Presentation on theme: "Montgomery County Fire & Rescue Training Academy"— Presentation transcript:
1Montgomery County Fire & Rescue Training Academy Infection ControlThis is a self running show, you can not advance the show prematurelyMontgomery County Fire & Rescue Training Academy
2May or may not be contagious INFECTIOUS DISEASEA disease caused by the growth of disease causing microorganisms in the body.May or may not be contagious
3Four Types of Infectious Agents BacteriaVirusFungusParasites
4Smaller than red blood cells BacteriaSmaller than red blood cellsLive on their own, outside body cellsAntibiotics usually effective
5Herpes Simplex Hard to kill without harming healthy cells VIRUSSmaller than bacteriaMust penetrate and inhabit body cells to surviveHerpes SimplexHard to kill without harming healthy cellsSolution: ImmunizationMeasles
6Basically, the ONLY way to prevent viral infection VIRUSHerpes Zoster (Shingles)Immunization prevents a virus from entering the body cellsBasically, the ONLY way to prevent viral infection
20May take years to develop AIDSLate stage HIV disease, when opportunistic diseases developMay take years to develop
21ROUTE OF INFECTION HIV is a blood borne disease and: Semen, Cervicovaginal Fluid, Breast MilkSaliva has not been discounted or proven, but the HIV virus is found in it, although in small amounts.HIV infected blood has approximately 1 thousand viral particles per milliliter (ml.).
22INCUBATION PERIODDisease may develop in a matter of months or take several years.Antibodies usually detected by a blood test 2 weeks to 3 months after infection.May develop later in a small percentage of persons
23Illness, disability, and except in rare instances, DEATH! Prognosis:HIV/AIDS has become more manageable.It is a chronic disease for many people, but still has no definite cure or vaccineIllness, disability, and except in rare instances, DEATH!
24Now Hepatitis D, E, F & G Hepatitis Type A (HAV) Type B (HBV) Type C (HCV)Now Hepatitis D, E, F & G
25Hepatitis type A Highly contagious Usually transmitted via the fecal - oral routeOutbreaks of type A hepatitis often occur after people have eaten seafood that came from contaminated water.Common exposures occur in care facilities such as convalescent / nursing homes, mental institutions, day care centers and schools
26Incubation 15 to 50 days, depending on dose Average of 28 to 30 days Hepatitis type AIncubation15 to 50 days, depending on doseAverage of 28 to 30 days
27PROGNOSIS Hepatitis type A In most patients with HAV, liver cells eventually regenerate with little or no residual damage.Patients usually recover readily, with a life-long immunity to hepatitis type A, but not type B or type COld age & serious medical conditions (CHF, severe anemia, diabetes) make complications more likely.
28Description: HEPATITIS B A generalized inflammation of the liver caused by HBV that attacks and destroys liver cells.Description:
29HIGH-RISK PATIENTS Homosexual Males Users of Injectable Drugs Sexually Promiscuous (Multiple Partners)Prostitutes (sex for money or drugs)(homosexual and/or heterosexual)Babies born/breast feeding HBV motherNOTE: Some blood bank statistics report as many as 80% of homosexual males have been exposed to HBV
30Route of Infection:Classified as a blood borne disease, considered to be spread by contact with body fluids such as:BloodSalivaSemenVaginal FluidNote: HBV has approximately 1 billion viral particles per milliliter of blood, making HBV much more infectious than HIV and more difficult to kill on surfaces
31RECOMBIVAX VACCINEAvailable to all Montgomery County Fire & Rescue personnel, career and volunteer, through Fire Rescue Occupational Medical Services (FROMS) at no charge.
32with the average being 60-90 days. INCUBATION PERIOD:days[6-weeks to 6-months]with the average being days.
33PROGNOSIS:If detected early, prognosis is good. Although not usually fatal, it causes many liver diseases, such as cirrhosis and causes up to 80% of all liver cancer.Despite the fact that Hepatitis B is curable, it still causes about 200 deaths to HEALTHCARE WORKERS each year.
34Hepatitis C (HCV)Thought to be leading cause of hepatitis resulting from blood transfusions.NOT transmitted efficiently by sexual contactPrimarily a BLOODBORNE disease:Single needle stick can contaminateGreater likelihood of becoming a chronic carrier of HCV after infection.No current vaccineImmune globulin (IG) following exposure to HCV provides temporary, passive immunity.
