MSK injury, noise, heat, lasers, radiation, violence and motor vehicle accidents
Anesthetics (spontaneous abortions), medications (chemotherapeutics are carcinogens/teratogens, antivirals), glutaraldehyde (irritant & can cause contact dermatitis/asthma), formaldehyde (upper respiratory irritant, class I carcinogen and allergic contact dermatitis) and ethylene oxide (spontaneous abortions, irritant, respiratory, CNS effects)
When do you engage in medical surveillance?
Entry to hospital, change in exposure, periodic assessments.
What regulation is informing medical staff about MSDS location and exposures a part of?
HAZCOM, people are informed what things they are being exposed to
Work stress from job tasks and organization
Tb, HIV, Hep B/C, Allergens
Standard precautions against biologic hazards
Treat all blood, body fluids, secretions and excretions as if they are infected in all patients.
Contact precautions against biologic hazards
Disease is spread by direct contact with patient or the patient's environment. Gown and glove up b/f going in, dispose of gown and gloves before exiting. This is used for GI illnesses like norovirus, C. diff, and also RSV.
Droplet precautions against biologic hazards
Mask and respirator for close contact b/c respiratory secretions do not remain infectious for long or travel far distances (influenza, parainfluenza, adenovirus, RSV)
Airborne precautions against biologic hazards
Negative pressure room (Airborne infection isolation room), respiratory protection with respirators that are seal fit (N95). This is for disease that remain infectious over long distances when suspended in air (rubeola, varicella, Tb)
Actions after a needle stick
Wash w/soap and water, flush from mucous membranes, irrigate, report and seek medical treatment.
What is the risk of a non-vaccinated health care worker who was exposed to HBsAG positive blood? How do you treat an exposure?
31%. The virus remains viable on environmental surfaces for a week and resists drying, alcohol, heat and detergent. If you're a non-responder you can get HBIG
Hep C needle stick injury risk?
1.8%. Note that if you do convert there is treatment, but there is no method for prevention.
HIV needle stick injury risk? What do you do to assess risk?
0.3%. Mucous membrane and non-intact skin exposure is 0.1%. Assess w/rapid HIV test and give post exposure prophylaxis.