1. Bloodborne Pathogens/Standard Precautions Training for School Personnel ETOWAH COUNTY SCHOOL SYSTEM

2. Introduction In an educational setting, the school system is required to identify the personnel whose job duties expose them to blood and potentially infectious body fluids. Not every educator is occupationally exposed to bloodborne pathogens while performing his or her job. However, it is important for everyone in an educational setting to understand the dangers of infection and the safety procedures to minimize risk. School employees have a low to moderate risk of exposure to bloodborne pathogens. Employees most at risk of exposure are: School Nurses Athletic Coaches Custodians Special Education Teachers and Paraprofessionals Regular Classroom Teachers

3. Hepatitis B Facts Hepatitis B (HBV) is a virus spread through blood and body fluids of an infected person. There is no cure for HBV. Symptoms include fever, jaundice, fatigue, abdominal pain, nausea, and vomiting. People infected with HBV may not know they are infected or may not have symptoms; however, they can still infect others. HBV can be prevented by receiving the Hepatitis B vaccine and taking appropriate safety precautions. The vaccine can also be started within 24 hours of exposure.

4. What is a Bloodborne Pathogen? Bloodborne pathogens are microorganisms carried by human blood and other body fluids. The three deadliest bloodborne diseases are Hepatitis B virus (HBV) Hepatitis C virus (HCV) Human immunodeficiency virus (HIV)

5. Hepatitis C Facts Hepatitis C (HCV) is also a virus spread through blood and body fluids of an infected person. Symptoms include jaundice, fatigue, loss of appetite, fever, diarrhea, and abdominal pain. Chronic liver disease caused by HCV is the #1 cause of liver transplants in the U.S. Many people infected with HCV may not know or do not have any symptoms. There is no vaccine for HCV.

6. Human Immunodeficiency Virus (HIV) HIV is a bloodborne infectious disease. HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). It weakens the body’s immune system leading to serious infections and diseases. An infected person can pass on the HIV infection before symptoms appear. Symptoms of HIV vary and may include weakness, fever and sore throat, headaches, nausea, diarrhea, thrush (a fungal infection of the mouth), weight loss, and swollen lymph glands. HIV is a fragile virus and will not survive for long outside the human body. AIDS is a fatal disease. There is no cure or vaccine available for HIV.

7. Transmission of Bloodborne Pathogens Transmission of a bloodborne pathogen can occur any time that body fluids containing blood from an infected person enters the body of someone else through broken skin (cuts, nicks, abrasions, dermatitis, and acne) or the mucous membranes of the mouth, eyes, or nose. Sweat, tears, saliva, vomit, urine, and feces are not considered to be potentially infectious unless visible blood is present. Indirect transmission occurs when you touch a contaminated object or surface and then transfer the infection to the mucous membranes or broken skin. Contaminated surfaces are a major cause of the spread of hepatitis. HBV can survive on environmental surfaces, dried and at room temperature, for at least one week.

8. Standard Precautions Standard precautions are practices and procedures that help prevent the transmission of bloodborne pathogens. All blood and body fluids should be treated as if they are infectious. Standard precautions should be used even when you think there is no risk involved. You may be a carrier of a BBP and not know it; using preventative measures protect your students and staff. The steps of standard precautions include: Hand hygiene Use of barrier techniques Cleaning and sanitizing Proper disposal techniques

9. Hand Hygiene Intact skin is your first defense against infection. Wet hands thoroughly under warm or tepid water. Dispense liquid soap (preferred to bar soap) into hands. Vigorously rub hands together for at least 15 seconds, paying particular attention to the nails, cuticles, spaces between the fingers, and under jewelry. IT IS THE FRICTION OF LATHERING THAT KILLS GERMS. Rinse hands thoroughly. Dry hands with a paper towel. Use a towel to turn off the water. Dispose of paper towel into a waste receptacle.

10. Hand Sanitizers Do not require water. Are an excellent alternative to handwashing when soap and water are not available and hands are not visibly soiled. Apply about ½ teaspoon to the palm of hand. Vigorously rub hands together covering all surfaces as in hand washing until hands are dry. Again it is the friction of drying alcohol that kills germs. Wash hands with soap and water as soon as you can.

11. Barrier Techniques/Personal Protective Equipment Safety devices or safeguards worn by employees to protect against environmental hazards Designed to reduce the risk of disease transmission Always wear gloves when you anticipate touching blood, bodily fluids, or contaminated surfaces Every Automatic External Defibrillator (AED) has an accessory pouch that includes gloves and a face shield. Sharps containers, red biohazard bags, utility gloves, goggles, aprons and gown are examples of PPE.

12. Gloves/PPE Disposable gloves should be used for provision of first aid or contact with any blood or other potentially infectious materials. Students should clean their own wounds if possible. Slip each hand into a clean glove without touching the inside of the glove except with the skin of your hand. Pull glove over the wrist as far as it will go to maximize coverage. Remove gloves by turning the glove inside out as it is pulled over the hand. During the removal of the second glove, avoid touching the outer surface by slipping the fingers of the ungloved hand under the glove and pulling it inside out as it is pulled over the hand. Dispose of used gloves in a waste container lined with a plastic bag. Do not wash or reuse gloves. Wash hands thoroughly using the proper procedure.

13. Sharps/Glass Protect yourself and others from sharp objects. If you have a needle or anything with a sharp point, dispose of it in the sharps container in the nurse’s office. Use a dustpan and broom for picking up broken glass and dispose of it in a puncture resistant container. NEVER use your hands. Never smash down trash in a garbage can with your hands or feet. Always carry trash away from your body.

14. Cleaning Up Call the custodian to clean up blood or body fluids on surfaces. They will use a germicidal cleaner which will kill bloodborne pathogens. A soiled bandage that is not dripping with blood or body fluid is not considered hazardous waste and may be disposed of in regular trash. Double bag all contaminated materials. Do not eat or drink in areas that may be contaminated. Make sure work surfaces, particularly any public counter, are kept clean using a disinfectant that kills germs.

15. When an Injury/Exposure Occurs Assess the severity of the situation calmly and quickly; approach the situation safely. Reassure the victim in order to keep them calm. Avoid being exposed to blood or bodily fluids yourself Use PPE ◦Notify the school nurse for assistance Administer first aid immediately. For an exposure, immediately wash the exposed area with soap and water, flush with water for at least 15 minutes. If eyes, nose, or mouth are exposed, flush with running water for at least 15 minutes. Report to your school nurse for medical care.

16. Resources for More Information Your School Nurse Centers for Disease Control and Prevention (http://www.cdc.gov)http://www.cdc.gov