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3500 Series > 3505 - Exposure Control Plan For Bloodborne Pathogens > Flashcards

3505 - Exposure Control Plan For Bloodborne Pathogens Flashcards

1
Q

Who shall be responsible for:

  1. Functioning as TFD’s Infectious Disease Control Officer (IDCO)
  2. Administering this plan
  3. Ensuring that this plan is implemented
  4. Reviewing all exposure incidents in accordance with the guidelines set forth in this document (IDCO or his/her designee)
  5. Consulting the Tacoma-Pierce County Health Department in the event that consent for source testing cannot be obtained (IDCO or his/her designee)
A

The Assistant Chief of EMS

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2
Q

Who shall be responsible for:

  1. Maintaining and updating this document annually to reflect changes in WISHA regulations and in technology that will help eliminate or reduce exposure to bloodborne pathogens
  2. Soliciting input from TFD personnel on the identification, evaluation, and selection of effective engineering controls, including safer medical devices
  3. Documenting in each update, TFD’s consideration and implementation of appropriate commercially available and effective safe devices
  4. Providing initial and annual exposure control training to TFD Personnel in accordance with the guidelines set forth in this document
  5. Maintaining the employee medical records required by this plan
A

The EMS Training Program Manager

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3
Q

Who shall be responsible for maintaining an adequate supply of PPE, biohazard bags and station boxes at their stations.

A

Station Captains, Captain Paramedics, and Paramedic Supervisors

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4
Q

Who shall be responsible for monitoring on-scene personnel’s use of PPE in accordance with this document.

A

Company Officers and In-Charge Paramedics

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5
Q

Who shall be responsible for:

  1. Providing guidance when contacted by personnel following an exposure incident
  2. Establishing and posting at their stations a cleaning and decontamination schedule in accordance with the guidelines set forth in this document
  3. In March of each year, evaluating TFD’s engineering controls and exempted tasks or devices
  4. Providing input to the EMS Training Program Manager for updates
A

Captain Paramedics and Paramedic Supervisors

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6
Q

Who shall be responsible for:

  1. Assisting personnel with operation of the commercial washer for laundering contaminated uniform items
  2. Placing items in the dryer when decontaminating/laundering is complete
A

Station 4 personnel

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7
Q

Who shall be responsible for handling the routine washing and decontamination (OPIM) of turnout gear in accordance with TFD Policy 5016.

A

Stations 8 and 9 personnel

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8
Q

A specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee’s duties. Examples of non-intact skin include skin with dermatitis, hangnails, cuts, abrasions, chafing, and acne.

A

Exposure incident.

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9
Q
  1. The following human body fluids: Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly
  2. contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids
  3. Any unfixed tissue or organ (other than intact skin) from a human (living or dead)
A

Other Potentially Infectious Materials (OPIM).

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10
Q

Universal precautions.

A

An approach to infection control. According to the concept of universal precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.

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11
Q

The following ARE considered exposures:

A

a. Stuck or cut by a contaminated needle or other sharp
b. Blood or body fluids (semen, vaginal secretions; CSF, synovial, pleural, pericardial, amniotic, peritoneal fluids; any fluid with visible blood) sprayed or splashed into the eyes, nose or mouth, or on open cuts or sores
c. Human bite with broken skin

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12
Q

Universal Precautions

  1. Universal precautions shall be observed by TFD personnel in order to:
  2. All blood or OPIM will be considered:
  3. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be:
A
  1. prevent contact with blood or other potentially infectious material.
  2. infectious regardless of the perceived health status of the source individual or patient population.
  3. considered potentially infectious materials.
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13
Q
  1. Facilities and supplies for employee hygiene shall be maintained as follows:
    a. Hand washing facilities and alcohol-based hand cleaners shall be available at:
    b. Shower facilities shall be available at:
    c. Sterile water, hydrogen peroxide, alcohol-based hand cleansers, and paper or clean cloth towels shall be available:
A

a. at fire stations and other TFD facilities
b. fire stations
c. on TFD apparatus

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14
Q

Hand and body washing

 a. Latex and Nitrile Gloves provide a barrier, but are not:
 b. When hand washing facilities are readily available, such as at the hospital or fire station, employees shall wash hands and other contaminated skin after:
 c. When hand washing facilities are not readily available, such as on an incident scene, employees shall use\_\_\_\_\_\_\_\_\_\_\_ as an interim measure, then wash with soap and warm running water as soon as feasible
A

a. completely impermeable
i. Consequently, hand washing is required after the removal of gloves or other PPE
b. the removal of personal protective gloves
c. an alcohol based hand cleaner

