1. Bloodborne Pathogen Training Operation Strong Safety James G Vretis, DO MAJ, MC, TXSG ACC Staff Surgeon

2. u Bloodborne pathogens are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people What Are Bloodborne Pathogens?

3. u HIV: Human Immunodeficiency Virus causes AIDS - no cure or vaccination u HBV: Hepatitis B virus causes liver disease - vaccination available u Non-A or Non-B Hepatitis u Syphilis u Malaria Bloodborne Diseases

4. u Inflammation of the liver - most common bloodborne disease u Is transmitted primarily through "blood to blood" contact u Symptoms range from flu-like to none at all u No symptoms - person is infectious and can spread the disease. Can survive in dried blood and surfaces for up to seven days u Hepatitis infects about 300,000 people in USA annually u Can lead to serious conditions such as cirrhosis & liver cancer HBV Or Hepatitis

5. u Mild flu-like symptoms u Fatigue u Possible stomach pain u Loss of appetite u Nausea u Jaundice u Darkened urine HBV Symptoms

6. Acquired Immune Deficiency Syndrome u Attacks the body’s immune system and weakens it, preventing it from fighting other diseases u 35,000 people are infected annually u An infected person may carry the virus for years before symptoms appear u No cure and no vaccine at present HIV or AIDS

7. u The HIV virus is very fragile and will not survive very long outside of the human body. It is primarily of concern to employees providing first aid or medical care in situations involving fresh blood or other potentially infectious materials. HIV & Direct Contact

8. u Sexual contact with an infected partner u Sharing infected needles u Accidentally cutting yourself with a sharp object that is contaminated u Infected blood or body fluid on skin with open cuts, sores u Getting contaminated blood or body fluid in eyes, mouth Means Of Transmission

9. u Universal Precautions u Treat all blood and body fluids as potentially infectious u Skin protects from pathogens - cuts, dermatitis, chapping, small cracks allow germs to enter the body u First aid - use gloves, have as little contact as possible with blood or body fluids u Wash hands with antibacterial soap after contact u After contact, flush eyes and face with fresh water for several minutes Protect Yourself

10. u After an accident, the entire area must be cleaned with disinfectant u Cleaning equipment must be disinfected u Wear gloves while cleaning, apron or goggles if appropriate u Restrict access to the area u Use disposable towels - dispose of properly Clean-up And Housekeeping

11. u Cleaning surfaces contaminated with blood, vomit feces u ALWAYS wear gloves and protective apron or clothing u Be alert for sharp objects, broken glassware, used syringes in trash u Do not pick up broken glass - use brush or broom & dustpan u Dispose of glass, sharp objects safely u Laundry - bloody or contaminated linens or sharp objects Other Exposure Hazards

12. Warning labels must be placed on containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious material; and other containers used to store, transport, or ship blood or other potentially infectious materials. Signs & Labels

13. u Any liquid or semi-liquid blood or other potentially infectious materials. u Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed. u Items that are caked with dried blood or other potentially infectious materials Regulated Waste

14. Emergencies u In an emergency situation, always use Universal Precautions u Minimize your exposure by wearing u Gloves u Splash goggles u Pocket mouth-to-mouth resuscitation masks u Other barrier devices

15. Common Sense Rules u Wash hands & remove protective clothing before eating, drinking, smoking, handling contact lenses, or cosmetics u Use antibacterial soap u Keep hands away from eyes, nose, mouth while cleaning u Frequent hand washing is best defense against spreading infection

16. u Wash the exposed area thoroughly with soap and running water. u Use non-abrasive, antibacterial soap u Flush mouth, nose, eyes for 15 minutes if blood is splashed in mucous membranes If You Are Exposed

17. u Report the exposure to your supervisor u Fill out an exposure report form u Request blood testing & Hepatitis B vaccination Other Actions If Exposed

18. The best protection against exposure is to ensure you are wearing the appropriate personal protective equipment (PPE). For example, you may have noticed that emergency medical personnel, doctors, nurses, dentists, dental assistants, and other health care professionals always wear latex or protective gloves. To protect yourself, it is essential to have a barrier between you and the potentially infectious material. PPE

19. u Treat all blood or potentially infectious body fluids as if they are contaminated. u Always wear personal protective equipment in exposure situations. u Replace PPE that is torn or punctured. u Remove PPE before leaving the work area. u Properly disinfect or dispose of used PPE u Wash hands immediately after removing PPE Rules To Follow:

20. u Gloves should be made of latex, nitril, rubber, or other water impervious materials. u Inspect gloves before use u Double gloving can provide an additional layer of protection. u If you have cuts or sores on your hands, you should cover these with a bandage or similar protection as an additional precaution before donning your gloves. u Don’t touch the outside of used gloves Gloves

21. u Use goggles if there is a risk of splashing or vaporization of contaminated fluids u Face shields provide additional face protection for the nose and mouth. u Aprons protect Other PPE

22. u Remove clothing that is contaminated with blood as soon as possible u Use Universal Precautions when handling contaminated laundry u Place clothing in approved & labeled bags or containers Contaminated Clothing

23. u Protect yourself on and off the job - know the facts u Practice good personal hygiene u Use gloves and protective clothing u Wash your hands often, after work or exposure u Keep areas clean - report problems immediately to supervisors Summary

24. 24 If it is wet, and not yours: Don’t touch it!

25. 25 James G Vretis, DO MAJ, MC, TXSG ACC Staff Surgeon james.vretis@txsg.state.tx.us