BLOODBORNE PATHOGENS ATEP ANNUAL TRAINING

Universal Precautions Training This training is designed to: Provide basic understanding of Blood borne Pathogens (BBP) Discuss Blood borne diseases and their transmission Explain the term “Universal Precautions” Recognize common modes of transmissions in the work place Differentiate between Engineering Controls and Work Practice Controls Review Personal Protective Equipment (PPE) and Hand washing Provide information on Hepatitis B Vaccine and Exposure Incidents As required by: Commission on the Accreditation of Athletic Training Education (caATe) Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard 29 CFR 1910.0130

Blood borne Pathogens Blood borne Pathogens (BBP) are microorganisms such as viruses and bacteria that are carried in the blood and can infect and cause disease in people who are exposed to blood containing the pathogen. These microorganisms can be transmitted through contact with contaminated blood and body fluids.

Common Examples Blood borne diseases The two diseases specifically addressed by the OSHA standard are: Hepatitis B Virus (HBV) Human Immunodeficiency Virus (HIV) Also included are: Malaria Syphilis Hepatitis C virus (HCV) Hepatitis D virus (HDV)

Characteristics of Hepatitis Hepatitis means inflammation of the liver Can result in cirrhosis and liver damage potentially life-threatening bloodborne pathogen but most people recover May be present in the body for up to six months before symptoms occur HBV can be transmitted indirectly Can survive in dried blood up to 7 days There is a vaccine – 95% prevention rate One third of HBV have no signs or symptoms

HEPATITIS B VACCINE If you are working with a “high risk group” you should discuss getting the vaccine with your physician.

Characteristics of HIV HIV attacks the immune system People can carry the virus for years without visible symptoms HIV is fragile and does not survive very long outside the body In some cases HIV develops into AIDS No known vaccine to prevent infection or cure

Transmission of Bloodborne Diseases Blood borne Pathogens are transmitted when contaminated blood or body fluids enter the body of another person. Those body fluid include: Blood Semen Saliva Vaginal & Penal Secretions Mucous Membrane Secretions Cerebrospinal Fluid Synovial Fluid Pleural Fluid Peritoneal Fluid Pericardial Fluid Amniotic Fluid Any body fluid (such as vomit) visibly contaminated with blood Any unidentifiable body fluid Dermatitis Acne Cuts

Transmission of Bloodborne Diseases In the athletic training setting, contact is most likely to occur when caring for an injured individual and contact is made with the bodily fluid. Therefore we practice Universal Precautions with EVERY individual at all times.

What do we mean “Universal Precautions”? The concept of Universal Precautions is that all blood and potentially infectious materials must be treated as if they are known to contain HIV, HBV or other blood borne pathogens. Assume all blood and body fluids are contaminated and potentially harmful to your health!!

6 Steps to consider for Universal Precautions 1. ASSUME ALL BLOOD AND BODY FLUIDS ARE CONTAMINATED AND POTENTIALLY HARMFUL TO YOUR HEALTH.

Steps to consider for Universal Precautions 2. WASH HANDS AND WORK SURFACES FREQUENTLY. 2. WASH HANDS AND WORK SURFACES FREQUENTLY.

Steps to consider for Universal Precautions 3. AVOID CONTACT WITH SHARP OBJECTS. 4. USE GLOVES AND OTHER PERSONAL PROTECTIVE EQUIPMENT WHEN YOU ANTICIPATE EXPOSURE TO BLOOD OR OTHER BODILY FLUIDS.

Steps to consider for Universal Precautions 5. WASH YOUR HANDS IMMEDIATELY FOLLOWING EXPOSURE

Steps to consider for Universal Precautions 6. DISPOSE OF HAZARDOUS MATERIAL SAFELY USING ENGINEERING CONTROLS LIKE A SHARPS BOX FOR NEEDLE DISPOSAL.

WORKPLACE TRANSMISSION Accidental Injury Injury that may occur from broken glass, sharp metal, needles, knives or even exposed orthodontic wires. Indirect Transmission Occurs from contact with an object or surface contaminated with infectious material and then transferred to your mouth, nose, eyes or open skin.

When an Injury Occurs Assess the situation Administer First Aid Report the Incident

Assess the Situation Take a moment to collect yourself so you can approach the situation. Be calm and reassure the victim Assess the severity of the injury Avoid exposing yourself to blood or other bodily fluids without precautions

ADMINISTER FIRST AID When blood or other bodily fluid is present, put on a pair of gloves first! If bleeding is severe you can hand gauze to the individual for them to apply pressure to the wound. If you are accidentally exposed to blood or another fluid in the course of first aid, wash the exposed area with an antibacterial soap and water as soon as possible. If your eyes, nose or mouth have been exposed, flush them with running water.

REPORT THE INCIDENT Report the exposure to your preceptor immediately in case there is a need for additional medical attention. Complete the Bodily Fluid Exposure Report immediately and give to your preceptor. Your preceptor will then contact the Program Director to report the exposure.

