murrieta fire bloodborne pathogen training 2012
DESCRIPTION
Murrieta Fire Bloodborne Pathogen Training 2012. Art Durbin, Paramedic, RN, MICN, BSHS, MA. At the end of this class the student will be able to:. List the Five Microorganisms CDC and OSHA require you to understand. Verbalize the S/S of hepatitis infection - PowerPoint PPT PresentationTRANSCRIPT
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Murrieta Fire Bloodborne Pathogen Training 2012
Art Durbin, Paramedic, RN, MICN, BSHS, MA
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At the end of this class the student will be able to: List the Five Microorganisms CDC and
OSHA require you to understand. Verbalize the S/S of hepatitis infection Cite appropriate Measures for personal
protection. Verbalize the chain of disease
transmission and how it can be broken
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At the end of this class the student will be able to: (Cont.)
Verbalize the procedure to follow if you are exposed.
List the OLD & New antiviral agents When to use Antiviral agents for HIV
or Hepatitis Discuss Vaccines
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COMPLETE the Pre Evaluation Quiz
How much do you remember?
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Chain of Disease Transmission
The organism
Mode of Entry
Host Resistance
Dosage
Virulence
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Chain of Disease Transmission Defined
Organism – Bacteria Versus Virus Dosage – The number of the
organism you receive from the exposure
Virulence – the ability of the organism to survive in the environment
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Chain of Disease Transmission Defined (cont.)
Host immune system – Are you healthy
Mode of entry – puncture, eye or mouth splash of blood,
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Factors for Evaluating theDegree of exposure
1. Contaminated needle-stick injury.2. Blood/OPIM contact with the
surface of the eye, or inner surface of the nose or mouth.
3. Blood/OPIM in contact with open area of the skin.
4. Cuts with sharp objects covered with blood or OPIM.
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Primary BBP fluids
1. Blood *2. Semen3. Vaginal secretions
* = most concerned with in our everyday job!
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Other Potential Infectious Material/fluids
1. Cerebral Spinal Fluid2. Synovial fluid *3. Amniotic fluid *4. Peritoneal fluid *5. Any fluid with gross (visible) blood
* = with visible blood
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No Risk, HBV, HCV, HIV*reference CDC 1910.1030
Tears & Sweat * Sputum & Saliva * Urine & Stool * Vomit * Nasal secretions **{UNLESS they contain visible
blood}
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Airborne Diseases
1. Contact time/Transport time2. Ventilation - 3. Organism type - 4. Host resistance – PPE used
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Human Immunodeficiency Virus Transmission > Blood, Semen &
Vaginal secretions and OPIM Portal of exit > Bleeding or OPIM
especially if contaminated with blood.
Means of transmission > Sexual both Heterosexual & MSM Contaminated Needle, infected blood in the mouth, eyes.
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Human Immunodeficiency Virus (Cont.)
Portal of entry > Percutaneous or Mucous membranes
Susceptible host > everyone depending on the virus load and those with poor immune systems.
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HIV Statistics Review the most current CDC stats
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Estimated Incidence of AIDS and Deaths of AIDSCases* Attributed to Heterosexual Contact, 1985-1999,
United States
DeathsAIDS
0
1500
1000
500
2000
2500
3000
3500
1985 1986198719881989199019911992199319941995199619971998 1999
Quarter-Year of Diagnosis/Death*Adjusted for reporting delays and unreported risk
Nu
mb
er
of
Case
s/D
eath
s
1993 definitionimplementation
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Estimated AIDS Prevalence* among Men,by Risk Exposure, 1985-1999, United States
*Adjusted for reporting delays and unreported risk
Nu
mb
er
of
Case
s(t
hou
san
ds)
0
20
40
60
80
100
120
140
160
19851986198719881989199019911992199319941995 1996199719981999
MSM
MSM-IDUIDU
Heterosexual contact
Quarter-Year
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*Adjusted for reporting delays and unreported risk
Nu
mb
er
of
Case
s(t
hou
san
ds)
198519861987198819891990199119921993199419951996199719981999
IDUHeterosexual contact
Estimated AIDS Prevalence* among Women,by Risk Exposure, 1985 - 1999, United States
0
20
40
60
80
100
120
140
160
Quarter-Year
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Mother's Exposure Category by Year of Child's Birth forPerinatally Acquired AIDS, 1980-1998, United States
Year of Birth
Perc
en
t of
Case
s
1980 1982 1984 1986 1988 1990 1992 1994 1996 19980
10
20
30
40
50
60
70
Injection drug use
Heterosexual contact
Mother's risk not specified
Transfusion
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Children <13 Years of Age Living with HIV Infection*and AIDS, Reported through 1999
NJDEMDDC
CTRIMA
6
4
13
7
42
5
6
4
5
2
1
1
9
13
12
4
3392
1743
767
79
17
2318
29
54
24
3299
52
258
16315
9284
15
7
9
23
0
05
0
6
7
3
1
5
16
27
27
335
65
41
2051
45
105
43
107
36797
7327
116
383
167
214126
153279
90
174
803
608
175 93
141
* 34 areas conduct confidential HIV infection surveillance for children <13 years old
HIV infection reporting initiated in July 1999
1
HIV
N=1,876 N=3,622
AIDS
P.R. V.I.
