Infection Control
Purpose
This program has been developed for the protection of all District employees and shall identify the proper procedures for infection control.
Scope
This SOP shall be applicable to all District personnel.
Responsibility
It shall be the responsibility of all District personnel to ensure that the intent of this order be followed.
Procedure
The following procedures will be posted permanently in each fire station and other areas as appropriate.
I. Personal Hygiene
Immediate Care of Infectious Exposures:
In the event of blood or other body fluid contact with the eyes mouth, or injured skin (to include chapped or abraded skin), the following care will be initiated immediately after care of the emergency patient is completed:
A. Eye Contact - irrigate for several minutes
B. Mouth Contact - rinse several times with clean water
C. Non-intact skin - wash aggressively with disinfectant
Hand Washing:
Employees will wash their hands thoroughly after any contact with patients or their belongings, or equipment that has contacted them, including contacts when gloves have been worn.
When washing in the station after patient contact, employees will not use kitchen sinks. To prevent cross-contamination, the water will be left running until hands are dried, and a paper towel will be used to turn off the faucet.
When washing will be delayed and employees see a need for immediate hand cleaning, an antiseptic waterless preparation will be used. This will be followed by thorough washing at the earliest opportunity. In all cases, employees will exercise caution to avoid touching eyes, nose, mouth, etc., with the hands before hand washing.
Personal Protective Equipment (PPE):
When a firefighter’s bunker jacket and pants or jumpsuit becomes contaminated with blood or body fluids, the employee will remove the gear immediately or as soon as feasible. The PPE will be placed in a biohazard red bah and put in the proper container for shipment to a laundry facility or immediately put into the washer for decontamination. Caution !! Bunker gear and fire resistive jumpsuits should be washed with a non-chlorinated laundry detergent! Bunker gear shall be hung up after washing and allowed to drip or air dry. Never dry bunker gear in a mechanical dryer! Remember, always wear disposable gloves when handling contaminated laundry.
II. Infection Barriers
Gloves:
Employees will wear disposable gloves provided by the District whenever they are exposed to blood or body fluids or materials that may be contaminated with body fluids, including cleaning of contaminated equipment. Employees are encouraged to wear gloves during all patient contact.
As far as it is practical, employees will don protective gear, particularly disposable gloves, in advance of the patient encounter. Firefighters are advised to don disposable gloves first if they plan to wear turnout gloves when they respond on medic assists. When donning disposable gloves or other gear in a patient’s presence is unavoidable, it will be done in a routine and calm manner, and explained in a way to reassure the patient and cause no offense.
Spare disposable gloves will be kept in a uniform pocket to ensure ready availability.
Footgear:
If the boots are contaminated with blood or other body fluids they will be washed or scrubbed using hot water and a non-chlorinated laundry detergent.
Infection Control Procedures
Eye Protection, Masks, Gowns, and Arm Protectors:
Protective eye/nose/mouth gear shall be worn when spraying body fluids are anticipated. Gowns, and arm protectors shall be worn when large splashes or quantities of blood or other body fluids are present or anticipated in order to prevent contamination of work clothing, under garments, and skin.
Respiratory Protection:
Personal respiratory protection should be used when a person is entering an area or room where patients with known or suspected infectious TB are present
A NIOSH approved High Efficiency Respirator will be used. Each employee will be fit tested according to manufacturers and CDC guidelines. For our purposes, the respirator will be used once and discarded.
Patient Ventilation:
To avoid the theoretical risk of respiratory or fluid borne disease transmission during artificial respiration, employees will apply mouth-to-mask ventilation or use other adjuncts, whenever possible without delaying or compromising ventilation’s. Appropriate equipment must be kept immediately available to ensure that no delays in patient care occur.
III. Needle Handling
Contaminated needles shall be placed directly into puncture resistant containers for that purpose rather than being recapped. When needles must be recapped for transport to a safe container, the one-hand method and taping will be used. (The cap will be set down and released before the needle tip is inserted. After capping, the needle hub will be secured to the cap with tape.) This and the procedure described immediately below, will only be done in the rare case when it is impossible to place the needle directly into a sharps container.
When a contaminated needle must be set down after use and before disposal and capping, it will be placed in a visible spot free of waste, equipment and other items, preferably on the floor. This is to be avoided unless absolutely necessary, and the employee doing so remains responsible to dispose of the needle properly at the earliest possible moment. Uncapped needles will not be laid on beds or seating areas inserted into upholstery, dropped into pockets or equipment kits, or otherwise placed unsafely.
IV. Waste Disposal
Regulated Waste:
All units will carry biohazard red bags for use when disposing of regulated waste. Regulated waste is any waste possibly contaminated with blood or other body fluids other than contaminated sharps, such as blood-saturated dressings at an emergency scene. Engine Co’s shall remove their regulated waste bags immediately upon returning to the station house, and place the bag into the regulated waste container designated in the apparatus room. Remember, always wear disposable gloves and other PPE as needed when handling contaminated waste! And wash hands after ungloving!
V. Cleaning and Disinfecting
Cleaning will consist of scrubbing the item or surface with soap and water until all visible foreign matter is removed. Disinfecting will consist of washing or soaking the cleaned item with disinfectant solution.
Employees will wear disposable gloves during both cleaning and disinfecting.
Medical equipment will be cleaned and disinfected after each patient contact. The following notes apply:
A. Disposable equipment will not be reused.
B. After cleaning, small items that can be reused (such as non-disposable ventilation masks) will be soaked in disinfectant for 30 minutes.
C. Regulated waste and contaminated clothing containers will be cleaned after contaminated waste or clothing have been removed.
D. Laryngoscopes and other reusable instruments shall be cold sterilized using sterilizing solution in a disinfecting tray for a minimum of 10 minutes.
Environmental Surfaces:
Wash with an antimicrobial solution.
Handwashing:
Wash with an antimicrobial solution.
Mannequins:
Soak in a 1:10 solution of bleach and water for at least 10 minutes. Rinse with fresh water and thoroughly dry all components.