the proper size for your hands (small, medium, large, or extra large). Other PPE also available are heavy-duty utility gloves, CPR microshields, antiseptic wipes, convenience bags, sharps containers, and mouth to mask resuscitator shield. To remove gloves: place finger of one gloved hand on the wrist of the other gloved hand. Peel the glove from the wrist to the fingers so that the glove is inside out. Place the inside-out glove in the palm of the gloved hand. Peel the remaining glove in the same manner (from the wrist to the fingers) while enfolding the first glove into this one. Following these practices minimizes contamination. Gloves should be disposed of immediately and never re-used. Wash your hands with soap and water after disposing the gloves. Goggles: Anytime there is a risk of splashing or vaporizing of contaminated fluids, goggles and/or other eye protection should be used to protect your eyes. Bloodborne pathogens can be transmitted through the thin membranes of the eyes so it is important to protect them. Splashing could occur while cleaning up a spill, during laboratory procedures, or while providing first aid or medical assistance. Aprons: may be worn to protect your clothing and to keep blood or other contaminated fluids from soaking through to your skin.

4 Hand washing 1. Use warm water only not hot, not cold. 2. Wet both hands and wrists well before applying soap. 3. Apply liquid soap to palms first (about 1 tsp.). 4. Lather well; spread lather to back of hands and wrists. 5. Continue scrubbing, paying careful attention to fingernails and between fingers. The scrubbing time should be a minimum of 20 seconds. 6. Rinse hands and wrists well to remove all soap and detergent. 7. Dry completely. 8. Turn off faucet using disposable towels when there is no knee control. This avoids recontamination of clean hands. If hand washing facilities are not readily available, such as on an athletic field, playground or school bus, use antiseptic towelettes or a waterless hand cleaner as a temporary measure. Wash your hands with soap and water as soon as possible. Personal Hygiene Eating, drinking, applying cosmetics or lip balm and contact lens handling are prohibited in work areas where there is a reasonable likelihood of occupational exposure. Also, food and drink should not be stored in close proximity to where blood or other potentially infectious materials are present. Employees are asked to physically cover all exposed skin lesions, abrasions or cuts so as to protect themselves and others from potential bloodborne pathogens exposure. Needles Contaminated needles and other contaminated sharps shall not be bent, recapped or moved unless accomplished through the use of a mechanical device such as forceps, pliers, or broom or dust pan. Never break or shear needles. Needles shall be disposed of in labeled sharps containers only. Immediately, or as soon as possible after use, contaminated reusable sharps (scissors, knives, etc.) shall be placed in appropriate containers until properly reprocessed. These containers shall be: puncture resistant, labeled, and leak proof on both sides and bottom. Sharps Handling

5 Use disposable gloves. Mechanical devices such as tongs, dustpan or broom will be available to pick up contaminated sharps such as blood covered broken glass. This will avoid direct contact with the sharps. Contaminated glass may not be picked up by hand. All Sharps will be disposed of in approved Sharps Containers located in the Health Office of each school building. Sharps Containers will be appropriately disposed of according to Infectious Waste Procedures. When moving containers of contaminated sharps from the area of use, the containers shall be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping. Sharps containers are labeled with the biohazard symbol that is readily visible and are picked up from health offices once per year, or on an as-needed basis. Laundry Laundry contaminated with potentially infectious materials should be handled as little as possible Place soiled laundry in a labeled or color-coded leak proof bag Contaminated Surfaces Any equipment or contaminated surface must be cleaned and decontaminated as soon as possible after coming in contact with potentially infectious materials Appropriate commercial preparations or a 10% bleach to water solution may be used The Hepatitis B virus can survive in dried blood for at least one week Basic First Aid Guidelines Here are some circumstances which might occur in the educational setting. Remember to always wear gloves when dealing with any potentially infectious materials. As long as the injured student or staff member is able, encourage them to administer their own first aid. If it is necessary to assist, always remember to use Universal Precautions. Scrapes, cuts, abrasions: Apply pressure with gauze to control bleeding. Encourage the victim to do this if at all possible. Clean the area gently with soap and water Apply bandage to cover the wound Dispose of all contaminated materials as directed Remove your gloves, dispose as directed and wash your hands If any playground, PE or other school equipment is contaminated it should be cleaned and disinfected before reusing Bloody Nose: Have student sit slightly forward Pinch nostrils for 5 minutes by the clock, repeat another 5 minutes as needed. If bleeding continues contact nurse. If you need to help, apply gloves first.

6 Bloody tissues, gauze and gloves should be disposed of as directed Have the student clean up all visible blood on their hands and skin with soap and water Human Bites: Wash the area with soap and water Cover with bandage Report the incident to school nurse and building principal Athletic Injuries: Existing wounds should be covered before participation in athletic events Play should be stopped immediately when an athlete is injured and bleeding Control bleeding, clean the wound and cover with appropriate dressing Contaminated clothing or towels should be placed in an appropriate bag that is marked. Any contaminated equipment should be cleaned and disinfected before reusing Although most exposures do not result in infection it is important that you remember the following steps if you are exposed to any blood or OPIM Immediately wash the area with soap and warm water, or Flush eyes or any mucous membranes with large amounts of water Report the incident to your school nurse or building principal Post exposure evaluation, counseling and any necessary treatment or testing can be started right away Hepatitis B Vaccination Information: The CDC recommends that if you come into contact with blood on a regular basis as part of your job, that you get immunized against hepatitis B. USD 264 will provide this vaccine at no cost to you. Persons with immune system abnormalities, such as dialysis patients, have less response to the vaccine, but over half of those receiving it do develop antibodies. Full immunization requires three doses of vaccine over a six-month period, although some persons may not develop immunity even after three doses. This vaccine will not prevent hepatitis caused by Hepatitis A or C viruses. There is no evidence that the vaccine has ever caused Hepatitis B. However, persons who have been infected with HBV prior to receiving the vaccine may go on to develop clinical hepatitis in spite of immunization. The duration of immunity is unknown at this time. Possible Side Effects The incidence of side effects is very low. No serious side effects have been reported with the vaccine. A few persons experience tenderness and redness at the site of infection. Low-grade fever may occur.

7 Rash, nausea, joint pain, and mild fatigue have also been reported. The possibility exists that more serious side effects may be identified with more extensive use. Special Precautions Hypersensitivity to yeast of any other component of the vaccine (alum and thimersol), a mercury derivative would contraindicate its use. Pregnant women should receive advice from their doctor before receiving the vaccine. As with any vaccine, administration of Hepatitis B Vaccine should be delayed if possible, in persons with any febrile illness or active infection. Completing the Bloodborne Pathogen Training Returning Employees: 1. Print and complete the Bloodborne Pathogen Training form. Return this form to the Central Office. New Employees: 1. Print and complete the Bloodborne Pathogen Training form 2. Print and complete ONE of the following three forms: a. Hepatitis B Consent Form This indicates you would like to have the vaccine ( 3 injections over 4-6 months) through the district and includes information about the vaccine. b. Hepatitis B Refusal Form This indicates you decline having the vaccinations c. Previous Hepatitis B Vaccine Form This indicates you have already had the vaccinations and provides the district with the dates 3. Print and complete the Bloodborne Pathogen Test 4. Contact the school nurse in your building to grade your test. Bring the Bloodborne Pathogen Training Form, one of the forms from #2 and your test. All paper work will be turned in to her and then sent to the Central Office for your personnel file. References: Dalhart bloodborne pathogen online training Center for Disease Control (CDC) Coastal Bloodborne Pathogens for Schools

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