new bbp training

8/7/2019 New Bbp Training

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LEXINGTON FIREDEPARTMENT

Instructor: Johnny Sampson



WHY ARE WE HERE? OSHA BB Pathogen standard

± anyone whose job requires exposure to BBpathogens is required to complete training

± employees who are trained in CPR andfirst aid

The more you know, the better you willperform in real situations!



WHAT IS A BB PATHOGENPathogens are micro-

organismssuch as viruses, parasites,fungi or bacteria that cancause disease in people,

plants, and animals .



WHAT IS AN EXPOSURE?1. Must involve exposure to blood, semen, vaginal

secretions, tissue or the following body fluids:cerebrospinal, amniotic, peritoneal, synovial,

pericardial, pleural2. Contact with EMR mucous membranes, non-intact

skin, or vascular system Examples, needlestickinjury, open wound, splash to eyes, nose, mouth

3. The exposure occurred in performance of employment or professional duties (includesemergency medical responders)



Common BB PathogenDiseases

Malaria Brucellosis Syphilis

He patitis B( H BV)He patitis C( H CV)

H umanImmunod ef ici e ncyVirus ( H IV)



Human ImmunodeficiencyVirus (HIV)

HIV is the virus that leads to AIDS

HIV depletes the immune system

HIV does not survive well outsidethe body

No threat on contracting HIVthrough casual contact



Human Immunodeficiency Virus Human Immunodeficiency Virus

(HIV) (HIV)

jj HIV attacks the body's immune HIV attacks the body's immune system, weakening it so that itsystem, weakening it so that itcannot fight other deadly cannot fight other deadly

diseases.diseases.



ACQU IRED IMM UN E ACQU IRED IMM UN E

DEFI C IE NCY S YN DROME DEFI C IE NCY S YN DROME

jj A IDS is a fatal disease, and A IDS is a fatal disease, and while treatment for it is while treatment for it is improving, there is no known improving, there is no known

cure.cure.



HIV S Y MPTOMS HIV S Y MPTOMS

ÁÁ Weakness Weakness ÁÁ Fever Fever ÁÁ Sore throatSore throatÁÁ Nausea Nausea ÁÁ Headaches Headaches ÁÁ Diarrhea Diarrhea ÁÁ

White coating on the tongue White coating on the tongue ÁÁ Weight loss Weight loss ÁÁ Swollen lymph glands Swollen lymph glands



Hepatitis B (HBV)

1²1.25 millionAmericans arechronically infected

Symptoms include:jaundice, fatigue,abdominal pain, lossof appetite,intermittent nausea ,vomiting

May lead to chronicliver disease, liver cancer, and death

Vaccination availablesince 1982

HBV can survive for atleast one week indried blood

Symptoms can occur 1-9 months after exposure



WHAT IS HBV?± Is a virus that caus e s in fe ction andIs a virus that caus e s in fe ction and

in fl ammation o f th e live r in fl ammation o f th e live r

±± Is transmitt e d primari ly through "b loodIs transmitt e d primari ly through "b loodto b lood" contactto b lood" contact



CONCENTRATION OF HBVHIGH

BLOODSERUM

WOUND DRAINAGE



MODERATESEMEN

VAGINAL FLUIDSALIVA



LOWURINEFECESSWEAT

TEARSBREAST MILK



Hepatitis C (HCV) Hepatitis C is the most common chronicbloodborne infection in the United States

Symptoms include: jaundice, fatigue,abdominal pain, loss of appetite, intermittentnausea, vomiting

May lead to chronic liver disease and death



W H A T AB O U T W H A T AB O U T

HEP A TITIS A? HEP A TITIS A? ÁÁ Hepatitis A Hepatitis A is a viral infection of is a viral infection of the liver caused by the Hepatitis A the liver caused by the Hepatitis A virus.virus.




HEP A TITIS A? HEP A TITIS A? Á Hepatitis A is a contagious disease thatspreads from person to person. A ffected

individuals must have eaten somethingthat had been directly or indirectly contaminated with the feces of another affected individual.




