Universal Precautions in Athletic Environment 1991 OSHA (Occupational Safety and Health Administration) established standards for employer to follow that govern occupational exposure to blood- borne pathogens Developed to protect healthcare provider and patient All sports programs should have exposure control plan –Should include counseling, education, volunteer testing, and management of bodily fluids

Preparing the Athlete –Prior to participation, all open wounds and lesions should be covered with dressing that will not allow for transmission –Occlusive dressing lessens chance of cross- contamination Hyrdrocolloid dressing is considered a superior barrier Reduces chance that wound will reopen, as wound stays moist and pliable When Bleeding Occurs –Athletes with active bleeding must be removed from participation and returned when deemed safe –Bloody uniform must be removed or cleaned to remove infectivity

Personal Precautions –Those in direct contact must use appropriate equipment including Latex gloves, gowns, aprons, masks and shields, eye protection, disposable mouthpieces for resuscitation Emergency kits should contain, gloves, resuscitation masks, and towelettes for cleaning skin surfaces –Doubling gloves is suggested with severe bleeding and use of sharp instruments –Extreme care must be used with glove removal –Hands and skin surfaces coming into contact with blood and fluids should be washed immediately with soap and water (antigermicidal agent) –Hands should be washed between patients

Availability of Supplies and Equipment –Must also have chlorine bleach, antiseptics, proper receptacles for soiled equipment and uniforms, wound care equipment, and sharps container –Biohazard warning labels should be affixed to containers for regulated waste, refrigerators containing blood and containers used to ship potentially infectious material –Labels are fluorescent orange or red –Red bags or containers should be used for potentially infectious material

–Disinfectant Contaminated surfaces should be clean immediately with solution of 1:10 ratio approved disinfectant to water Should inactivate HIV Contaminated towels should be bagged, labeled, and separated from other soiled laundry, then transported in biohazard container –Wash in hot water (159.8 degrees F for 25 minutes) –Laundry done outside institution should be OSHA certified –Sharps Needles, razorblades, and scalpels use extreme care in handling and disposing all sharps Do not recap, bend needles or remove from syringe Scissors and tweezers should be sterilized and disinfected regularly

Protecting the Coach and Athletic Trainer –OSHA guidelines are designed to protect coaches, athletic trainers and other employees. –Coaches generally do not come into contact with blood and therefore risk is greatly reduced –Responsibility of institution to protect athletic trainer Provide necessary supplies and education –Athletic trainer has personal responsibility to follow guidelines Minimize risks by not eating/drinking, applying cosmetics/lip balm, handling contact lenses, and touching face before washing hands in athletic training room

Protecting the Athlete From Exposure –Use mouthpieces in high-risk sports –Shower immediately after practice or competition –Athletes exposed to HIV or HBV should be evaluated and immunized against HBV

Post-exposure Procedures Athletic trainer should have confidential medical evaluation that documents exposure route, identification of source/individual, blood test, counseling and evaluation of reported illness Laws that pertain to reporting and notification of results relative to confidentiality vary from state to state