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15
Q

Personal Protective Equipment (PPE)

  1. All PPE used by TFD will be provided without cost to employees.
  2. PPE will be chosen based on:
  3. The PPE will be considered appropriate only if it __________blood or other potentially infectious materials to pass through or reach the employees’ clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time, which the protective equipment will be used.
  4. Employees will receive training on the appropriate use of PPE provided for specific tasks.
  5. If required PPE is not available, contact____________who will insure that supplies are replenished.
  6. For instructions on the use of PPE for specific tasks that may expose workers to blood or other potentially infectious material, contact:
  7. The following personal protective equipment is provided for personnel:
A
  1. the anticipated exposure to blood or other potentially infectious materials.
  2. does not permit
  3. the 40-hour Paramedic Supervisor
  4. the Paramedic Training Program Manager.
  5. Gloves, Gown, Mask, Eyewear
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16
Q

Gloves

  1. Gloves shall be worn where __________________hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes.
  2. Disposable gloves shall/shall not be worn while driving apparatus or vehicles.
  3. Disposable gloves shall/shall not be washed or decontaminated for re-use.
  4. Disposable gloves shall be ______________ when they become contaminated or as soon as possible if they are torn, punctured, or when their ability to function as a barrier is compromised.
A
  1. it is reasonable to anticipate that employees will have
  2. shall not
  3. shall not
  4. replaced as soon as practical
17
Q

Laundry

  1. All turnouts contaminated with bloodborne pathogens (OPIM) shall be decontaminated/laundered at:
  2. All uniform items contaminated with bloodborne pathogens (OPIM) shall be decontaminated/laundered at:
  3. Uniform items include Nomex pants, shirts, blue weather coats, etc.
  4. Laundering contaminated turnouts and uniforms at home or other facility (e.g., public laundry facility) is:
A
  1. Stations 8 or 9, in accordance with TFD Policy 5016.
  2. Station 4.
  3. prohibited.
18
Q

Signs and Labels

  1. Containers of regulated waste and other containers used to store or transport blood or infectious materials shall:
  2. The label will be:
A
  1. have warning labels.

2. a fluorescent orange or orange-red biohazard label as illustrated with lettering in a contrasting color.

19
Q

Hepatitis B Vaccine
1. All employees shall be_________ the hepatitis B vaccine series at no cost to the employee within 10 days of initial assignment unless:
a - d
2. ________ will provide employees with information on hepatitis B vaccinations addressing its safety, benefits, efficacy, methods of administration and availability.
3. All occupationally exposed employees are __________ to receive the hepatitis B (HB) vaccination series and post-vaccination antibody testing.
a. If an employee chooses to decline HB vaccination, then the employee must ____________
b. Employees who decline may _________

A
  1. offered
    a. The employee has previously received the series
    b. Antibody testing reveals that the employee is immune
    c. Medical reasons prevent taking the vaccination; or
    d. The employee chooses not to participate
  2. The EMS division
  3. strongly encouraged
    a. sign the declination statement a copy of which will be kept in the employee’s confidential medical record
    b. request and obtain the vaccination at a later date at no cost
20
Q

Post-Exposure Management

 a. Dirty needlesticks, blood/OPIM in the face, eyes, mouth, or on non- intact skin, and human bites that break the skin shall be considered:
 b. Wounds and skin sites that have been in contact with blood or OPIM should be:
 c. Mucous membranes should be: 
 d. \_\_\_\_\_\_\_\_\_\_\_ will provide a confidential medical evaluation to all exposed employees 
      i. It is important that employees receive a prompt medical evaluation because HBIG, hepatitis B vaccine, and HIV post-exposure prophylaxis (PEP) are most likely to be effective if administered as soon after exposure as possible 
 e. If the employee does not give consent for HIV serological testing during collection of blood for baseline testing, the IDCO or his/her designee shall request that the lab preserve the baseline blood sample for at least \_\_\_\_\_\_\_\_
      i. If the exposed employee elects to have the baseline sample tested during this waiting period, testing shall be performed as soon as feasible
A

a. substantial exposures
b. washed with soap and water
c. flushed with water
d. Allenmore Hospital
e. 90 days