HEP A TITIS A? HEP A TITIS A? Á Hepatitis A is mostly transmitted by the fecal-oral route. It enters through the mouth,multiplies in the liver and is passed in the feces. The virus can then be carried on an infected person's hands and can be spread by direct contact, or by consuming food or drinkthat has been handled by the individual.




HEP A TITIS A? HEP A TITIS A? Á Hepatitis A can also be transmitted by contaminated water or ice, eating raw shellfishharvested from sewage contaminated water, or eating uncooked fruits, vegetables or other food that may have been contaminated duringprocessing.




HEP A TITIS A? HEP A TITIS A? Á Most adults who contract Hepatitis A develop symptoms that usually occur

suddenly and worsen over a period of several days. These often include loss of appetite, fatigue, nausea, vague stomach

pain, darkening of the urine, and jaundice .




HEP A TITIS A? HEP A TITIS A? Á The Hepatitis A virus can survive on surfaces ( such as toys and cutting boards)

for up to 1 month!




HEP A TITIS A? HEP A TITIS A? Á Hepatitis A has an incubation period of 15 to 50 days, with the average about 28

days. During this time, the individual may have no symptoms, but is contagious and spreading the virus!



TRE A TME N T OF TRE A TME N T OF

HEP A TITIS A? HEP A TITIS A? B ecause Hepatitis A is a viral illness,antibiotics will not work. The virus

must run its course, and lasts for about4-6 weeks. Treatment is usually supportive, such as rest and hydration.A bout 15 % of individuals require hospitalization.



TRE A TME N T OF TRE A TME N T OF

HEP A TITIS A? HEP A TITIS A? A typical case of Hepatitis A results in 27 lost days of work. A small percentage

will require liver transplant. The adultdeath rate is 27 per 1000 cases. ( Ab out100 per year in U .S.) Most are older withprevious health pro b lems.



PREVE N TIO N OF PREVE N TIO N OF

HEP A TITIS A? HEP A TITIS A? Á Prevention is bestaccomplished by proper hand

washing! Á Proper cleaning and preparation of foods.Á Proper cleaning of food prep areas.



THE GOOD N E W S AB O U T THE GOOD N E W S AB O U T

HEP A TITIS A? HEP A TITIS A? Á Once recovered from Hepatitis A , you are immune

for life!

Á There is a vaccine



OTHER BL OOD B OR N E P A THOGE N S OTHER BL OOD B OR N E P A THOGE N S

Malaria Malaria ÁÁ U sually U sually transmitted by the transmitted by the bite of an infective mosquito bite of an infective mosquito ÁÁ May May be transmitted by be transmitted by injection or transfusion withinjection or transfusion withblood of infected persons or blood of infected persons or contaminated needles and contaminated needles and syringes by drug users.syringes by drug users.




Syphilis Syphilis ÁÁ U sually transmitted by directU sually transmitted by directcontact with infectious contact with infectious

exudates from obvious or exudates from obvious or concealed, moist, early, lesions concealed, moist, early, lesions of skin and mucous of skin and mucous

membranes.membranes.




Syphilis Syphilis ÁÁ A lso transmitted by contactA lso transmitted by contactwith body fluids and with body fluids and

secretions (saliva, semen,secretions (saliva, semen,blood, vaginal discharges) of blood, vaginal discharges) of infected people.infected people.



Syphilis Syphilis



Potentially Infectious Bodily

Fluids

Blood Saliva Vomit Urine Semen or vaginalsecretions

Skin tissue, cellcultures

Any other bodilyfluid



AIRBORNE BAD STUFF

TUBERCULOSIS

MENINGITIS



TUBERCULOSIS

Is an infectious disease which usually

infects the lungs, but may affect other body systems as well. Caused by Mycobacteriumtuberculosis. Spread airborne by droplets



TUBERCULOSIS

SYMPTOMS COUGH LASTING LONGER

THAN 2 WEEKS COUGHING UP BLOOD CHEST PAIN SOB



TUBERCULOSIS

SYMPTOMS WEIGHT LOSS

CHILLS NIGHT SWEATS FEVER LOSS OF APPETITE



TUBERCULOSIS

TREATMENT Antibiotics are used to kill the

bacteria. ionized (INH) rifampin

pyrazinamide Possible side effects are liver disease.



