CHAPTER 3 PART 2

Biosafety

A term used to describe the application of safety precautions taken to ensure the safe handling of biological substances that pose a risk to health

Biohazard

Anything harmful or potentially harmful to health

Must be identified with a biohazard symbol

Parenteral

Other exposure routes from biohazards other than the digestive track

Ingestion is the most easily recognized biohazard exposure

The most common biohazard exposure routes

Airborne, ingestion, nonintact skin, percutaneous, and permucosal

Nonintact skin

Biohazard can enter the body through visible and invisible pre-existing breaks in the skin, such as abrasions, burns, cut, scratches, sores, dermatitis, and chapped skin

Percutaneous

Through the skin

Exposure to biohazardous microorganisms in blood or body fluid occurs through intact, unbroken skin from accidental needle sticks or from other sharps

Permucosal

Through the mucous membrane

Exposure occurs when infectious microorganisms and other biohazards enter the body through the mouth, nose and eyes in droplets generated by sneezing or coughing, Splashes, and by rubbing or touching the eyes nose, or mouth with contaminated hands

Blood-borne pathogens BBP

Any infectious microorganism present in the blood and other body fluids and tissues

Ex: some hepatitis viruses (CMV), syphilis, Malaria, West Nile virus, HCV, HBV, HIV

(occupation safety and health administration) OSHA bloodborne pathogens standard

Enforced by federal law

Intended to reduce/eliminate occupational exposure to bloodborne pathogens

Availability and use of PPE

Special training

Medical surveillance

Availability of vaccination against HBV for all at-risk persons

The most frequently occurring laboratory acquired infection

Hepatitis B Virus (HBV)

Common Blood-borne pathogens BBPs in the laboratory setting

Hepatitis B virus HBV: can be present in blood and other body fluids, Survive up to a week in dry blood on work surfaces and other objects. Primarily transmitted through needles

Hepatitis C virus HCV: can enter the body in the same manner as HPV and is found in blood and serum. Has no vaccine and is the most chronic BBP in the United States

Human immune deficiency virus HIV: Attacks the bodies immune system and can cause AIDS

The risk to healthcare workers is primarily through exposure to blood. HIV can enter the body through all the same roots as hepatitis viruses

All are exposed through sexual contact in a non-medical setting

Needle stick safety and prevention act

Imposed additional requirements on healthcare employers concerning sharps procedures in order to further reduce healthcare worker exposure to blood-borne pathogens

Revision and updating the exposure control plan

Solicitation Of employee input in selecting engineering and work practice controls

Modification of definitions relating to engineering controls

New record keeping requirements, including the requirement to keep sharps injury log

Exposure control plan

A written control plan for HCWs involving HAI

The plan must be reviewed and updated at least annually to document the evaluation of implementation of safer medical devices

Exposure incident procedure

Needlestick procedure- Carefully remove shards of glass or other objects that might be embedded in the wound and wash site with soap and water for a minimum of 30 seconds

Mucous membrane exposure- flush the site with water or sterile saline for a minimum of 10 minutes

Report the incident then report provider for evaluation, treatment, and counseling

EPA Environmental protection agency

A government agency whose mission is to protect peoples health in the environment by enforcing environmental laws

OSHA REQUIRE SURFACES AND SPECIMEN COLLECTION AND PROCESSING AREAS TO BE DECONTAMINATED BY CLEANING THEM WITH BLEACH SOLUTION OR OTHER DISINFECTANT

Regulates chemical exposure

Surface decontamination, cleanup of body fluid spills, and biohazard waste disposal

Surface decontamination- 1:10 Which solution or other disinfectant approved by EPA For cleanup of surfaces in specimen collection, and in process areas

Cleanup of body fluid spills- ADA approved, chemical solutions and kit, Gloves must be worn, Absorbed material without spreading it over wider area

Biohazard waste disposal-All non-reusable items contaminated with any fluid go in biohazard waste containers

OSHA hazard communication standard

HCS

OSHA developed this to protect employees who may be exposed to hazardous chemicals

All chemicals must be evaluated for health hazards, and all chemicals found to be hazardous must be labeled as such

HazCom

Include a statement of warning such as danger or poison

Statement of toxic, flammable, combustible (explosive)

First aid measures for spills

GHS

Globally harmonize system of classification and labeling of chemicals

Requires chemicals to be labeled correctly

-Increase employee safety by providing consistent easily understandable information concerning the safe handling and use of hazardous chemicals

The hazard communication standard has been aligned to this

Safety data sheets SDS

A data sheet that lists every hazardous chemical

DOT

Department of transportation labeling system

Vehicles that carries Hazardous chemicals

Needs to have a 4 digit number that identifies the chemical being transported, A hazardous class number and a hazardous class symbol.