21
Q

Source Testing

a. The person (if known) whose blood or body fluid is the source of an exposure will be tested for _________as soon as feasible
b. Information from the medical record at the time of the exposure (e.g., laboratory test results, admitting diagnosis, or previous medical history) or the source person will be gathered to help to confirm or exclude
c. HBV, HCV and/or HIV testing shall be performed if the infection status of the source person is unknown (true or false?)
d. Results of source testing shall be provided to:
e. The IDCO or his/her designee will consult with___________ in the event that consent for source testing cannot be obtained

A

a. HBV, HCV, and HIV infection
i. When it is already known the source is infected with HBV, HCV or HIV then testing need not be repeated
b. bloodborne infection
c. True
d. the employee, and the employee shall be informed of all applicable laws and regulations concerning disclosure of the identity and infectious status of the source
e. the Health Department

22
Q

Review of Exposure Incidents

a. The circumstances of all exposure incidents will be reviewed to determine the following: 1-4
b. If it is determined that revisions need to be made, the plan administrator will ensure that appropriate changes are made to this exposure control plan
c. Documentation of this evaluation should accompany

A

a. i. Why the exposure incident occurred
ii. Type and brand of device involved
iii. If procedures were being followed
iv. If procedures, protocols, and/or training need to be revised
c. the exposure report

23
Q

Who is responsible for maintenance of the required medical records.

A

The EMS Paramedic Training Program Manager

24
Q

Employee medical records shall be maintained for at least:

A

the duration of employment plus 30 years.

25
Q

Employee medical records will be provided upon request of the employee or to anyone having written consent of the employee within:

A

15 working days.

26
Q

Record Keeping—Sharps Injury Log

  1. __________ is responsible for maintenance of the confidential Sharps Injury Log on OSHA 300 or equivalent log.
  2. The Sharps Injury Log will be maintained for:
  3. The Sharps Injury Log shall contain, at a minimum: a-d
A
  1. The City Risk Manager
  2. five years.
  3. a. The routes of exposure
    b. An explanation of and circumstance under which the incident occurred
    c. The type and brand of device involved in the incident
    d. The department or work area where the exposure occurred
27
Q

6.0 PROCEDURE FOR POST-EXPOSURE TREATMENT AND REPORTING
Immediate on-scene treatment of exposed personnel
1. Eyes:
2. Face:
3. Mouth:
4. Skin:
5. Dirty needlestick:

A
  1. Rinse with running water for at least five minutes. Be sure to remove contact lenses.
  2. Blow nose and wash face with warm, soapy water.
  3. Spit discreetly then rinse mouth with 50:50 Hydrogen Peroxide and water mixture.
  4. Wash any affected skin with warm, soapy water.
  5. Milk site immediately then clean with betadine or soap and water.
28
Q

6.0 PROCEDURE FOR POST-EXPOSURE TREATMENT AND REPORTING

Immediate on-scene notification by exposed personnel

A
  1. Tell the Officer and/or In-charge Firefighter/Paramedic about the exposure.
  2. Ask on-scene paramedic caring for the source patient to draw source patient’s blood.
29
Q

6.0 PROCEDURE FOR POST-EXPOSURE TREATMENT AND REPORTING

Source blood draw on scene by paramedic

A
  1. If the exposure involved a dirty needlestick, a human bite that broke the skin or blood/OPIM in the eye or on non-intact skin, perform a blood draw on the source patient.
  2. Fill two gold top tubes.
  3. Label the filled tubes as follows:
    a. SP for “exposed person’s name”
    b. Date and time of blood draw
    c. Name of paramedic performing the blood draw
  4. Give the filled tubes to the exposed personnel.
  5. Request source patient’s consent to test blood for bloodborne pathogens (HIV, hepatitis C antibody, and hepatitis B surface antigen).
  6. Have the source patient or family member sign the Source Patient Consent Form for Antibody Blood Test.
  7. Document the consent on the source patient’s EMIR.
  8. Have a witness sign also.
  9. If the source patient is not capable of consenting (e.g., unconscious or dead), request permission from the source patient’s family.
  10. If no blood was drawn on scene, inform the Emergency Department staff and request that the source patient’s blood be drawn and tested.
  11. If the source patient was taken to a receiving center other than Allenmore Hospital, ask the Allenmore Emergency Department physician to contact the other receiving center and request that the physician there get permission for the blood draw on the source patient.
30
Q

Exposed personnel notification of Paramedic Supervisor or Paramedic Captain following on-scene treatment