35Transmitted By Mosquitoes West Nile VirusaBloodborne DiseaseTransmitted By Mosquitoes
38A bacterial infection that infects via the respiratory system TBUsually settles in the lower 2/3 of the lungs, where ventilation (exchange) is minimal.May spread to lymph nodes and other areas: brain, meninges, kidneys, adrenal glands, stomach, intestines, peritoneum and bones.
39High-Risk Persons Recent Immigrants Persons living in overcrowded / poverty conditions (homeless).Persons with low immunityHIV, Cancer, Long term steroid use, ElderlyAlcohol/Drug abusers
40Long-term care facility residents Close contact of TB patients High-Risk PersonsHIV Infected personsCorrectional InmatesLong-term care facility residentsClose contact of TB patientsSubstance Abusers
41High-Risk PersonsForeign-born individuals from countries with high incidence of TBHealth-care workers providing care to high-risk groupsPersons with previous Hx of TBPeople in Poverty: Crowded conditions, poor sanitation, poor nutrition
42Multi-Drug Resistant TB MDR-TBMulti-Drug Resistant TBUsually found only in high-density population areasCommon in DC, New York
43PROGNOSIS:After several weeks, otherwise healthy patients may develop a specific immunity, encapsulating the TB bacteria in granular tumors.These granulomas usually remain dormant for life, but are capable of producing the disease again at any time.If untreated, 8-20% of TB patients will develop serious diseases.
44Route of Infection:Droplet infection, transmitted by inhaling droplets from infected carrier by coughing, sneezing, or talking
45EMERGENCY CARE: A-B-C, O2 as needed NIOSH approved face masks for all EMS personnelDisposable surgical masks on:Patient, unless on O2Family members riding in the ambulanceNotify hospital of potential TB patient so they may prepare respiratory isolation.Ventilate back of ambulance by opening windowsTB Bacillus is very sensitive to light and air.
47DESCRIPTION:Inflammation of the membranes of the brain and spinal cord (meninges). Meningitis may be caused byBacteriaVirusOther organism that reaches the meninges by:BloodstreamLymphatic SystemTrauma (open wounds)From adjacent sinuses
48Patients at High-Risk Persons in overcrowded / poor living conditions HomelessSchools & CollegesInstitutionsMilitary BarracksPersons with low immunityHIV, Cancer, Long term use of steroids
49VERY SERIOUS IF:Petechiae (small, purple, spider-like hemorrhage spots on skin)Signs of InfectionChillsLow Or Dropping B/PRapid, Shallow RespirationsRapid PulsePurpura - purple spots that don’t turnwhite when pressed
50Route of Infection DROPLET Transmitted by inhaling droplets from coughing, sneezing or talking by the infected carrierSaliva Exchange
51Prognosis: Favorable with PROMPT diagnosis & treatment May leave long term neurological disorders if diagnosis and/or treatment are delayed.Potentially fatalMost serious inChildren (especially neonates)Elderly
52EMERGENCY CARE: A-B-C, O2 as needed NIOSH approved face masks for all F/R personnelDisposable surgical masks on:Patient, unless on O2Family members riding in the ambulanceNotify hospital of potential meningitis patient so they may prepare respiratory isolation.Ventilate back of ambulance by opening windows
55Body Substance Isolation Eliminates the Means of Entry InfectiousAgentSusceptibleHostReservoirMeans ofEntryMeans ofExitMode ofTransmission
56Body Substance Isolation Consider ANY patient’s blood or body fluid to be infectiousGLOVES : All fire/Rescue personnel MUST don appropriate protective gloves PRIOR to arrival at the scene of any EMS incidentAnytime you could possibly contact body fluidsDuring extrications, wear under heavy glovesWhile decontaminating &/or disinfecting
57MASKSWear in any situation in which blood or body fluids could be splashed in your face, or droplet infection is suspected.With a potential or known TB or meningitis patient, put a surgical mask on the patient.Mouth-to-mouth ventilations should not be performed, rescuer should use a pocket mask with a one-way valve
58EYE PROTECTIONWear any time blood or body fluids could be splashed in your eyes, such as active bleeding, vomiting or mentally disturbed patients (spit)
59GOWNSIndicated for situations such as childbirth or uncontrolled bleedingBlood-soiled gowns and/or other contaminated clothing is considered infectious.
