Welcome to the Communicable Disease Re-Certification for 2024

Why do we need to be retrained annually? 

Because the OSHA Standard (1910.1030 Bloodborne Pathogen) requires it. 

All of the material contained herein may be subject to placement on the final exam, which personnel must pass with at least an 80%. 

What is an Exposure Exactly?

Occupational Exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties. (OSHA)

Avoiding Exposure

The risk for exposure comes mostly from: 

• Patient care

• Cleaning or working with contaminated equipment or instruments 

• Cleaning or working on contaminated surfaces

Protection from exposure comes from:

• Treating all blood and body fluid as infectious

• Frequent handwashing

• Not eating or drinking during patient contact, while in work areas, or while cleaning. 

• Not recapping sharps

If Exposed, Follow Procedures in the Bloodborne Pathogens Exposure Checklist

• Take immediate action to minimize the exposure duration and/or quantity (see best practices)

• Notify a supervisor

• Seek immediate medical treatment at the ED or FROMS

• If after FROMS hours go to ED

• Notify On-Duty Safety Officer

• Notify EMS Duty Officer

• Complete a First Notice of Loss report

• Follow-up with FROMS

Exposure Best Practices

Intact Skin . . . 

• Wash with soap & water 

Needlestick, Cut or Non-Intact Skin . . . 

1. Wash with chlorhexadine soap & water or wash with soap & water 

2. Pour 3% Hydrogen Peroxide over exposed area. 

Mouth . . .

1. Spit

2. Rinse mouth with 3% hydrogen peroxide 

Eyes

1. Remove contact lenses

2. Rinse eyes with tap water or saline 

Safe Handling of Sharps

• Minimize distraction, always maintain focus on task 

• Keep fingers/hands away from point 

• Always engage the safety immediately after use! 

• Protect the people who handle your trash. Always dispose of contaminated sharps in "sharps" containers

Personal Protective Equipment 

• Gloves, shoe covers, face protection 

• Change compromised PPE immediately 

• Gloves with tears or holes will not protect you 

• Wear double gloves for maximum protection

Discuss the following site-specific practices & procedures with a supervisor

• Types of PPE available at your location, including latex-free alternatives 

• Location(s) of PPE – Handling & Removal of PPE – Decontamination of PPE – Disposal of PPE

• Selection of appropriate PPE 

• Job tasks performed at your location – What types of PPE are necessary? Gloves, face shields, masks, safety goggles for splash protection * 

All blood exposures must be reported -- Discuss site specific method for reporting

A general explanation of the epidemiology and symptoms of bloodborne diseases:

• Bloodborne pathogens are viruses or infectious agents carried by human blood and body fluids. Examples include: HIV, HBV, HCV

• Firefighters and EMTs  are at risk for exposure to bloodborne pathogens each shift but mostly when involved in patient contact. 

• Bloodborne pathogens cause disease when they enter the body, usually through cuts, punctures, other breaks in the skin, or contact with mucous membranes (eyes, nose, mouth). 

• The mechanism of entry can include:

  • Direct Transmission 

  • Cut/Puncture (needlestick, broken glass) 

  • Splash onto open sore (broken skin) or mucous membrane (eyes, nose, mouth)

  • Indirect Transmission (touching a contaminated surface and transferring the infectious material to your eyes, mouth or an open sore•

Infectious vs. Communicable

The two terms are frequently used interchangeably in our business, but it is important to note that in reference to many specific diseases there may be a difference.

According to the CDC, an infectious disease is a disease caused by a microorganism and therefore potentially infinitely transferable to new individuals.  It may or may not be communicable.  An example of a non-communicable disease is disease caused by toxins from food poisoning or infection caused by toxins in the environment, such as tetanus.  A communicable disease is an infectious disease that is contagious and which can be transmitted from one source to another by infectious bacteria or viral organisms.

A bit more on handwashing, hand sanitizer, and soap . . . 

So, we're telling you to wash your hands frequently, but you have so many questions about the whole thing, like: Why is it so important to wash your hands?  What's the most effective way to wash your hands?  When is it okay to use hand sanitizer?  Which is better, hand sanitizer or soap?  What type of hand sanitizer should I use?  Thankfully, the CDC does a great job of pulling research and answering all these questions for us.  Here are the highlights of the latest research concerning handwashing:

• Germs get onto hands after people use the toilet, change diapers, handle raw meats, touch infected surfaces-wash your hands

• 1 gram of human feces (the weight of a paper clip) can contain 1 trillion germs-wash your hands

• Animal and human feces can spread many germs like norovirus, e. coli, salmonella, and adenovirus, which are transported on our hands-wash your hands

• Using soap and water is the best way to reduce the number of  microbes in most situations

• Use an alcohol-based hand sanitizer with at least 60% alcohol when soap and water aren't available

• Non-alcohol based hand sanitizers are not as effective as alcohol-based sanitizers

An FDA Q&A on hand sanitizer, soap, and COVID-19 can be found here.

A quick article on how soap kills the COVID-19 virus can be found here.

For more on why you should wash your hands, including interesting statistics, please click here.

For more on when and how to wash your hands, please click here.

For more on hand sanitizer, including explanations and research, please click here.

See the World Health Organization (WHO) video on handwashing below.

Under FCGO 20-03, MCFRS publishes and maintains a series of documents and checklists that serve as guidelines for infection control, hazard avoidance, personal protection, and decontamination procedures.  All personnel must be well-versed and practiced in the content of these documents and procedures.

Personnel should view the MCFRS Infection Control Plan here.

Personnel should view the Infection Control and Hazard Exposure Reduction Manual and attachments here.

Personal Protective Equipment General Guidelines

Our approach to PPE  is that we have a baseline of PPE and we increase the amount and nature of PPE as necessary based on the risk assessment of operating personnel.  This risk assessment (scene size up) should consider all available information such as:

• • CAD remarks

  • Patient history

  • Environmental clues such as evidence of recent travel and evidence of recent illness

At the very least every patient contact will require medical gloves, eye protection, a surgical mask.  If there is any chance of splashing, splattering, or dripping from above of bodily fluids, then protection must be expanded.  The amount and type of protection used depends on the situation.  PPE should be placed/staged in areas where you'll need it, e.g. airway kits and airway stations should have face shields on hand. 

Decontamination General Guidelines

• Take quick action

  • Remove clothing, rinse affected areas, Redress, 

  • The faster you remove contaminants, the less time they have to find a way to infect you. 

• Plan the decontamination

  • Gather all the materials you will need and think about your work flow. 

    • What type of decontamination agent is best?

    • How much contact time does it require?

  • Try not to track contaminants into places where they were not before. 

  • Avoid splashing and other actions that might contaminate or expose you where you were not before.

  • Wear PPE. As the risk of splashing goes up, increase the amount of protection.

• Clean up gross material first.  If there is bulk debris it will prevent the decontamination fluid from reaching the surface. You want to kill the germs on the surfaces. 

• Dispose of dirty material in the appropriate containers.