  1. Contact ___________ and inform him/her that an exposure has occurred.
    a. If not available, contact the Administrative Paramedic Supervisor
  2. Advise _________ of the steps already taken.
  3. Request guidance from as necessary.
A
  1. on-shift Paramedic Supervisor or Captain Paramedic
  2. Paramedic Supervisor or Captain Paramedic
  3. Paramedic Supervisor or Captain Paramedic
31
Q

Hospital evaluation of exposed personnel

  1. Report to:
  2. Be sure to be admitted _________ in the Emergency Department.
  3. Provide the ________ to the Emergency Department personnel if permission was obtained from the source patient or his/her family.
  4. Keep _______ consent form.
  5. Give a copy to __________
  6. Follow the recommendations of ___________
  7. Be sure to obtain the _________ before leaving the Emergency Department.
  8. MultiCare Employee Health will follow up by phone within about ________ to provide the results of the source patient’s blood tests.
A
  1. Allenmore Hospital.
  2. as a patient
  3. source patient’s consent form
  4. original signed
  5. Emergency Department personnel.
  6. the Emergency Department physician.
  7. discharge summary
  8. five days
32
Q

No consent to conduct tests from source patient

  1. If the patient expired before giving consent for testing and there is no family available to give permission, the source patient’s blood _______ at the Allenmore Hospital lab for hepatitis B, hepatitis C and HIV.
  2. If you have obtained a blood sample, but the source patient refuses to give consent to test his/her blood:
A
  1. can be tested anonymously

2. notify the IDCO immediately so that a court order for testing can be obtained through the Health Department.

33
Q

Required reports to be completed by exposed personnel

  1. Complete:
  2. Ask supervisor to complete:
  3. If applicable, complete:
  4. If you were evaluated by a physician for the exposure complete:
  5. Self Insurer ________.
  6. Refer to _________ for additional reporting requirements that may apply.
  7. Before going off duty route completed reports to:
  8. Before going off duty, phone __________ and leave a voice message about the exposure incident.
    a. Provide incident number and information about what treatment or testing was done
A
  1. Exposure Report (HRE 003).
  2. Supervisor’s Report of Employee’s Occupational Injury or Illness (HRE 002).
  3. “Source Patient Consent Form for Antibody Blood Test.”
  4. SIF-2,
  5. Accident Report
  6. TFD Safety Policy 5013
  7. the Assistant Chief, EMS.
  8. the Medical Services Officer or Assistant Chief of EMS
34
Q

PROCEDURE FOR LAUNDERING CONTAMINATED CLOTHING Personnel with uniforms contaminated by OPIM shall:

  1. Handle contaminated laundry:
  2. Use ____________to empty all pockets and/or during any other time contaminated laundry is handled or sorted.
  3. Place uniform items __________and label with owner’s name and station assignment before transporting to the laundry facility.
  4. Take the items to:
  5. Items shall be washed______ in the commercial washing machine at Station 4 as follows:
    a. Water temperature at
    b. Run one complete wash cycle using:
    c. Run a second complete wash cycle using:
    d. If you had a lice exposure, be sure items:
  6. For additional guidance, follow instructions ____________regarding operation of the washer as necessary.
  7. Keep a _________for use in the event of contamination.
  8. Pick up items when laundering is complete.
A
  1. as little as possible, with minimal agitation.
  2. the appropriate level of PPE (gloves, goggles, etc.)
  3. in a red biohazard bag
  4. Station 4.
    a. Do not route through a messenger
  5. TWICE
    a. 140 degrees
    b. one cup of Lysol and NO SOAP
    c. one cup of liquid soap
    i. Do not use powdered soap
    d. are dried completely in the dryer
  6. posted on the commercial washer and/or consult Station 4 personnel
  7. spare uniform available
35
Q

Personnel with turnouts contaminated by OPIM shall:

  1. Handle contaminated laundry as little as possible, with minimal agitation.
  2. Use the appropriate level of PPE (gloves, goggles, etc.) to empty all pockets, separate shell and liners and/or during any other time contaminated laundry is handled or sorted.
  3. Place items in a red biohazard bag labeled with owner’s name and station assignment before transporting them.
  4. Take the items to:
    a. Do not route through a messenger
  5. Consult with _____________ regarding issuing of spare gear.
    a. Items taken to Station 13 will be laundered at:
A
  1. Station 8 or 13.
  2. Station 8 or 13 personnel
    a. Station 9

3500 Series (8 decks)

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