INFECTIONS Flashcards
What is a fomite?
an object that is contaminated with a micro-organism
What is a high-traffic fomite?
things people are touching frequently (ex, doorknobs, tap handles, pens, cellphones, keyboard)
What is the chain of infection?
1) Infectious Agent
2) Reservoir
3) Portal of exit
4) Transmission
5) Portal of entry
6) Vulnerable host
What are the 4 types of infectious agents?
1) Virus
2) Bacteria
3) Fungus
4) Parasite
4 transmission routes
1) direct contact
2) indirect contact
3) droplets
4) airborne
Sidenote:
5) vectorborne (bites)
6) vehicle transmission (water, food, to multiple hosts)
Possibility of a micro-organism to grow is depent on (3):
1) virulence - ability to grow
2) invasiveness- ability to enter
3) pathogenicity- ability to cause disease
Examples of bacteria:
strep
ecoli
staph
tuberculosis
examples of virus:
HPV
HIV
HEP
examples of fungus:
gangrene
Candida
ringworm
athlete’s foot
examples of parasites:
tapeworm
fleas
lice
How long can Hep B survive on equipment?
a week or more
How long can HIV survive on a damp, warm surface?
several hours
How long can Hep A survive on a damp, warm surface?
months!
What is Hepatitis?
inflammation of the liver
What causes Hepatitis?
a virus (usually) also from toxins such as alcohol and medications (acetaminophen, etc)
Is Hepatitis communicable?
Viral, yes.
Hep contracted due to toxins, no.
Hepatitis B-
How is it transmitted?
Is there a cure? Is there a vaccine?
- transmitted through blood and secretions (body fluids)
- NO CURE
- Vaccine, yes.
Symptoms of Hepatitis B
Acute: jaundice, light colour stools, fatigue, joint pain, fever, nausea, stomach pain
Chronic: weakness, weightloss, confusion, loss of interest in sex, swollen stomach or ankles, poor blood clotting, small red spider-like blood vessels on skin (TCM symptoms of damp heat)
Symptoms of Hepatitis C
jaundice (20-30%)
fatigue (10-20%)
stomach pain, loss of appetite (10-20%)
Hepatitis C-
How is it transmitted?
Is there a cure?
Is there a vaccine?
- transmitted through blood
- no vaccine
- treatment available
Hepatitis A
how is it transmitted?
Is there a cure?
Is there a vaccine?
- transmitted by drinking/eating food/water contaminated with fecal matter
- transferred via feces, small risk of blood transfer
- both vaccine and treatment available
Symptoms of Hep A
diarrhea
How is HIV transmitted, what does it affect?
What kind of infections agent?
- transmitted via blood, some body secretions
- affects immune system
- virus
How is Tuberculosis transmitted? What kind of infectious agent?
- droplets, close and continued contact (spreads best in areas with poor ventilation)
- bacteria
How is Pneumonia transmitted?
What kind of infectious agent?
- droplets, etc
- can be bacteria (adults), virus (children), or fungus
Where do you report unknown skin infections to?
Communicable Disease Control (CDC)
List 2 types of interventions for infections
- gloves (nitrile, vinyl, latex)
- masks
What will your use of intervention depend on? (5)
- likelihood of exposure to blood and body fluids
- anxiety/stress level of patient
- health of patient
- immune status of practitioner
- clinical environment/ resources available
List some examples of when to wash your hands. (4)
- after taking off gloves
- after touching your eyes, mouth, nose
- after touching anything that might lead to cross-contamination
- after every client
- after handling food items
- after handling money/ phone for payment (fomites)
- after using phone, computer, electronics
- if hands are visibly soiled
List the steps of proper hand-washing. (7)
1) remove jewelry
2) turn on tap- warm water
3) apply liquid soap, enough for good lather
4) wash all surfaces of hands, nails, up to and including wrists, for 15 seconds
5) rinse with water
6) grab paper towel to dry hands
7) turn off tap with paper towel (and use paper towel to open door if necessary)
3 important points re:liquid hand sanitizer
- use for 30 seconds or until dry
- if using natural hand sanitizer, must be same % effectiveness as Purrel
- use hand lotion throughout day to make up for all the drying (cracks = open wounds)
What is used to clean skin/ swab?
- 70% isopropyl alcohol
higher % evaporates too quickly, is too harsh
Proper technique for swabbing skin? (2)
- single straight motion
- in circular direction, outward from the point
When to use (single-use) gloves? (5)
when you expect contact with:
- blood/ body fluids/ secretions/ pus
- mucous membranes
- undiagnosed rashes
- contact with broken skin
- if practitioner has HIV or Hep B (not patient)
What are the 3 glove materials, and which will you use?
