Infection Control Program

Section 2 - EMERGENCY OPERATIONS

PURPOSE:

The Maitland Fire Rescue Department recognizes the potential exposure of its firefighters, in the performance of their duties, to communicable diseases. To minimize the risk of exposure, the Maitland Fire Rescue Department will implement an infection control program.

The purpose of this policy is to provide minimum criteria for infection control in the fire station, at an incident scene, and at any other area where fire department members are involved in routine or emergency operations.

PROCEDURE:

• Members with infections that constitute, in the course of their duties, a risk of infection to patients or other members shall be evaluated by a physician to determine what functions the member can perform.
• Members with extensive skin lesions or severe dermatitis on hands, arms, head, face, or neck shall not engage in direct patient contact, handle patient care equipment, or handle medical waste.
• Members who are pregnant are discouraged from engaging in Emergency Medical and Firefighting operations. This is due to the dangers to both the member and the fetus from potential infectious and toxic exposures of uncontrollable type, frequency, and severity. It is the responsibility of the member to request a transfer to another position if such conditions are present and they are desirous of following the above recommendations.

Training and Education

• The Infection Control Officer will be responsible to ensure that all members are educated on potential occupational health risks. The training shall include proper use of personal protective equipment, SOP’s for safe work practices in infection control, and proper methods of disposal of contaminated articles and medical waste.
• The education program shall provide information on epidemiology, modes of transmission, and prevention of diseases including, but not limited to, meningitis, childhood communicable diseases, herpes viruses, hepatitis A, hepatitis B, hepatitis non-A/non-B, or hepatitis C, tuberculosis, human immunodeficiency virus, lice, and scabies. Information on applicable government regulations shall also be provided.

Infection Control Liaison

• The Infection Control officer will serve as the Infection Control Liaison.
• The Infection Control Liaison shall be responsible for maintaining communications between the fire department, the health care facility, and other appropriate health care professionals.
• When notified of an exposure, the infection control liaison shall investigate the incident, notify all members who were potentially exposed, and ensure that those members receive appropriate medical follow up.

Immunization

• The fire department will make available to all personnel the opportunity to receive appropriate immunizations, including vaccination against Hepatitis B. If a member refuses to receive the immunization, he/she will be required to sign a declination of immunization.

Infection Control Garments and Equipment

• Members engaging in any emergency patient care shall don medical gloves prior to initiating such care due to the variety of diseases, mode of transmission, and unpredictable nature of the work environment.
• Medical gloves shall be removed as soon as possible after the termination of patient care, taking care to avoid skin contact with glove exterior surface and shall be disposed of in accordance with disposal requirements.
• Members shall not eat, drink, or smoke while wearing gloves.
• Masks, splash resistant eyewear, and fluid resistant clothing shall be present on all fire department vehicles that provide emergency medical operations. They shall be donned prior to any patient care situations, by the members who will be providing treatment, involving dealing with the airway (intubation, suctioning, ventilating), childbirth, situations where bodily fluids may be encountered, and large volumes or spurting blood.
• Artificial respiration equipment shall be used by members performing airway management. Do not perform mouth-to-mouth resuscitation.
• All members shall take precautions during procedures to prevent injuries caused by needles, scalpel blades, and other sharp instruments or devices.
• Needles shall not be recapped. Following use, all sharp objects shall be immediately placed in sharps containers. Sharps containers shall be in all patient transport vehicles and readily available in drug boxes.

Skin Washing

• Hands shall be washed after each emergency medical incident, after cleaning and disinfecting emergency medical equipment, after cleaning protective equipment, after any cleaning function, before and after using bathroom, before and after handling food or cooking and food utensils. (wash with soap and water and rub vigorously for at least 10 seconds)

Clothing

• All protective equipment and clothing shall be inspected and cleaned regularly.
• When protective clothing, station/work uniforms, or other clothing is contaminated, it shall be cleaned as soon as possible.
• Small stains from body fluids shall be permitted to be spot cleaned and then disinfected. (See NFPA 1581)
• Clothing that is contaminated with large amounts of body fluids shall be placed in leak proof bags, sealed, and transported for proper cleaning or disposal.

Emergency Medical Equipment

• Dirty or contaminated emergency medical equipment shall not be cleaned or disinfected in fire station kitchen, living, sleeping, or personal hygiene areas. Sink in biohazard area to be utilized for these functions. (Refer to Infection Control Program and Exposure Control Plan for bio-hazard area procedures)
• Infection control garments shall be worn whenever there is a potential for exposure to body fluids during cleaning.
• Prior to cleaning, dirty or contaminated equipment shall be stored separate from cleaned and disinfected emergency medical equipment.
• Reusable emergency medical equipment that comes in contact with mucous membranes shall require cleaning and a high level disinfection or sterilization after each use.

Disposal of Materials

• Sharps containers shall be disposed of following federal, state, and local regulations. The fire department will contract with a disposal agency. A box is provided in the biohazard area for this purpose. Place any disposable items that came in contact with patients in this receptacle. Whenever the puncture resistant containers become somewhat filled, place the container in the biohazard waste box.
• Contaminated disposable medical supplies and equipment, contaminated disposable infection control garments, and contaminated wastes shall be placed in leak proof bags, sealed, and disposed of as medical waste. (Red bags on unit, bio-hazard waste box in bio-hazard area, sharps boxes)
• When normally non-disposable items cannot be disinfected (determined by the Infection Control Liaison) they shall be placed in leak proof bags, sealed, and disposed of as medical waste.

Exposures

• If a member has sustained an exposure, the exposed area shall be thoroughly washed immediately using soap and water on mucosal surfaces, and soap and running water on skin surfaces. If soap and running water are not available, alcohol or other skin-cleaning agents that do not require water shall be used until soap and running water can be obtained.
• All members will report an exposure immediately and the infection control liaison shall be notified.
• All exposures shall be recorded in writing as soon as possible after the incident. The record of the exposure shall become part of the member’s confidential permanent health file.
• The member will be sent to a facility (Centra Care or Emergency Room to begin follow up care and enter the Needle Stick Program as outlined in the Infection Control Program and Exposure Control Plan.
  

Refer to the Department Infection Control Program & Exposure Control Plan for specifics.