M ENINGITIS Two types: Viral (or Aseptic) and

Bacterial

Infection of the meninges (a thinlining covering the brain and spinalcord) Transmitted by the exchange of respiratory or throat secretions.(coughing, sneezing, sharing a cup,etc.) from an infected person



M ENINGITIS

Fever

Stiff neck Headache Nausea / vomiting Drowsiness Mental status changes



V IRAL

M ENINGITIS

Caused by many different

viruses (enteroviruses andmumps virus are two types) Patients recover on their own Bed rest, pain control Lasts 7-14 days



M ENINGITIS

Diagnosed by spinal tap, CSF ischecked in lab. The diagnosis is then made bygrowing bacteria from a sample of

spinal fluid



BACTERIALM ENINGITIS

Caused by exposure to one of threetypes of bacteria:Neisseria meningitidisStreptococcus pneumoniae

Haemophilus influenzae




Advanced bacterial meningitis canlead to brain damage, coma, anddeath. Survivors can suffer long-term complications, includinghearing loss, mental retardation,paralysis, and seizures.




Anyone can get bacterial meningitis, but it ismost common in infants and children.People who have had close or prolongedcontact with a patient with meningitis canalso be at increased risk. This includes

anyone with direct contact with dischargesfrom a meningitis patient's mouth or nose.




TRANSMITTED BY DROPLETS

IN THE AIR.

WE MAY NOT KNOW THEPATIENT HAS THIS UNTIL WEGET EXPOSED!




IF WE GET EXPOSED, WE

MAY BE TREATED WITHCIPRO OR ANOTHER TYPEOF ANTIBIOTIC THAT THE

MD RECOMMENDS.



There is now a vaccine for meningitis

Vaccine is based on bacteria mostresponsible for menigitis



M RSA AND

V RE

MRSA STANDS FOR METHICILLINRESISTANT STAPHYLOCOCCUS AUREUSINFECTION.

METHICILLIN IS A TYPE OF ANTIBIOTIC. STAPHYLOCOCCUS AUREUS IS A TYPEOF BACTERIA COMMONLY FOUND ONTHE SKIN AND NOSES OF PEOPLE.

IT IS USUALLY HARMLESS AT THESE

SITES.



M RSA AND

V RE

IF THE BACTERIA GETS INTO THEBODY THROUGH BREAKS IN THESKIN, INFECTIONS CAN SET IN.

IN HEALTHY INDIVIDUALS, THIS ISUSUALLY NOT A PROBLEM.

IN SICK PATIENTS, THE INFECTIONMAY BECOME SERIOUS.



M RSA AND

V RE

MRSA IS SPREAD THROUGHDIRECT CONTACT WITH A PATIENT,AND THEN TOUCHING OTHERPATIENTS WITHOUT USING PROPERCLEANING AND HAND WASHING

PROCEDURES.



WHAT SHOULD WE DO?

ALWAYS WEAR GLOVES. KEEP THE PATIENT COVERED WITHA SHEET.

AVOID TOUCHING THE PATIENTDIRECTLY, IF POSSIBLE.

WASH HANDS THOROUGHLY AFTERPATIENT CONTACT.



WHAT SHOULD WE DO?

THE WATERLESS HAND CLEANERSHOULD BE USED AFTERREMOVING YOUR GLOVES.

EQUIPMENT USED FOR THEPATIENT SHOULD BE DISINFECTED

PROPERLY BEFORE BEING USEDON ANOTHER PATIENT.



ISOLATION SIGNS

Look for them Where??

What are other signs you need toprecautions???



V RE

VANCOMYCIN RESISTANTENTEROCOCCI

THESE ARE BACTERIA THATHAVE DEVELOPED ARESISTANCE TO MOST

ANTIBIOTICS. VRE CAN CAUSE INFECTIONS,ESPECIALLY IN SICK PEOPLE.



V RE

THESE INFECTIONS AREDIFFICULT TO TREAT, DUETO THEIR RESISTANCE TOTHE ANTIBIOTICVANCOMYCIN , WHICH ISONE OF THE STRONGESTANTIBIOTICS AVAILABLE.



V RE

PROPER USE OF PPE ANDHAND WASHING IS THEBEST WAY TO PREVENT THESPREAD OF VRE.