- latex (no- too many allergies)
- vinyl (no- not very durable, rips easily)
- NITRILE (yes- less durable than latex, but more than vinyl, and less chance of allergies)
List 3 rules re: handling sharps.
- person pulling out the sharp should be the person to dispose of the sharp (no passing needles!)
- sharps should be opened in front of the patient, just before use
- open just as many as you need, or dispose of any extras (don’t keep leftovers open)
What must your Biohazard/sharps container have? (4)
- tight-fitting lid
- handle
- biohazard label
- warning line at 3/4 full
What must you have openly available to patients in clinic (to normalize it)?
- masks
- hand sanitizer
- tissues
- garbage disposal
3 tips/rules for treating patients with airborne infections:
- see them last
- both of you wear masks
- air out room afterwards, (fans, open windows)
What are the 4 Low-Level Disinfectants?
- Quaternary ammonium compounds
- chlorine bleach (1:500) (*cheapest! use gloves when applying)
- 3% isopropyl alcohol
- phenols (aka phenolics)
What don’t detergent wipes do?
don’t disinfect!
just clean
What to do to contact surfaces between patients?
clean and disinfect (patient table, chair)
Name the 3 Intermediate-Level Disinfectants and their exposure times.
- 70-90% isopropyl alcohol (10 minutes)
- chlorine bleach 1:50 (10 minutes)
- household bleach 1:10 (don’t use)
Name 3 High-Level Disinfectants and their exposure times.
- 6% hydrogen peroxide (45 minutes)
- chlorine bleach 1:50 (20+ minutes)
- 0.55% OPA (10+ minutes)
What do Low-Level Disinfectants do?
- kills some bacteria, some viruses, come fungus
- not tuberculosis (bacteria), not mycobacterium fungus, not spores
What do Intermediate Disinfectants do?
- kills most bacteria, most viruses, most fungus
- not bacteria spores
What do High-Level Disinfectants do?
- kills all bacteria, all viruses, all fungus
- not bacteria spores
What are non-critical items? How do you disinfect them?
- items that contact intact skin, or does not directly touch patient (ex: pens, electro-stim, tens machine)
- clean first, then use a low-level disinfectant
What are semi-critical items? How do you disinfect them?
- items that contact mucous membranes or non-intact skin (cups/ gua sha)
- clean first, then high-level disinfectant
What are critical items? How do you disinfect them?
- enters tissues including bloodstream (needles)
- goes directly into sharps container
List some barriers that affect a disinfectant’s efficacy. (8)
1) dirt/ debris (hasn’t been washed)
2) humidity/moisture (must be dried between cleaning and disinfecting)
3) incorrect temperature (too cold or too hot)
4) incorrect exposure time
5) object has hinges/crevices/cracks (nature of item/ overuse)
6) water is too hard
7) reactions to rubber/plastic/silicone (some degrade in contact with chemicals)
8) used past expiry date
What are the steps to deal with blood spills on a linen? (6)
1) wear utility gloves
2) blot up as much blood as possible with paper towel, throw out in biohazard container
3) clean area with detergent (linen and blood-spilled area)
4) dry with disposable towel; dispose of towel
5) disinfect with an intermediate/high-level disinfectant
6) put linen in its own separate bag within linen bag; wash separately with bleach
List 3 steps for linens maintenance.
- always change sheets between patients
- wash with hot water
- bleach at least once per week
List the steps to cleaning instruments (cups, gua sha). (12)
1) soak instruments that can’t be washed right away in warm water
2) put on utility gloves
3) rinse instruments in warm water
4) put instruments in warm water with soap
5) clean surfaces with a brush
6) check to make sure it’s clean
7) drain dirty water
8) rinse instruments again
9) place in a disinfectant solution
10) clean and disinfect sink, bucket, and brush
11) wash gloves
12) wash hands
What are the most important vaccines to get? (2)
- Hep B
- Tetanus
What vaccines should you consider?
- influenza
- measles
- mumps
- diptheria
- polio
- reubella (German measles)
(and Hep B and Tetanus are musts)
What to do in case of a needle stick injury? (7)
1) take needle out- put in sharps container
2) let bleed freely for few minutes
3) wash with warm, soapy water
4) bandage if necessary
5) assess patient’s health status (communicable diseases)
6) go to an infectious disease specialist, or emergency (might give prophylaxis- if taken within few hours, kicks out infection)
7) document the incident
Can you work with herpetic finger infections?
No- gloves do not prevent the spread
Can you work with shingles (herpetic zona)?
Not until lesions are crusted over.
Can you work with a cold?
Yes- take extra hygiene precautions
