Exposure Control Plan

Question 1

purpose (infectious disease manual)

Answer 1

reduce exposure to infectious disease and potential cancer-causing pathogens for FCFRD

Question 2

POC for infectious disease exposure/notification

Answer 2

Safety Officers (SAFO)

Question 3

who oversees the maintenance, compliance, surveillance, and education of the Exposure Control Plan

Answer 3

Infectious Control Prevention Officer (ICPO)

Question 4

Infectious Disease Personal Protective Equipment

Answer 4

• minimum required = NFPA 1999-certified exam gloves + ANSI Z87.1-2015 protective eyewear
• greater protection = NIOSH approved N-95 or P100 respirators + second pair of gloves + disposable protective sleeves/gowns + FluidGuard boot covers

Question 5

Personal Infection Control Trauma Kit (PIC-T)

Answer 5

• for rapid treatment of life-threatening injuries / victims / FRD employees
• if it gets contaminated, clean with disinfectant wipes / get a loaner from EMS Sup

Question 6

Exam Gloves

Answer 6

NFPA 1999-certified exam gloves

Question 7

Eye Protection

Answer 7

ANSI Z87.1-2015 approved

Question 8

NIOSH N95

Answer 8

• use when:
  — patients condition/history suggests airborne infectious disease (TB, meningitis, measles, whooping cough)
  — high-risk of body fluid aerosolization (intubation, suctioning, childbirth)
  — hoarding situations (think: aerosolized mold and human/animal waste)
• don’t use when:
  — patient has a pulmonary condition that may compromise their breathing (consider non-rebreather)
• consider using with ODs
• remember: one-time use

Question 9

P100 Respirators

Answer 9

• used during incidents of suspected fentanyl use

Question 10

Contaminated Station Uniforms and PPE

Answer 10

• Guided by OSHA 29 CRF 1910.1030 - blood-born pathogens
• Class C/D uniforms shall not be worn home / should be laundered at work
• Fire stations with one washing machine should rinse the machine with hot water and one-half cup bleach after cleaning contaminated uniforms
• grossly contaminated uniforms properly discarded using red biohazard bags
• contaminated PPE placed inside TWO, red biohazard bags and FRD-033 taped on outside of bag then sent to PPE center for cleaning

Question 11

Hand Hygiene

Answer 11

• proper hygiene = soap + warm water + rubbing vigorously for at least 20 seconds, focusing on areas between fingers/fingernails
• most significant barrier to transmission

Question 12

obtaining IV access

Answer 12

must use Chux Pads

Question 13

sharps control

Answer 13

• maintain high level of safety
• when completing a procedure using a sharp/scalpel, dispose in 2-gallon/2-quart containers or P2 sharp shuttles
  — commands: “sharps away”; “passing sharps”

Question 14

who regulates storage and disposal of medical waste / infectious materials?

Answer 14

OSHA and VA Department of Environmental Quality

Question 15

State Board of Health, Chapter 31 - VA EMS Regulations: 12VAC5-31-720 — EMS Vehicle Sanitation adhere to the following requirements

Answer 15

• FS shall not store biomedical waste or contaminated equipment
• ER response equipment is not authorized in FS living quarters or kitchen
• P2 sharp shuttles are one-time use only and sharps are placed in approved containers
• disposal of medic unit sharps containers are done by securely taping the lid to the container before transferring to hospital biohazard disposal room
• contaminated non-sharps items are placed in the red biohazard bags, with grossly contaminated items double bagged
• OIC ensures that no infectious waste is left at the incident scene / disposed of at the hospital
• containers/bags used to contain medical waste MUST be labeled with the fluorescent orange-colored Biohazard label
• all biohazard containers must be removed prior to reserve apparatus being returned

Question 16

incident related blood and body fluid wash down and/or clean up

Answer 16

• PD may request FRD to assist with accident scene clean up by providing roadway wash down
• FRD shall not assist in the collection, removal, or transportation of body parts, tissue remnants, or bone fragments

Question 17

maintenance of equipment

Answer 17

• all equipment shall be inspected, cleaned, and disinfected daily
• all patient movement/transport equipment cleaned/disinfected after each use
• hospital clean holding area equipment
  — FRD employees must contact the ER charge nurse if grossly contaminated equipment is found in the clean holding area
  — if matter persists, FRD employees notify the EMS Sup or SAFO

