1. Universal Precautions
presenter- introduce yourself
Health Services Department

2. Why You Have This Training
California Education Code Section requires that schools provide annual training to all teachers and school employees to help them deal effectively with the issues surrounding HIV/AIDS and other sexually transmitted diseases.
CAL-OSHA – Blood borne Pathogens Standard (8- CCR-5193)
California Health and Safety Codes, Sections and
Education Code Section requires that in-service training be provided to all teachers and school employees who provide HIV/AIDS prevention instruction. This in-service training shall be conducted periodically to enable the staff to remain current with new developments in the scientific understanding of HIV/AIDS and with new prevention education techniques. This component also outlines specific training that school board members, administrators, teachers, school nurses, counselors, parents, classified personnel, and others should receive to deal effectively with the issues surrounding HIV/AIDS and other sexually transmitted diseases.
CAL-OSHA defines blood borne pathogens as microscopic organisms, which are present in human blood and have the ability to cause diseases in other humans.
The California Health and Safety Code, Division 105, Part 4, requires that each year, all employees and regular volunteers be given information on the possible transmission of HIV and hepatitis B in the workplace, the guidelines for confidentiality, and the implementation of standard/universal precautions

3. Presentation Overview
The content for “Standard/Universal Precautions to Meet OSHA Guidelines” should include:
Hand washing
Use of disposable gloves
Waste disposal
Modifications for CPR & first aid involving contact with blood
Use of disinfectants
Steps to follow in case of exposure

4. What are Universal Precautions?
“Universal Precautions” are the act of protecting yourself from coming in contact with another person's bloodborne pathogens or bodily fluids, which can be spread either directly or indirectly.
Pathogens can enter the body through:
Breaks in the skin (tattoos, piercings, razors, needles)
Eyes
Mouth
Sexual transmission
Universal Precautions and Body Substance Isolation are based on the principle that all blood, body fluids, secretions, excretions except sweat,
nonintact skin, and mucous membranes may contain transmissible infectious agents.

5. What are Bloodborne Pathogens?
Bloodborne pathogens are infectious microorganisms in human blood and some other bodily secretions that can cause disease in humans.
These pathogens include, but are not limited to, human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV).
In order to reduce or eliminate the hazards of occupational exposure to bloodborne pathogens, an employer must implement an exposure control plan for the worksite with details on employee protection measures

6. Bodily Fluids Bodily fluids that can be infectious include: Blood
Feces
Urine
Vomit
Respiratory secretion (nasal discharge)
Wound drainage from scrapes and cuts
Semen
Vaginal secretions

7. Human Immunodeficiency Virus (HIV)
An infectious agent that invades and disables a person’s immune system.
Infection is through HIV‑infected blood , infectious body fluids such as semen and vaginal fluid, or injection drug use (sharing of contaminated syringes)
There is no cure for HIV infection.
Many people who are HIV-positive do not have any symptoms of HIV infection for many years
HIV is an infectious agent that invades and disables a person’s immune system, the body’s natural defense against disease. The only way a person can become infected with HIV is through exposure to HIV‑infected blood or other infectious body fluids including semen and vaginal fluid or injection drug use (sharing of contaminated syringes and other injection equipment). Recipients of blood transfusions or organ donations can also be at risk. There is no cure for HIV infection.
Other body fluids and waste products-like feces, nasal fluid, saliva, sweat, tears, urine, or vomit-don’t contain enough HIV to infect you, unless they have blood mixed in them and you have significant and direct contact with them.
Sacramento County is listed in the top 10 counties for HIV and AIDS cases in California (http//

8. Symptoms
Most of the symptoms and illnesses of HIV disease come from opportunistic infections that attack the immune system (flu, respiratory or gastrointestinal infections)
Fever
Chills
Rash
Night sweats
Muscle aches
Sore throat
Fatigue
Swollen lymph nodes
Ulcers in the mouth

9. Community Resources
California HIV/AIDS Hotline CDC National HIV/AIDS Hotline English Spanish Free HIV and STD testing CARES st St. (near O Street) Sacramento, CA
There are many more resources online

10. Hepatitis B and C
Serious diseases caused by a virus that attacks the liver that can cause cirrhosis (scarring), liver cancer, liver failure, and death
Infection is through infected blood, sexual contact, sharing needles, syringes, drug-injection equipment, unsterile equipment, razors or toothbrushes. The virus can live on surfaces for several weeks.
A vaccine is available to prevent infection of Hepatitis B.
There is no vaccine for HIV/AIDS or Hepatitis C.
Both Hepatitis B and Hepatitis C can remain dormant and asymptomatic for many years in your body.
Hepatitis B is spread when blood, semen, or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus during activities such as:
Sex with an infected partner, Sharing needles, syringes, or other drug-injection equipment
Sharing items such as razors or toothbrushes with an infected person, Direct contact with the blood or open sores of an infected person
Exposure to blood from needlesticks or other sharp instruments
Have participants sign Hepatitis B waiver. The CDC recommends a three series vaccination for Hep B
The CDC now recommends that you get tested for Hepatitis C if you are born between Baby boomers have a high rate of Hepatitis C.