704 marking system

colored diamond sign used by emergency workers to quickly see chemical dangers

Health hazards are indicated in the blue diamond on the left

The level of fire hazard is indicated in the red diamond

The stability or reactivity hazards are indicated in the yellow diamond on the right

Other specific hazards are indicated in the white diamond on the bottom

The colored diamonds contain a number that rates the degree of hazard from 0 to 4

NFPA

National fire protection association

Hazardous material labeling system called the 704 marketing system Was developed by NFPA to label areas where hazardous chemicals and other materials are stored

The CLSI clinical laboratory safety guidelines states that safety showers and eyewash station should be-

Within a 10 second walk from all locations in which hazardous chemicals or infectious materials are used

Chemical spill procedures

Require cleanup, using special kits that contain absorbent and neutralizer materials

The type of materials used depends on the type of chemical spill

Electrical safety

Fire and electrical shock are potential hazards associated with the use of electrical equipment such as centrifuges

Four components present at the same time are necessary for fire to occur

Fuel, heat, oxygen, chemicals

Keep components apart to prevent fire

NFPA

National fire protection Association

NFPA acronym : RACE

R- rescue

A- activate

C- confine

E- extinguish

PASS

P-pull in

A- aim nozzle

S- squeeze trigger

S-sweep nozzle

CLASS A

Occur with ordinary, combustible materials, such as wood, papers, or clothing.

These fire extinguishers require water base solutions such as soda acid or water to cool the fire

CLASS B

Occurs with flammable liquids and vapors such as paint oil grease or gasoline.

Blocking the source of oxygen by smothering, the fuel is required to extinguish this type of fire

Fire extinguishers use foam, dry chemical, or Carbon dioxide smother the fire

CLASS C

Occurs with electrical equipment and require non-conducting agents to extinguish

Extinguishers use dry chemical, carbon dioxide, halon, or other Nonconducting agents to smother the fire

CLASS D

Occurs with combustible or reactive materials such as sodium potassium, magnesium, and lithium

Dry powder agents or sand are required to extinguish these fires

CLASS K

Fire is involving high temperature, cooking oils, grease, or fat

Extinguishers use a potassium based alkaline liquid, which cools and smothers them without splashing

Classes of fire

Class A: ordinary materials, such as wood, papers or clothing. these fires require water based solutions to extinguish it

Class B: flammable liquids and vapors such as paint, oil, grease, or gasoline. requires blocking the source of oxygen or smothering the fuel is required to extinguish this type of fire.

Class C: electrical equipment. require nonconducting agents to extinguish

Class D: Combustible or reactive metals, such as sodium, potassium, magnesium, and lithium. Dry powder, agents or sand are required to extinguish these fires, and they are the most difficult

Class K: high temperature cooking oils, grease or fats. These fires require agents that prevent splashing and that cool and smother the fire.

Radiation safety

The principles involved in radiation exposure are distance, shielding, and time. this means that the amount of radiation you are exposed to depends on how far you are from the source of radioactivity, what protection you have from it, and how long you are exposed to it. exposure time is important because radiation affects are cumulative.

Be careful collecting specimens from patients in rooms with the radiation symbol on the door because they might’ve been treated with radioactive medicines

External hemorrhage

Abnormal or profuse bleeding

Can be effectively controlled by firmly applying direct pressure on the wound until the bleeding stops or EMS arrives

Elastic band can be used to hold compress in place

Only use tourniquet as last resort

Shock

Occurs when there is an insufficient return of blood flow to the heart, resulting in inadequate supply of oxygen to the brain and other organs and tissues of the body

Conditions including hemorrhage, heart attack, trauma, and drug reactions can lead to some degree of shock

First aid for shock is to improve blood circulation,

Keep the victim laying down, call for emergency service, maintain an open airway for the victim, Elevate the legs, attempt to control bleeding, Keep the victim warm

Stroke symptoms

Set a numbness or weakness in the face, arm, or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding speech

Sudden trouble seeing in one or both eyes

Trouble walking, dizziness, loss of balance

American Heart Association ECC adult chains of survival

The series of actions rescuers Must take to improve the chance of survival after cardiac arrest

2 chains

In hospital cardiac arrest

Out of hospital cardiac arrest

In hospital cardiac arrest (IHCA)

1. Recognition of cardiac arrest and activation of the emergency response system

2. Immediate high quality CPR

3. Rapid defibrillation

4. Basic and advanced emergency medical services

5. Advanced life-support and post cardiac arrest care

6. Recovery

Out of hospital cardiac arrest OHCA

1. Recognition of cardiac arrest and activation of the emergency response system

2. Early CPR emphasizing chest compressions

3. Rapid defibrillation

4. Advanced rescue by EMS

5. Post cardiac arrest care

6. Recovery

Adult CPR

Compression rate 100 to 120 per min

Compression depth of 5 to 6 cm (2in)

Full recoil after each compression

Minimize frequency and duration of interruptions in compressions

Ventilation rate of 2 1-second breaths every 30 compressions

Child CPR

CPR beginning with 30 compression (Single rescuer), Or 15 compressions by two healthcare professionals

An infant or child compression rate of 100 to 120 per minute

Compression to ventilation ratio of 30:2 or 15:2

A compression depth of at least 1/3 the anterior posterior diameter of the chest (4cm, 1.5in) for infants and 5cm, 2in for children up to puberty

Allowing complete chest expansion after compression

A brief rhythm check every two minutes