Question 18

cleaning with a bleach solution

Answer 18

• bleach solution = 1-part bleach / 9-parts water
• allow the equipment to remain wet for a max of 10-mins before flushing with water and towel drying

Question 19

maintenance of fire stations

Answer 19

• cleaning and maintenance must be completed daily

Question 20

Transmission of Infectious Diseases

Answer 20

• Anthrax
• Chicken pox/Shingles
• C.Diff
• Ebola
• Hepatitis A/B/C
• HIV/AIDS
• Influenza (A/B)
• Lyme Disease
• Measles
• Meningococcal Disease
• Norovirus
• Pertussis (Whooping Cough)
• Rabies
• SARS
• Smallpox
• MRSA/Staph
• TB
• West Nile/Zika Virus

Question 21

Transmission of Infestation

Answer 21

• Bed Bugs
• Lice
• Scabies

Question 22

CDC and Prevention Advisory Committee recommends uniformed employees and volunteers to have what immunizations?

Answer 22

• Hep A/B
• Flu
• Tetanus
• Tetanus, Diphtheria, and Pertussis (Tdap)

VATF1:
- yellow fever
- measles, mumps, and rubella
- meningococcal disease
- polio

Question 23

OSHA defined “risk” exposure

Answer 23

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

blood or bodily fluid exposure to intact skin for a period longer than 30 minutes

Question 24

OSHA defined “non-risk” exposure

Answer 24

blood or bodily fluids contact with intact skin for less than 30 mins

Question 25

OSHA’s 29 CFR 1910.134 - Respiratory Protections Standard

Answer 25

- an occupational infectious disease exposure to airborne pathogens: — all settings where administrative and engineering controls are either not applied, or not likely to protect employee from inhaling infectious airborne droplet nuclei - definition of an airborne pathogen risk exposure = any unprotected contact with a person known or suspected of having active TB, meningitis, chicken pox, measles, pertussis, etc.

Question 26

Actions of an Employee Exposed to an Infectious Disease

Answer 26

1. immediately wash with antiseptic soap, rinse any skin areas affected from blood, body fluid splashes, vomit, and spit. 2. for animal bites, the affected area must be washed with soap and water / cover to control bleeding. 3. safely remove station uniforms with heavy/gross amounts of contaminants and place them in red biohazard bags. 4. notify the SAFO with the following: — hospital destination, source patient name/MRN/trauma name/DOB — contact number they will/must answer from SAFO/ICPO/IDP — FRD-314 (infectious disease exposure report) — if due to needlestick/animal bite, an injury packet must also be submitted to SAFO *Note: if source patient refuses transport, notify SAFO/EMS Sup and remain with source patient — inform patient exposure has occurred and transport to hospital — submit FRD-314 and FRD-107 - consent to collect and test blood to ICPO — if patient refuses, EMS Sup may request to draw blood for testing

Question 27

Animal Bites

Answer 27

1. clean area with soap/water asap 2. request animal control PD 3. notify SAFO 4. note type of animal / keep animal contained or within sight until APPD arrives 5. transport employee to ER 6. submit an injury packet (FRD-071; FRD-315A; FRD-317)

Question 28

Notification of Management of an Off-Duty Infectious Disease Exposure

Answer 28

1. Contact SAFO (if unavailable, UFO) 2. Provide: — source patient name, DOB, MRN, receiving hospital — destination hospital, ER charge nurse, contact info — transport service / unit number — transport OIC / contact number — submit FRD-314 to the on duty SAFO/ICPO

Question 29

Infectious Disease Return to Duty Status

Answer 29

Determined by IDP or PSOHC physician

Question 30

Post-Exposure Prophylaxis

Answer 30

- given for positive exposures to HIV, Hep B/C, neisseria meningitidis (meningococcal disease), anthrax, TB, and rabies - can be given based on medical judgement of vaccination record for pertussis, measles, and varicella exposures

Question 31

Citizen “Good Samaritan” Infectious Disease Exposure Reporting

Answer 31

- risk exposure for citizens is sent to health department - right is guaranteed to the GS through the Code of Virginia 32.1-45.1 - Submit the good samaritan citizen exposure info intake form (FRD-399-A) to SAFO — citizen receives a copy FRD-399-B with the incident number written inside