11. Symptoms Symptoms of acute Hepatitis B, if they appear, can include:
Fever
Fatigue
Loss of appetite
Nausea
Vomiting
Abdominal pain
Dark urine
Clay-colored bowel movements
Joint pain
Jaundice (yellow color in the skin or the eyes)
On average, symptoms appear 90 days (or 3 months) after exposure, but they can appear any time between 6 weeks and 6 months after exposure.

12. Resources
Additional information about HIV/AIDS and Hepatitis can be found at:

13. Preventing Transmission
Thorough hand-washing is the single most important factor in preventing the spread of infectious diseases.
All staff members and students should wash hands regularly
Teachers should teach students to wash hands as part of routine hygienic practice and allow time for hand washing before eating

14. When To Wash Before and after administering first aid
After removing disposable gloves
Before preparing food, before and after eating
After using the restroom
When hands are visibly dirty or after contact with contaminated body fluids (blood, saliva, vomit, feces, urine, semen, menstrual flow, wound drainage/dressings, nasal discharge, etc.)
After touching or caring for students, especially those with nose, mouth or other discharges

15. Handwashing OSHA recommends the following steps:
Wet hands with warm running water and apply soap from a dispenser.
Scrub hands for a minimum of 15 seconds, paying special attention to fingertips and nails
Rinse well under running water with water draining from wrist to fingertips.
Leave water running.
Dry hands with a paper towel and then turn off the water with paper towel.

16. Gloves WEAR disposable single-use gloves whenever you:
Anticipate contact with blood or other body fluids
Touch any body fluids, particularly blood
Examine the mouth or assist with dental care
Come in physical contact with anyone who has open cuts, lesions, etc.
Handle emergencies and regular care
Gloves should be standard components of first-aid supplies and readily accessible for all
Wear gloves when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, non-intact skin, or potentially contamination could occur

17. When should gloves be changed?
OSHA recommends replacement of disposable gloves as soon as practical after they have become contaminated, or as soon as feasible if they are torn, punctured, or their ability to function as a barrier is compromised.
Hands must be washed after the removal of gloves.

18. CPR and First Aid Modifications
Wear disposable gloves to avoid direct contact with skin and bodily fluids
Wash hands immediately after contact with injured person and removal of gloves
Use a CPR device that prevents backflow of fluids from victims mouth

19. Cleanup and Disposal of Soiled Materials
Wear disposable gloves or reusable utility gloves
Place all soiled materials into containers or bags marked biohazard, according to the American Red Cross
Place all needles or sharp objects in special puncture- proof containers
Use EPA-registered disinfectants according to the manufacture’s instructions
Wear disposable gloves or reusable utility gloves for cleaning the environment or contaminated equipment
Place all soiled tissues, pads, gauze bandages, towels, etc., into a plastic bag and tie or seal the bag. Place it in a second plastic bag labeled as biohazard material, according to the American Red Cross. Biohazard waste cannot be disposed of in the dumpster and will need to be picked up by Health Services
Place all needles or sharp objects in special puncture-proof containers. Needles should not be bent, broken, or recapped
Use EPA-registered disinfectants that have microbiocidal (i.e., killing) activity against the pathogens most likely to contaminate the patient-care environment. Use in accordance with manufacturer’s instructions

20. SCUSD Exposure Control Plan
What should I do if exposed to body fluids (e.g. needlestick, splash, human bite, or human scratch)?
Clean injury with soap and water immediately; however, clean only with water on mucous membranes (eyes and mouth).
Notify your supervisor right away. Complete incident report.
Obtain any needed medical treatments, which may include vaccinations.
A copy of the Exposure Control plan is available for review at every school site and program office
Flush eyes and mouth with plain water
Supervisor or designated employee will report exposure incident to appropriate parties

21. References http://www.cdph.ca.gov/Pages/DEFAULT.aspx
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Last Updated 9/2/12