60PROTECT BROKEN SKINCuts, abrasions, insect bites, etc. should be protected with a Band-Aid or a dressing.
61SHARPSIV needles, etc. are to be placed in a sharpe-safe container as soon as possibleNEVER leave on seat, litter or squad benchNEVER leave ANY contaminated materials or sharps at the scene or patient's residenceNEVER recap a used needle: put it in a sharps container.
62WASH YOUR HANDS !!!With disinfectant or anti-bacterial soap as soon as possible after every call.At the hospitalAfter handling items soiled with blood or body fluidsWash your hands when you take the gloves off
63Cleaning/Decontamination Procedures All non-disposable equipment used in patient care should be cleaned after each useAny equipment in contact with body fluids needs to be cleaned and disinfectedWear gloves and other protective devices as neededClean with detergent, etc. To remove dirt, blood, etc. You cannot disinfect a surface that is dirty
64Cleaning & Decontamination After cleaning, DISINFECT the equipment by using one or more of the following agents:A freshly mixed solution of 1 part bleach to 9 parts of waterFor non-metallic surfacesEspecially effective on fresh (non-dry) blood spillsContact time: minutes for high level disinfection, followed by clear water rinse & air dry
65Cleaning & Decontamination Disinfectant Soaps:May be used on most equipment where a high level disinfection is not necessary70 % Isopropyl alcohol:Contact time : 5-30 minutesIs NOT EFFECTIVE in presence of blood or dirtGood for use on skin, metals, and electrical equipment3 % Hydrogen PeroxideNot recommended for high-level disinfectionGood for removing blood on fabrics
66DISPOSABLE ITEMSAll sharps MUST BE transported and disposed of in a approved Sharps container………ONLY!
67DISPOSABLE ITEMSItems such as blood soaked sheets should be placed in a red BIOHAZARD impervious plastic bag & transported to the hospital with the patient.DO NOT throw the sheets in the hamperEach station must have an approved bio-hazard waste container. They are disposed of by an approved bio-hazard contractor
69WHAT IS NOT A PERCUTANEOUS EXPOSURE ? Blood or body fluids on equipmentBlood or body fluids on clothing with intact skin underneathBlood or body fluids on intact skin unless it is a LARGE quantity of blood & a prolonged exposure (i.e. greater than 20 mins)BLOODBORNE diseases CANNOT be transmitted by talking to or touching an infected person
70EXPOSURE PROCEDURE Immediate Self-Care: Percutaneous Wipe off excess blood from skin and scrub area with soap & water or antiseptic hand cleaner for 5-10 minutes.If the wound is bleeding, allow it to bleed to remove any contaminants.If soap & water are not immediately available apply your issued Antiseptic Handwash from your fanny pack until proper disinfecting measures can be taken.
71EXPOSURE PROCEDURE Immediate Self-Care: Mucocutaneous Flush eye(s) thoroughly for 15 minutes and/or rinse mouth with saline or water.As soon as patient care allows, or upon arrival at the hospital, wash your hands and the wound thoroughly.Wash face as necessary.Have emergency department physician assess and provide treatment for wound as needed.
72EXPOSURE PROCEDURE Immediate Self-Care Access the DRFS-STP Infectious Disease web site and click on “Exposure” for the current, complete exposure procedure.
73FOLLOW UP PROCEDURE Notify your Supervisor immediately Document the circumstances concerning the exposure.Career personnel must follow Policy & Procedure #807.If you were not on the transporting unit, regardless of the type of exposure, report to the hospital ED for the appropriate treatment.
74FOLLOW UP PROCEDUREFor both Career and Volunteer personnel: notify Fire & Rescue Occupational Medical Section (FROMS) at as soon as possible following an exposure.If it is determined that a patient that was treated has a communicable disease, the EMS section of the DFRS will notify the individuals departments.
75FOLLOW UP PROCEDUREIt is extremely important that the run sheets be left for all transported patients with the Emergency Department as well as properly listing all personnel that were involved with the incident on the MAIS report & FIREHOUSE!!!!
76QUESTIONS Contact the On-Duty EMS captain. Reference the Website on Quicklinks