ConfidentialHIV Reporting**
Required
Pediatric only
**HIV cases reported by patient name
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*>1 diagnosis reported for some children
Mycobacterium avium infection
Condition
Lymphoid pneumonitisRecurrent bacterial infectionsHIV wasting syndrome
Candida esophagitis
Number
29002061179415641462
% of Cases*
3324211817
Pneumocystis carinii
HIV encephalopathy1372 16
Cytomegalovirus disease 838 10
Pulmonary candidiasis 418 5
Severe herpes simplex infection 422 5Cryptosporidiosis
326 4
709 8
AIDS-Defining Conditions Most Commonly Reported for Children <13 Years of Age, N=8,718, Reported through 1999, United States
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Born1993-March 1999 in 34 States,‡ United States
who Received or whose Mothers Received any ZDV*
Quarter-Year of Birth
Percent of Perinatally HIV Exposed or Infected Children
Perc
ent
Rece
ivin
g Z
idovudin
e
1993N=1437
1994N=1371
1995N=1393
1996N=1343
1997N=1466
1998N=1389
1999N=302
0
20
40
60
80
100
*Any ZDV=Prenatal, intrapartum, or neonatal receipt of Zidovudine to reduce perinatal HIV transmission Includes 34 areas that conduct pediatric HIV Surveillance; data reported through December 1999
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Hepatitis General Signs and Symptoms of Infection May or may not have jaundice Dark urine, painful joints Enlarged tender liver General weakness & weight loss Photophobia and headache N/V, muscle ache Fever 100 to 104
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Hepatitis A Incubation > 2 to 6 weeks. Means of transmission >oral-fecal
route contaminated food, water & shell fish.
Susceptible host >anyone with risk activity.
Mortality > very rare, 0% carriers state.
Vaccine YES.
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Hepatitis B Incubation > up to 200 days Means of transmission >percutaneous,
sex, blood. Susceptible host >anyone with risk
activity and worsens with age.
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Hepatitis B (Cont.) Mortality > 25% develop liver disease
10% become carriers. Medical Rx: Documentation, Blood
testing, Counseling. Vaccine (YES).
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Recommendations for Post Exposure Treatment of Hepatitis B
If the employee has not had the Hep series then HBIG shot plus start the vaccination program.
No prophylactic medication is recommended by CDC.
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Hepatitis C Incubation > 6 to 7 weeks Means of transmission
>percutaneous, sex, tattooing, blood before 1992
Medical RX: Documentation, Counseling, Follow up blood work
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Hepatitis C (Cont.)
Mortality > 50% develop liver disease 85% become carriers
Prevention – Use of PPE
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Hepatitis C treatment Interferon alfa-2b Interferon alfa-2b + ribaviron
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Syphilis (Treponema palladium)
Mode of Transmission – Sex, Needle Stick, Direct contact with draining lesion
Incubation - 10days to 3 months Prevention – Gloves, good
handwashing Medical RX: PCN or Tetracycline
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West Nile Virus (WNV) Mode of transmission – Mosquito
bite Blood transfusion, Organ donation,
Breast milk, Sharps injury
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West Nile Virus (WNV) (Cont.)
Signs/symptoms – Mild headache, fever, body aches, skin rash on trunk, Swollen Lymph glands, Eye pain, N/V.
Severe – Stiff neck, disorientation, coma, tremors, seizures, paralysis, high fever.
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West Nile Virus (WNV) (Cont.)
Incubation – 3 – 14 days PPE – BSI, Needle Safe devices,
DEET, long sleeves Post exposure TX – NONE
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Tuberculosis Pulmonary (TB) Mode of Transmission – Inhalation
of Airborne droplets Incubation – 4 to 12 weeks S/S – Persistent cough for 2 – 3
weeks, weight loss, fever/night sweats, coughing up blood or bloody sputum
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Tuberculosis Pulmonary (TB) (Cont.)
Medical RX. – INH Prevention – Mask the patient,
exposure follow-up, Annual skin testing.
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What Happens if I am Exposed???
WHO/CDC Recommendations for Post Exposure Treatment for HIV exposure and Review!
1. Determine if it is an Exposure2. Notify your supervisor
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What Happens if I am Exposed??? (Cont.)
1. Supervisor retrieve red MFD exposure packet (follow exposure algorhythm)
We will review the contents of the red exposure packet now.
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Old & New antiviral agents AZT – zidovudine (Retrovir) 1987 ZDV – zidovudine/lamivudine
(Combivir) 1996 3TC – lamivudine (Epivir) 1995 IDV - indinavir (Crixivan) 1996 PI Abacavir (Ziagen) 1998
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Old & New antiviral agents (Cont.)
Amprenavir (Agenerase) 1999 PI Didanosine (Videx EC) 2000 Lopinavir/ritonavir (Kaletra) 2000
two PIs
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Side Effects of AntiVirals and Protease Inhibitors
Hepatitis (chemical) Liver damage or failure Kidney damage or failure
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Summary HIV infected patients are living
longer You can be protected from
Hepatitis A, B & D by vaccination. Hepatitis C is on the rise, no
vaccine yet and may claim more lives than AIDS by 2010
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Complete Your quiz & turn in your Pre Test.
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Thank You
The END Questions?