NOROV

IRUS A GROUP OF VIRUSES THAT CAUSEACUTE GASTROENTERITIS (ANINFLAMMATION OF THE STOMACH ANDINTESTINES)( AKA ³ STOMACH FLU´) INHUMANS.



NOROV

IRUS SYMPTOMS START SUDDENLY, ANDINCLUDE:

STOMACH CRAMPS NAUSEA VOMITING

DIARRHEA HEADACHES LETHARGY



NOROV

IRUS THE CDC ESTIMATES THAT 23 MILLIONPEOPLE A YEAR CONTRACTNOROVIRUS.

232 OUTBREAKS IN U.S. IN A 3 YEARPERIOD.

57% FOODBORNE 16% PERSON TO PERSON 3% WATERBORNE

23% UNDETERMINED



NORO V IRUS COMMONSETTINGS FOROUTBREAKS:

RESTAURANTS /CATERED MEALS(36%)

NURSING HOMES(23%)

SCHOOLS (13%) CRUISE

SHIPS(10%)



NOROV

IRUS MOST FOODBORNE OUTBREAKS ARELIKELY TO ARISE THROUGH DIRECTCONTAMINATION OF FOOD BY A FOODHANDLER.

FOOD CAN ALSO BE CONTAMINATEDAT THE SOURCE, SUCH AS OYSTERSFROM CONTAMINATED WATERS.



NOROV

IRUS The best

prevention isfrequent handwashing!



Transmission Potential Contact with another person¶s blood or bodily fluid that maycontain blood

Mucous membranes:eyes, mouth, nose

Non-intact skin Contaminatedsharps/needles



Your Exposure Potential

Industrial accident Administering first aid

Post-accident cleanup Handling of returned

product Janitorial or

maintenance work Handling of any waste

products



Universal Precautions

Use of proper PPE Treat all blood and

bodily fluids as if they are contaminated

Proper cleanup anddecontamination

Disposal of allcontaminated materialin the proper manner



Personal Protective

Equipment (PPE) Anything that isused to protect a

person fromexposure

Latex or Nitrilegloves, goggles,CPR mouth barriers,aprons, respirators



PPE Rules to Remember

Always check PPE for defects or tearsbefore using

If PPE becomes torn or defectiveremove and get new

Remove PPE before leaving a

contaminated area Do not reuse disposable equipment



Decontamination When cleaning up surfaces use approveddisinfectant ®

Do an initial wipe up

Spray and allow it to stand for ten minutesthen wipe up Dispose of all wipes in biohazard containers PPE should be removed anddisposed of in biohazard containers



Hand Washing

Wash handsimmediately after

removing PPE Use a softantibacterial soap

A hand sanitizer canbe used but washwith soap and water as soon as possible.



Regulated Medical Waste

Liquid or semi-liquid blood or other potentiallyinfectious material(OPIM)

Contaminated items that would release bloodor OPIM when compressed Contaminated sharps Pathological and

microbiological wastecontaining blood or OPIM



Signs & Labels

Labels must include theuniversal biohazardsymbol, and the term³Biohazard´ must beattached to:± containers of regulated

biohazard waste± refrigerators or freezers

containing blood or OPIM

± containers used to store,transport, or ship bloodor OPIM



Exposure Incident

A specific incident of contact with potentiallyinfectious bodily fluid

If there are no infiltrations of mucousmembranesor open skin surfaces, it is not considered anoccupational exposure

Report all accidents involving blood or bodilyfluids Post-exposure medical evaluations are offered



Post-exposure Evaluation

Confidential medicalevaluation

Document route of

exposure Identify source

individual Test source individuals

blood (with individuals

consent) Provide results to

exposed employee



Hepatitis B Vaccination

Strongly endorsedby medicalcommunities

Offered to allpotentially exposedemployees

Provided at no costto employees

Declination form



Recordkeeping

Medical records include: Hepatitis B vaccination

status

Post-exposureevaluation and follow-up results

Training records include: Training dates

Contents of the training Signature of trainer andtrainee



In Conclusion

BB pathogen rules are in place for your health and safety

Failure to follow them is a risk thatdoes not need to be taken



Lex ington Fir e De partm e nt

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