PreClinic Midterm Flashcards
Infection control
Goal: to create and maintain a safe clinical environment to eliminate the potential for disease transmission from clinician- client, client-clinician, client- client
Chain of infection
(1) Infectious agent (fungi/bacteria)
(2) Reservoirs (people/instruments)
(3) Port of exit( secretions: Sylvia/blood, droplets)
(4) Transmission (direct or indirect contact: fomite/vector)
(5) port of entry( mucous membrane)
(6) Susceptible host (elderly/imm. Comp.)
OSHA
Ensures safe/healthy workplace for Employees
- employer must protect employee
- requires hep. Immunization
- *does not require barriers**
Universal precautions
Infection control approach which all human blood and certain body fluids are treated as if Infected
Standard precautions
Infection control approach to protect DHCP and pt.s from pathogens spread by blood, body fluid,secretion, or excretion regardless of whether they contain blood
we use
CDC
Monitor, study and research infection control and Set Guidelines but DO NOT inforce
FDA
Regulate products and help them reach market in a timely manner
EPA
Protect human health and ENVIRONMENT (waste)
Standard of care
Evidence based protocol
Inf. control, gov. Agencies, boards
4 principles of infection control
(1) stay healthy- vaccinations, hand hygiene, educ.
(2) Avoid contact w/ blood and other infectious body substances - PPE, safely handle instr.
(3) Make client care items safe for use- cleaning, sterilization, disposal
(4) Limit the spread of blood and other infectious body sub. - barriers, disinfect
Airborne infection
- dust borne organisms
- Aerosol production (aerosols, spatter, origin)
** Aerosols can be invisible and suspended in air
Spatter is larger and suspends in air for a shorter amount of time
Prevention of transmission
(1) pre procedural oral hygiene (brushing, flossing, rinse)
(2) interruption of trans. ( rubber dam, suction)
(3) clean water
(4) protection of clinician
(5) protection of pt. (pt. glasses)
Communicable disease
Transmitted by blood, blood products, secretion and saliva.
Incubation period - interval between exposure to I fractious agent and 1st visible signs/symptoms of infection. individual unaware but contagious
Pathogens transmitted by oral cavity
TB, viral hep., AIDS, Herpetic lnfections
TB
- caused by Myobacterium tuberculosis
- infects lungs, lymph nodes, meninges, kidneys, bone, skin, oral cavity
- Mode of trans.: inhalation of droplets containing tubercle bacilli or Aerosols in dental environment
Incubation period- 12 wks after exposure
Early symptoms- fever, weight loss, cough
Later symptoms - night sweats, weakness, persistent cough
Treatment- anti-tuberculosis med.s (9-12 wks)
Viral Hepatitis
Causes inflammation of liver
Hep A
oral-fecal route Incub. 15-50 days symptoms: flu-like or none At risk: childcare prov., international travelers, HCP Treatment: let it run it's coarse **Rarely enters carrier state Precautions: hand wash, clean water Vaccines: HAVRIX-formalin-inactivated VAQTA- nonformalin- inactivated both IM admin.
Hep B
Potentially Fatal blood borne disease
Trans: through contact w/ infected body fluids
Incubation: 45/160 days
Symptoms: fever, malaise, extreme fatigue, rash , jaundice
At risk: HCP, drug users, sharing personal hygiene aids
** 5-10% develop into carrier state , carriers do not show signs/ symptoms but ARE contagious
Precaution: Vaccination (Recombivax HB & Enerix-B) IM admin.
Hep C
Commonly associated with blood trans.
- does NOT enter carrier state
Incubation: 2-20 wks
Symptoms: chronic liver disease is common, may be non-clinical or same as HBV
Trans: IV drug use, dialysis pt., piercing a and sharing OH aids
Precautions: No Vaccination, strict attention to inf. control
Hep D
AKA Delta hep. Causes infection ONLY in the presence of HBV Incubation: abrupt onset Symptoms: resemble HBV Trans: same as HBV Precautions: HBV vaccination
Hep E & G
Found in 3rd world countries with contaminated water
Incubation & symptoms: same as HAV
Trans: dirty water, oral-fecal route
Precautions: wash hands , bottle water, No Vaccine
Herpes virus
8 known Strains- produce diseases with latent, recurrent, and malignant tendencies
relation to periodontal infections*
Incubation: all forms have latency period and lie dormant among Neural Ganglia u till triggered by stimulus
-After exposure: lies dormant in Trigeminal ganglia
HSV-1
Herpetic gingivostomatitis, Herpetic whitlow, genital herpes, herpes labialis (reactivation more common), ocular/ ophthalmic herpes
HSV-2
Genital herpes, herpes labialis, ocular/ ophthalmic herpes
Varicella-zoster virus
Chicken pox- varicella virus
Shingles- zoster infection
- discharged from ruptured vesicles on skin and via resp. Track
After initial exposure: migrates to dorsal root ganglia and sensory ganglia
Epstein-Barr Virus
Infectious mononucleosis , oral hairy leukoplakia
Found In: saliva
After initial exposure: dormant in throat and B-Lymphocytes
HIV
HIV- compromised persons immune system
AIDS- last stage of infectious process
Can persist within cells such as macrophages for long periods
Trans: most body fluids, blood, semen , ect.
Oral manifestations: fungal inf., viral inf., bacterial inf.
** dental management ***
Hand wash
Effective solutions contain: broad- spectrum anti microbial , fast acting, substantivity level, few allergic reactions
Antimicrobial- chlorhexidine glucoate, triclosan, para-chloroxylenol, and iodophors
Factors affecting gloves
Petroleum- based lotions
Length of time worn
Types of disinfectants
Chlorines - corrosive to metals, caustic to humans (3min.)
Phenols- compatible w/metals , glass, plastic, rubber (10 min.)
Iodophors - can discolor surfaces (10 min.)
Gluteraldehydes- highly toxic and corrosive to metals (10 hrs.)
Quat-alcohol compounds - may cause surface staining (5-10 min.) * we use
Steam under pressure sterilizer
Begins at 250- 270 degrees
Process time: 3-30 min.
Adv.: quick, wide variety of materials
Dis.: corrode carbon-steel inst. and dulls cutting edges , unsuitable for rubbers, oils, and powders
Dry sterilizer
Begins: 320-375 degrees
1 hr.
Adv: oils, powders, greases, and some handpieces that cannot withstand steam under pressure, does not dull cutting edges or corrode metal
Dis: long exposure time, no plastics/ waxes, no liquids
Chemical vapor sterilizer
Produces vapors of : fermaldehyde, ethanol and acetone, ketone, water and other alcohols.
Begins: 25 lbs.pai at 270 degrees
20 min.
Adv: short exposure time, does not corrode
Dis: ventilation needed
Monitor of sterilizer
Biological indicator: weekly testing
