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CleaningUpBodyFluids
Ifthereisexposuretoblood,urine,fecesorvomittheareamustbecleanedimmediatelyandnoneofthechildrenmustbeabletohaveaccessthatareauntilthespothasbeencleaned,disinfectedandcompletelydry.
Removeallthechildrentoanotherareaintheroomortheplayarea.Whileanotherstaffpersonmonitorsthechildrengetthesuppliesyouneedtocleanup.
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CleaningUpBodyFluidsContaminatedmaterialsshouldbeplacedinaclosableplasticbag,transported,andstoredawayfromthechildren.
Plasticgrocerybagsfromthestoredonotmeetthiscriteria.Theyshouldnotbeputintothechild’scubby,exposed,orplacedwherechildrenmayhaveaccesstothem.
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CleaningUpBodyFluidsTissuesfromrunnynosesandorotherOPIMSshouldbeflushedorplacedinatrashcanwithalidsothatchildrendonothaveaccesstothedirtytissue.Thiswouldalsoincludeusedlattecups,gum,food,ormake-up.
Thesepersonalitemsmaycontainsalivathatmaybecontaminated.Asweknow,curiouschildrenwillinvestigatediscardeditemsiftheyhaveaccess.
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CleaningUpBodyFluidsManyfacilitiesdotheirownlaundry.Soiledbeddingshouldbeplacedinaseparateplasticbagandnottossedintoabasketwithblanketsandtoys.Itisrecommendedthatcontaminatedbeddingandothermaterialsbecleanedseparatelyfromuncontaminatedmaterials.
Whenwashingbeddingthathasbeencontaminatedalwaysuseadisinfectantandhighheatinthedryingcycle.Laundertowelsandwashclothesforthekitchenseparately.
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CleaningUpBodyFluidSpillsSpillsofbodyfluids,includingblood,feces,nasalandeyedischarges,saliva,urineandvomitshouldbecleanedupimmediately.• Wearglovesunlessthefluidcanbeeasilycontainedbythematerial(e.g.,papertissueor
cloth)beingusedtocleanitup.Becarefulnottogetanyofthefluidyouarecleaningupinyoureyes,nose,mouthoranyopensoresyoumayhave.
• Cleananddisinfectanysurfaces,suchascountertopsandfloors,onwhichbodyfluidshavebeenspilled.
• Discardfluid-contaminatedmaterialinaplasticbagthathasbeensecurelysealed.• Mopsusedtocleanupbodyfluidsshouldbe:(1)Cleaned(2)rinsedwithadisinfectingsolution(3)wrungasdryaspossible(4)hungtodrycompletely• Besuretowashyourhandsaftercleaningupanyspillevenifyouworegloves.
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BiohazardWarningLabelsBiohazardstickersareavailablefromthehealthdepartment.Theyshouldbeplacedondiapercontainers,usedneedleorepipincontainers,andbagsthatcontainbowelmovement,bloodorvomit.Redbagsorcontainersareunderstoodtobethesymbolforbiohazardmaterial.
Universal Precautions and Infectious Disease
Makesurethatyoudisposethesematerialsinasecurespot.Usecoveredgarbagecontainers.Whendisposingofthemoutsidemakesurethatchildrendonothaveaccessandthatanimalsandbirdswillnotopenandstrewcontaminatedmaterials.
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SharpsFartoofrequently,housekeepers,custodiansandothersarepuncturedorcutbyimproperlydisposedneedlesandbrokenglass.This,ofcourse,exposesthemtowhateverinfectiousmaterialmayhavebeenontheglassorneedle.Forthisreason,itisespeciallyimportanttohandleanddisposeofallsharpscarefullyinordertoprotectyourselfaswellasothers.Needlesmustbedisposedofproperlyinsharpscontainerssuchasthisone.Improperlydisposedneedlescaninjurehousekeepers,custodiansandotherpeople.
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NeedlesNeedlesorothersharpsshouldnotbebent,recapped,ormovedexceptasnotedbelow:
• Needlesmayberecappedonlybyusingamechanicaldevice.• Needlesshouldbemovedonlybyusingamechanicaldeviceortoolsuchasforceps,
pliers,orbroomanddustpan.• Neverbreakorshareneedles.• Needlesshallbedisposedofinlabeledsharpscontainersonly.• Sharpscontainersshallbeclosable,puncture-resistant,leak-proofonsidesandbottom,
andmustbelabeledorcolor-coded.• Whensharpscontainersarebeingmovedfromtheareaofuse,thecontainersshouldbe
closedimmediatelybeforeremovalorreplacementtopreventspillageorprotrusionofcontentsduringhandlingortransport.
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BrokenGlassware• Brokenglasswarethathasbeenvisiblycontaminatedwithbloodmustbesterilizedwith
anapproveddisinfectantsolutionbeforeitisdisturbedorcleanedup.• Glasswarethathasbeendecontaminatedmaybedisposedofinanappropriatesharps
container:ie.closable,puncture-resistant,leak-proofonsidesandbottom,withappropriatelabels.(LabelsmaybeobtainedfromEHS.)
• Brokenglasswarewillnotbepickedupdirectlywiththehands.Sweeporbrushthematerialintoadustpan.
• Uncontaminatedbrokenglasswaremaybedisposedofinaclosable,punctureresistantcontainersuchasacardboardboxorcoffeecan.
ByusingUniversalPrecautionsandfollowingthesesimpleengineeringandworkpracticecontrols,youcanprotectyourselfandpreventtransmissionofbloodbornepathogens.
