PMLS2-Infection Control

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PRINCIPLES OF MEDICAL LABORATORY SCIENCE 2

LABORATORY | MID-YEAR TERM

[TRANS] LESSON 2: INFECTION CONTROL, SAFETY, FIRST AID, AND PERSONAL WELLNESS
Class C Electrical equipment C
(“Curyente)
OUTLINE Class D Sodium, potassium, Mg, Li = D, powder
I Hazards (Di ko sure) combustible and reactive agents or
A Types of hazards
sand
B How to use a fire extinguisher
II Infection Class K Cooking oil, grease, fats with K, special
A Microorganisms and Caused Disease (Kitchen) high temperature equipment
B Types of Infections
C Chain of Infection HOW TO USE A FIRE EXTINGUISHER
III Breaking the Chain of Infection • P.A.S.S.
A Handwashing Technique
B Personal Protective Equipment
o Pull pin
o Aim the BASE of the fire
o Squeeze the lever – gently to avoid recoil
o Sweep side to side
• In case of fire, remember R.A.C.E.
HAZARDS o Rescue
• Biological: infectious agents, including airborne or o Alarm
bloodborne organisms such as bacteria, viruses o Contain
o Extinguish
• Physical: wet floors, heavy lifting (e.g., boxes and patient
transfers)
• 4 Fs you need to look for:
• Sharps: dangerous both because of the physical injury they
o Fire alarm
may cause and because they may carry bloodborne
o Fire escape
pathogens such as human immunodeficiency virus (HIV),
o Fire extinguisher
hepatitis B virus (HBV), or hepatitis C virus (HCV).
o Friend
o may leave an open wound
• Chemical hazards: e.g. liquids, anticoagulants; should not
be ingested, no contact with eyes, mucosa
INFECTION
o Material Safety Data Sheet (MSDS): chart, table • when a microorganism invades the body, multiplies, and
or diagram what the chemical is composed of, causes injury or disease
quantity of each element, what you can do in case • Pathogen: microbe that can cause diseases, and
of accidental contact with chemicals microbes could be bacteria, fungi, protozoa or viruses
• Infection control: set of procedures that must be followed
at all times that aims to break the chain of infection

MICROORGANISMS AND CAUSED DISEASE

Table 2. Virus
Organism Disease
Adenovirus Upper respiratory
infections
Hepatitis virus (A-E and G) Hepatitis
Herpes simplex Oral and genital
herpes
Varicella-zoster virus Chickenpox,
Virus
shingles
Poliovirus Polio
Human immunodeficiency Acquired
virus (HIV) immunodeficiency
syndrome
• Electrical and Fire hazards: e.g. short circuit Influenza virus Flu

Table 1. Fire hazard Table 3. Bacteria


Classes of Description Extinguisher Organism Disease
Fire Bordetella pertussis Pertussis or
Class A Combustible materials = A, ABC Bordetella bronchiseptica whooping cough
(Ash) wood, paper Corynebacterium Diphtheria
Class B Flammable liquids and ABC, BC, Bacteria
diphtheriae
(Boil) vapors (paint, oil, grease, halogenated Escherichia coli Food poisoning, or
gasoline) agents normal residents of
**requires blocking oxygen

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TRANS: LESSON 2: INFECTION CONTROL, SAFETY, FIRST AID, AND PERSONAL WELLNESS

the colon, **They wait patiently until a suitable reservoir is


“traveler’s diarrhea” available.
Haemophilus influenzae Meningitis, pink
eye, upper
respiratory PORTAL OF EXIT
infections • The infectious agent must have a way to exit the reservoir
Mycobacterium Tuberculosis to continue the chain of infection.
tuberculosis • If reservoir is human/animal: can be through the nose,
Neisseria gonorrhoeae Gonorrhea mouth, and mucous membranes and in blood or other body
Neisseria meningtides Meningococcal fluids.
meningitis o Phlebotomists provide a portal of exit when they
Salmonella Food poisoning collect blood.
Staphylococcus aureus Skin and wound
**common bacterial infections, food MEANS OF TRANSMISSION
infection in sexually active poisoning
• a way to reach a susceptible host
women
o Direct contact: unprotected host touches or is
Treponema pallidum Syphilis (STI/STD)
touched by the reservoir
Streptococcus “Strep throat”,
o Droplet: the host inhales material from
rheumatic fever
the reservoir such as aerosol droplets from
an infected person
Table 4. Fungi and Parasites ▪ COVID also via airborne
Organism Disease o Airborne: inhalation of dried aerosol
Candida albicans Candidiasis nuclei circulating on air currents or attached to
Fungi Cryptococcus Cryptococcosis dust particles
neoformans o Vehicle: ingestion of contaminated food or water
Entamoeba histolytica Amebiasis and o Vector: parasites such as malaria transmitted by
(E. histo) dysentery a mosquito bite
Protists
Giardia lamblia Giardiasis
(Parasites)
Plasmodium spp. Malaria
PORTAL OF ENTRY
Trichomonas vaginalis Trichomoniasis
**lot of variations of diseases • After the infectious agent has been transmitted to a new
reservoir it must have a means to enter the reservoir.
• Plasmodium species: all causes malaria **can be the same as portal of exit
**targets different RBCs ▪ nose, mouth, mucous membranes, and open wounds
o Plasmodium vivax = Vata, young erythrocytes • Medical and surgical procedures provide a very convenient
(reticulocytes) portal of entry for infectious agents
o Plasmodium falciparum **hence, all needles are packaged individually (sterile)
o Plasmodium ovale **needle is never used more than once
o Plasmodium malariae = Matanda, senile
RBCs SUSCEPTIBLE HOST
• can be another patient or the health-care provider
TYPES OF INFECTIONS o Patients: ideal susceptible hosts because
• Communicable: can spread from person to person their immune systems that normally provide
• Nosocomial & healthcare-associated infections (HAIs): defense against infection are already
acquired while in the hospital and other healthcare facilities involved with the patient’s illness.
usually caused by infected personnel, patients, visitors, **receiving chemotherapy and
food drug or equipment. immunocompromised = very
susceptible
CHAIN OF INFECTION o Newborns and infants: immune system is
• requires a continuous link between six components still developing (weaken as people age)
o Factors that contribute to the susceptibility of
INFECTIOUS AGENT healthcare provider: stress, fatigue, lack of
• consist of bacteria, fungi, parasites, and viruses. proper nutrition
• The pathogen; causes the disease
E.g. Aedes aegypti, Flavi virus’ reservoir -> gut of mosquito
RESERVOIR Portal of exit -> mouth
• a place where the infectious agent can live and possibly
multiply **break chain of infection by infection control
• Humans and animals = ideal reservoirs
• Fomites: equipment and other soiled objects that serve as BREAKING THE CHAIN OF INFECTION
reservoirs particularly if they contain blood or other
body fluids HANDWASHING TECHNIQUE
• Not ideal conditions (e.g. dried blood) = Form spore, • No visible dirt on hands = alcohol; if visible = handwash with
become inactive soap and water
o 30 second rule