CONTROLS IN PLACE TO PREVENT EXPOSURE Engineering Controls Isolates or removes the blood borne pathogen from the work place. Physical or mechanical systems that eliminates the hazards at the source Example: sharps disposal container & biohazard containers Eye wash system Work Practice Controls Reduces the likelihood of exposure by altering the manner in which the task is performed. Hand washing Personal Hygiene Cover area that is soiled until proper cleansing done Frequent cleaning of treatment tables

HANDWASHING Hand washing is one of the simplest and most effective practices used to present transmission of blood borne pathogens. Take 2 paper towels and put under arm Turn on warm water and put soap on hands Rub for 20 seconds vigorously, getting fingers, hands, wrists and fingernails. Rinse thoroughly & use one towel to turn off faucet Use 2nd towel to dry hands and open door.

PERSONAL HYGIENE Use good judgment when working in areas with potential exposure. Refrain from eating, drinking or applying lip balm or cosmetics where there is a likelihood of exposure. Don’t keep food or drink in refrigerators or on countertops where there is potential for infectious material Minimize splashing or spraying of droplets when attending to an injury

PERSONAL PROTECTIVE EQUIPMENT—”PPE” To protect yourself, it is essential to have a barrier between you and the potentially infectious material. Gloves, goggles, masks and aprons should be used appropriately with the task and degree of exposure.

Gloves Gloves provide a barrier and shall be worn if contact with any body fluid is anticipated. When using disposable gloves do not attempt to wash or decontaminate them. When contaminated, torn, or punctured, replace gloves immediately or as soon as feasible. Prior to putting on gloves, long hair should be pulled back and secured with a clip to keep it off your face. This is to avoid the necessity of brushing it out of the way with potentially contaminated gloved hands. Practice putting on and removing gloves using the following procedure. This aids in the prevention of accidental exposure.

Glove Removal Procedure Gather any contaminated material and hold it in one hand. 2.Using the index finger of the opposite hand, pull the outside surface of the glove downward towards the fingers (turning the glove inside out and avoiding contact with your skin). 3.Continue holding glove with opposite gloved hand.

Glove Removal Procedure (continued) 4. Slide the index finger of your bare hand inside the glove on the opposite hand (avoiding contact with the outside contaminated surface of the glove). 5. Peel off glove turning it inside out around the other glove. 6. Holding the inside non-contaminated side of the glove, place it into a proper biohazard container. 7. Thoroughly wash hands with disinfectant soap and warm water.

ADDITIONAL PPE Gowns/aprons Eye Protection Gowns are used to protect the clothing of the wearer from becoming saturated and causing an exposure incident. These are used in situations where the potential for spraying or splashing of blood or body fluids exists. They should also be used during the clean-up process when large amounts of blood and other body fluids are present. Eye Protection Goggles, chin-length face shields, and glasses with solid side shields provide protection from splattering fluids and protection from incidental touching of eyes and/or face with gloved hands.

ATHLETIC TRAINING CLINIC RESTRICTIONS In the AT CLINIC (ATCL) where there is reasonable likelihood of exposure, students are not to eat, drink, apply cosmetics, smoke, or handle contact lenses. Do not store food or beverages in or around areas such as shelves, cabinets, or on bench tops where blood or other potentially infectious materials are present.

Post Evaluation TRUE OR FALSE Universal precautions refers to the infectious disease control systems, that assumes every direct contact with body fluids is infectious and requires every employee exposed to be protected as though all body fluids are infected with bloodborne diseases. Universal Precautions Training is required by the Occupational Safety Health Administration (OSHA) to limit the threat of Bloodborne Pathogens in the work place. Every school employee must understand the dangers of infection and safe practices to minimize risk. Hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) are 2 disease specifically addressed by the OSHA Bloodborne Pathogen Standard. Hepatitis is an inflammation of the liver. Symptoms of the disease range from jaundice, flu like symptoms to none at all. Hepatitis B virus can survive in dried blood for up to 7 days at room temperature.

Post evaluation continued: 7. The Hepatitis B vaccine series is an effective tool against the Hepatitis B Virus. It is suggested you receive the vaccine if you work in a high risk area. 8. HIV attacks the body’s immune system causing the disease known as AIDS and/or other opportunistic infections. 9. Symptoms of HIV include night sweats, weight loss, muscle and joint pain. 10. The HIV is fragile and does not survive very long outside the body. 11.Presently, there is no vaccine to prevent HIV. 12.Transmission of bloodborne diseases in the work place include accidental injury & indirect transmission. 13.Accidential injury may occur from contaminated objects like broken glass, needles, knives and sharp metal including orthodontic wires. 14.Indirect transmission happens when you touch a contaminated surface or object and then transfer the infections to you nose, mouth, eyes or open skin.

Post evaluation continued 15. An ECP (Exposure Control Plan) involves engineering controls and work place practices that outline a system of safeguards and barriers to reduce the risk of exposure to bloodborne pathogens to employees. Handwashing is one of the simplest and most effective practices used to prevent transmission of bloodborne pathogens. When an injury occurs, it is important to assess the situation first, before administering first aid. A sharps container for needles is an example of engineering controls in the work place. Personal Protective Equipment (PPE) must be worn utilized to reduce the risk of exposure. Gloves should be worn whenever needed to prevent contact. The Hepatitis B vaccine series is offered cost free to employees at risk for exposure, and whenever there is an exposure incident in the work place.

Post Evaluation Answers Congratulations if you answered all as TRUE