Reactions to Exposure
Emergency situations present many challenges and strict protocol to be followed. In many emergency situations there is a real risk of exposure to blood borne pathogens due to the potential for injuries and illnesses that can occur. A well-planned emergency procedure should include many things, including exposure control plans and training for staff members.
Exposure Control Plan
An exposure control plan (ECP) is a plan that is developed in order to reduce the exposure to germs in blood and other body fluids. OSHA requires employers to develop and implement plans and policies to protect employees from exposure to potentially infectious bodily fluids.
Your ECP should include the following elements:
- Who is responsible for the implementation of the ECP
- What employees have occupational exposure risks
- Methods of implementation and control (including PPE, housekeeping, first aid, sharps care, laundering, etc.)
- Hepatitis B provision
- Post exposure evaluation and follow up procedures
- Employee training for all staff (blood borne pathogen exposure control training and procedural training)
- Record keeping practices
- Blood borne pathogen exposure control
- Exposure incident report form
- Post exposure evaluation by health provider form
- Hepatitis B vaccine declination (mandatory)
- Sharps injury log
Responding to emergency situations should always include universal precautions that are written into center policy and emergency response plans. Whether a child scrapes an elbow at recess or becomes ill, protocol must be followed to minimize exposure risk and keep everyone in the center safe and healthy. Potential exposure has occurred when blood or bodily fluid comes in contact with a mucous membrane, non-intact skin, a contaminated object breaks the skin, or similar event occurs.
It’s important to evaluate the threat for the potential of exposure risk and notify the local emergency medical services (EMS) when appropriate. Evaluate the risk and follow cleaning and reactionary procedures as follows:
Bites and scratches – Wash the area with soap and water and cover with a band aid. If the wound breaks the skin, consult a health care professional.
Urine, feces, or vomit – If the contact occurs on the skin immediately wash the affected area with warm water and antibacterial soap.
Needlesticks – Wash the area thoroughly with soap and water, consult a health care professional if OPIMs are present on the needle or other sharp object.
Splashing of fluids – Flush the area with plenty of fresh running water. Eyes should be irrigated with water, saline, or another sterile agent.
Some tips for responses to exposure:
- Use PPE to protect yourself and others to help avoid exposure initially.
- Follow universal precautions and treat all bodily fluids as if they are contaminated.
- Saliva, urine, and feces are not substantial risks unless there is visible blood present, though they may pose a risk for OPIMs
- Notify a supervisor immediately if exposure occurs in the workplace. Documentation and further protocol is usually required.
Employers are responsible for investigating, documenting, and following up on exposure incidents after they occur. OSHA and other governing bodies often require or recommend that these incidents are recorded in order to help analyze and plan for the future to avoid future events. OSHA guidelines also require that employers follow up after an exposure incident in order to identify precautions that may prevent a reoccurrence. This may include changing standard operating procedures, changing equipment, identifying PPE successes and fails, and more.
Employers also should confidentially maintain employee medical records for those with the potential for occupational exposure. These records should include training records, vaccination records, and other information regarding potential exposure and prevention of exposure. These records are required by law to remain confidential and employers must uphold doctor patient confidentiality regulations as well.