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TRANS: LESSON 2: INFECTION CONTROL, SAFETY, FIRST AID, AND PERSONAL WELLNESS

1. Stand a few inches from the sink to avoid contamination prevent the transfer of microorganisms out of patient
2. Turn on the faucet and place hands under running water rooms.
3. Use soap and work up lather to ensure that surfaces are • Fluid-resistant gowns: worn when the possibility of
reached encountering splashes or large amounts of body fluids is
4. Scrub for at least 15 seconds. anticipated.
5. Make sure to scrub all surfaces especially between fingers • Gowns: tie in the back at the neck and the waist and have
and knuckles tightfitting cuffs.
6. Apply little friction and rub hands together for at least 15 o Large enough to provide full body coverage,
secs including closing completely at the back.
7. Rinse the hands from the wrist to fingertips using downward **Anteroom – room between patient’s room and lobby
motion
8. Dry hands using clean paper towel (can be used to turn off MASK, GOGGLES AND FACE SHIELDS
the faucet afterwards)
• Masks: worn to protect against inhalation of droplets
containing microorganisms from infective patients.
PROPER HAND WASH IN ORDER:
o Wet hands with water • Masks and goggles: worn to protect the mucous
o Rub palm to palm & vice versa (make sure to rub membranes of the mouth, nose, and eyes from splashing of
fingers) body substances.
o Rub palms with fingers interlaced & vice versa • Face shields: also protect the mucous membranes
o Rub back of palm with fingers interlaced & vice versa from splashes.
o Grasp thumb in rotating manner & vice versa
o Rub clasped fingers in rotating manner on both palms RESPIRATORS
& vice versa • may be required when collecting blood from patients who
o Rinse thoroughly have airborne diseases, such as tuberculosis.
• N95: NIOSH approved respirator
PERSONAL PROTECTIVE EQUIPMENT o individually fitted for each person who will be
wearing one.
GLOVES o For COVID: double masking
• protect the health-care worker’s hands from contamination
by patient body substances • With the increased incidents of antibiotic-
• to protect the patient from possible microorganisms on the resistant tuberculosis and the appearance of new strains
health-care worker’s hands. of influenza viruses = respirators have become more
routinely used.
**mandated by National Institute of Occupational Safety and
Health (NIOSH) -> phlebotomy procedures DONNING OF PPE

• NOT a substitute for handwashing 1. Identify and gather the proper PPE to don
• Wash hands before putting on and after removing 2. Hand hygiene using hand sanitizer
gloves 3. Isolation gown
▪ Sterile and nonsterile 4. NIOSH-approved N95 filtering face piece respirator or
▪ Powdered and unpowdered higher (facemask if respirator is not available)
▪ Latex and nonlatex 5. Face shield or goggles
6. Gloves – last to don; first to doff
LATEX ALLERGY
DOFFING OF PPE
• Increasing among health-care workers, phlebotomists
should be alert for symptoms of reactions associated with 1. Gloves (Glove to glove – skin to skin)
latex contact. 2. Gown
• Can trigger Type 1 hypersensitivity 3. Hand hygiene
• Reactions include: 4. Face shield or goggles
o Irritant contact dermatitis = patches of dry, itchy 5. Respirator or facemask
irritation on the hands, delayed hypersensitivity 6. Head cap
reactions resembling poison ivy that appear 24 to 7. Handwash after removing mask (and before putting it on
48 hours following exposure, true immediate again)
hypersensitivity reactions (respiratory difficulty).

• Preventing latex allergy: REFERENCES


o Handwashing after removal of gloves
o Avoiding powdered gloves Notes from the discussion by Prof. Michael
o Replacing latex gloves with nitrile or vinyl gloves Dacela
**Phlebotomists should report any signs of a latex reaction to a
supervisor because true latex allergy can be life-threatening. De La Salle Medical and Health Sciences
Institute powerpoint presentation:
GOWNS
• worn to protect the clothing and skin of health-care workers
from contamination by patient body substances and to

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