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Prentice9e PPT ch09
Prentice9e PPT ch09
Pathogens, Universal
Precautions, and Wound Care
McGraw-Hill/Irwin
9-2
Bloodborne Pathogens
Pathogenic organisms, present in human
blood and other fluids
Cerebrospinal fluid, semen, vaginal secretion and
synovial fluid) that can potentially cause disease
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Hepatitis B (HBV)
Major cause of viral infection, resulting in
swelling, soreness, loss of normal liver function
Signs and symptoms
Flu-like symptoms like fatigue, weakness, nausea,
abdominal pain, headache, fever, and possibly
jaundice
Possible that individual will not exhibit signs and
symptoms -- antigen always present
Can be unknowingly transferred
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Prevention
Good personal hygiene and avoiding high risk activities
Be cautious as HBV can survive in blood and fluids, in
dried blood and on contaminated surfaces for at least 1
week
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Management
Vaccination against HBV should be provided
by employer to those who may be exposed
Athletic trainers and allied health
professionals should be vaccinated
Three dose vaccination over 6 months
Post-exposure vaccination is also available
after coming into contact with blood or fluids
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Hepatitis C (HCV)
Acute and chronic form of liver disease caused by
HCV
Most common chronic bloodborne infection in United
States
Leading indication for liver transplant
Signs & Symptoms
80% of those infected have no S&S
May be jaundice, have mild abdominal pain, loss of appetite,
nausea, fatigue, muscle/joint pain, and/or dark urine
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Prevention
Occasionally spread through sexual contact
Spread via contact with blood of infected person,
sharing needles, or sharing items that may carry
blood (razors, toothbrush)
Consider the risks of getting a tattoo or body
piercing
ATC should always follow routine barrier
precautions
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Management
No vaccine for preventing HCV
Multiple tests available to check for HCV
Single positive = infection
Single negative = does not necessarily mean no
infection
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Human Immunodeficiency
Virus (HIV)
A retrovirus that combines with host cell
Virus has potential to destroy immune
system
According to World Health Organization
42 million people were living with
HIV/AIDS in 2004
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Acquired Immunodeficiency
Syndrome (AIDS)
Collection of signs and symptoms that are
recognized as the effects of an infection
No protection against the simplest infection
Positive test for HIV cannot predict when
the individual will show symptoms of AIDS
After contracting AIDS, people generally
die w/in 2 years of symptoms developing
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Management
No vaccine or cure for HIV
Research looking for preventive vaccine and effective treatment
Some antiviral drug combinations help to slows replication of virus
Prevention
Education is critical
Greatest risk is through intimate sexual contact with infected
partner
Emphasis safe sexual practices
Choose non-promiscuous partners
Use latex condoms to provide HBV & HIV barrier
Vaginal spermicides
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Bloodborne Pathogens in
Athletics
Chance of transmitting HIV among
athletes is low
Minimal risk of on-field transmission
Some sports have potentially higher risk
for transmission because of close
contact and exposure to bodily fluids
Martial arts, wrestling, boxing
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Policy Regulation
Athletes are subject to procedures and policies
relative to transmission of bloodborne pathogen
A number of sport professional organizations
have established policies to prevent
transmission
Organizations have also developed educational
programs concerning prevention, and medical
assistance
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Universal Precautions
Occupational Safety and Health Administration
(OSHA) established standards for employer to
follow that govern occupational exposure to
blood-borne pathogens
Developed to protect healthcare provider and
patient
All sports programs should have exposure
control plan
Include counseling, education, volunteer testing, and
management of bodily fluids
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Personal Precautions
Use appropriate equipment
Latex gloves, gowns, aprons, masks and shields, eye protection, disposable
mouthpieces for resuscitation
Emergency kits should contain, gloves, resuscitation masks, and towelettes for cleaning
skin surfaces
Non-latex gloves can be used when long term exposure to blood and bodily fluids is not
likely
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Disinfectant
Contaminated surfaces should be clean with
solution of 1:10 ratio approved disinfectant to
water
Contaminated towels should be bagged, labeled,
and separated from other soiled laundry, then
transported in biohazard container
Sharps
Needles, razorblades, and scalpels
Do not recap, bend needles
or remove from syringe
Scissors and tweezers should
be sterilized and disinfected
regularly
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Post-exposure Procedures
Athletic trainer should have confidential
medical evaluation that documents
exposure route, identification of
source/individual, blood test, counseling
and evaluation of reported illness
Laws that pertain to reporting and
notification of results relative to
confidentiality vary from state to state
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Types of wounds
Abrasions
Skin scraped against rough surface
Top layer of skin wears away exposing numerous
capillaries
Often involves exposure to dirt and foreign materials =
increased risk for infection
Laceration
Blunt force delivered over a sharp bone or a bone that is
poorly padded results in wound with jagged edges
May also result in tissue avulsion
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Puncture wounds
Can easily occur during activity and can be fatal
Penetration of tissue can result in introduction of tetanus bacillus to
bloodstream
All severe lacerations and puncture wounds should be referred to a
physician
Avulsion wounds
Skin is torn from body = major bleeding
Place avulsed tissue in moist gauze (saline), plastic bag and immerse
in cold water
Take to hospital for reattachment
Incision
Wounds with smooth edges
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Immediate Care
Should be cared for immediately
All wounds should be treated as though they
have been contaminated with microorganisms
To minimize infection clean wound with
copious amounts of soap, water and sterile
solution
Avoid hydrogen peroxide and bacterial solutions
initially
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Dressing
Sterile dressing should be applied to keep
wound clean
Occlusive dressing are extremely effective
in minimizing scarring
Antibacterial ointments are effective in
limiting bacterial growth and preventing
wound from sticking to dressing
Saline solution is recommended for
repeated cleaning
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Pain
Heat
Redness
Swelling
Disordered function
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Tetanus
Bacterial infection that may cause fever and convulsions
and possibly tonic skeletal muscle spasm for nonimmunized athletes
Tetanus bacillus enters wound as spore and acts on
motor end plate of CNS
Following childhood vaccination, boosters should be
supplied once ever 10 years
If not immunized, athlete should receive tetanus immune
globulin (Hyper-Tet) immediately following skin wound
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