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EmergencyProcedures
Inanemergencysituationinvolvingbloodorpotentiallyinfectiousmaterials,youshouldalwaysuseUniversalPrecautionsandtrytominimizeyourexposurebywearinggloves,splashgoggles,pocketmouth-to-mouthresuscitationmasks,andotherbarrierdevices.
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WhattoDoAfteranExposureOccurs
Notallexposurestobloodbornepathogensresultintransmissionofdisease.However,eachpotentialexposureshouldbeinvestigatedtodeterminetheriskoftransmission.Apotentialexposurehasoccurredwhen:
• Bloodorbodyfluidcomesincontactwithmucousmembranes(e.g.,eyes,noseormouth)
• Bloodorbodyfluidcomesincontactwithnon-intactskin• Acontaminatedobject(e.g.,aneedle)breakstheskin
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WhattoDoAfteranExposureOccursAnexposureshouldbeevaluatedforthreatpotential.Notifythelocalemergencymedicalservices(EMS)beforeattemptingfirstaidandpracticestandardoruniversalprecautions.
Intheeventyoucomeincontactwithbloodorotherbodyfluidsfollowingtheproperproceduresmayreducethechancesofcontractingadisease.
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WhattoDoAfteranExposureOccurs
Salivaisnotasubstantialconcernunlesscontaminatedwithbloodorthechildisill.Washwithsoapandwaterandcoverwithabandaide.
Allbitesthatbreaktheskinshouldbelookedatbyaphysician.
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BiteorScratchWounds
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WhattoDoAfteranExposureOccurs
Urine,fecesandvomitarenotamajorconcernforbloodpathogens,butareaconcernforOPIM’s.Ifthecontactoccursontheskin,immediatelywashtheaffectedareawithwarmwaterandsoap.Anantibacterialsoapisrecommended.
Universal Precautions and Infectious Disease
Exposuretourine,vomitorfeces
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WhattoDoAfteranExposureOccurs
Needlesticksshouldbewashedthoroughlywithsoapandwater.
Universal Precautions and Infectious Disease
Needlesticks
Aneedlestickinjuryisapercutaneouspiercingwoundtypicallysetbyaneedlepoint,butpossiblyalsobyothersharpinstrumentsorobjects.Commonlyencounteredbypeoplehandlingneedlesinthemedicalsetting,suchinjuriesareanoccupationalhazardinthemedicalcommunity.
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WhattoDoAfteranExposureOccurs
Universal Precautions and Infectious Disease
Nose,mouthorskinsplashingshouldbeflushedwithplentyoffreshrunningwater.Eyesshouldbeirrigatedwithwater,saline,oranothersterileirrigant.
Splashing
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WhattoDoAfteranExposureOccursIftheincidentoccursintheworkplace,notifyasupervisorandthehumanresourcedepartmentoncethesituationhasstabilized.Immediatereportingisnecessarytofacilitatepromptpost-exposuretreatment.
Employersshouldrequiredocumentationoranincidentreportfollowinganexposure.Thisdocumentationwillassistinanalyzingenvironmentalconditionsleadinguptotheincident,andincompilinginformationrequiredbyOSHAandothergoverningbodies.
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WhattoDoAfteranExposureOccursOSHAguidelinesrequireemployerstofollowupincidentalexposuresandidentifyadditionalprecautionsthatmaypreventrepetition.Theseactionsmayincludechangingstandardoperatingproceduresorequipmentoridentifyingrequiredpersonalprotectiveequipment.
Employersshouldalsomaintainmedicalrecordsforemployeeswithpotentialforoccupationalexposure.Theserecordsshoulddocumenttraining,vaccinations,andimmunizations.Allemployer-generatedreportsarerequiredbylawtoremainconfidential.
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WhattoDoAfteranExposureOccursInallcases,individualsexposedtopotentiallyinfectedmaterialshouldseekmedicalassistance.
Althoughabloodbornepathogeninfectionisofprimaryconcern,medicalproviderscantakestepstoreduceotherrisks(e.g.,secondaryinfections).
Professionalmedicalcounselingisalsoimportanttopreventpotentialtransmissiontootherindividuals.
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ExposureControlPlanAnExposureControlPlanwillhelpyoudevelopaplantoreduceexposuretogermsinbloodandotherbodyfluids.OSHArequiresemployerstodevelopandimplementplansandpoliciestoprotectemployeesfromexposuretopotentiallyinfectiousbodyfluids.
• DownloadamodelECPatwww.OSHA.govunderBloodbornePathogenStandard,Standard29CFR1910.1030orvisitwww.paaap.org/ECELSforanECPadaptedforchildcare
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ExposureControlPlanWhatshouldyourECPinclude?
• WhoisresponsiblefortheoverallimplementationoftheECP?• Whatemployeeshaveoccupationalexposure(atleastallwhogivedirectcare)• Methodsofimplementationandcontrol(policiesandprocedures)including
PPE’s,housekeeping,firstaid,sharpscare,laundry,etc.• HepatitisBprovision• Postexposureevaluationandfollowup• Employeetraining• Recordkeeping
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ExposureControlPlanWhatelseshouldyourECPinclude?
• BloodbornePathogenexposurecontroltraininglog(allstaffshouldreceivetraining)• ExposureIncidentReportform• PostExposureEvaluationbyhealthproviderform• PostExposureReferraltohealthproviderform• HepatitisBVaccineDeclination(Mandatory)• SharpsInjuryLog
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23Universal Precautions and Infectious Disease
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