Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
#: 1
DATE: 05/05/2004
PAGE: 1 OF 10
Wayne Township
Blood Borne Pathogens & Infection Control Policy
Purpose:
The purpose of this policy is to provide all members of the Wayne
Township Fire Department with the information necessary to prevent the
spread of infectious disease in the workplace. This information includes,
but is not limited to, principles of infection control, the infectious disease
process and the use of personal protective equipment and supplies as they
relate to the prevention of occupational acquired infectious disease.
SUBJECT: Infection Control Procedures / Blood Borne Pathogens
Contents:
1. Introduction.
2. Definitions.
3. Exposure Determination.
4. Health Maintenance.
5. Infection Control Policy.
6. Standard Operating Guidelines

Gloves.

Masks and Eye Protection.

Gowns.

Sharps (Contaminated Needles).

Suctioning a Patient.

Cardiopulmonary Resuscitation.

Venipuncture.
 Scene Operations
7. Post-Exposure Evaluation and Follow-up.
Adopted 11/04/2008
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STANDARD OPERATING PROCEDURES MANUAL
#: 1
DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 2 OF 10
1. INTRODUCTION
A. The Wayne Twp. Fire and Emergency Medical Services recognizes the
potential for exposure of its members to communicable diseases. To minimize
the risk of exposure, the Department will implement an infection control
policy. The infection control policy is to protect Fire Department personnel
and their families, and the patients from exposure to communicable diseases.
B. This policy will also serve to minimize liability for the transmission of
communicable disease and to reduce Department costs by preventing long
term disability claims and promote Department personnel productivity and
morale.
2. DEFINITIONS
A. Bloodborne pathogens means, pathogenic microorganisms that are present in
human blood, certain bodily fluids, and can cause disease in humans. These
pathogens include, but are not limited to, Hepatitis B (HBV) and human
immunodeficiency virus (HIV).
B. Contaminated means, the presence or the reasonably anticipated presence of
blood or other potentially infectious materials on an item or surface.
C. Decontaminated means, the use of physical or chemical means to remove,
inactivate or destroy bloodborne pathogens on a surface or item to the point
where they are no longer viable and the surface or item is rendered safe for
handling, use or disposal.
D. Exposure means, a specific eye, mouth, or other mucous membrane, noncontact, or parenteral contact with blood or other potentially infectious
materials that results from the performance of a Firefighter/EMT's job.
E. Personal protective equipment, is specialized clothing or equipment worn by a
firefighter/EMT for protection against a hazard. General work clothes not
intended to function as protection against a hazard are not to be considered
protective equipment.
3. EXPOSURE DETERMINATION
A. The following list of job classifications are considered to have a risk of
exposure.
1. Firefighter
2. Emergency Medical Technician
a. Basic EMT
b. Advanced EMT
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STANDARD OPERATING PROCEDURES MANUAL
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DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 3 OF 10
c. Paramedic
d. Custodian
4. HEALTH MAINTENANCE
A. All members hired by the Fire Department shall have a physical exam by the
physician designated by the Fire Chief. This exam will certify the member fit
for duty. All members may also have an annual physical.
B. All members will be offered the hepatitis B vaccination at no cost to the
member. The risks and benefits of the immunization will be explained to all
members and informed consent obtained.
C. Members may refuse immunization or may submit proof of previous
immunization. Members who refuse immunization will be counseled on the
risk and will be required to sign a refusal of immunization form. Members who
refuse immunization may later receive immunization upon request to the Fire
Chief or Infection Control Officer.
D. Members will be encouraged to review their own personal immunization
record for immunization against hepatitis B, influenza, rubella, polio, tetanus
and diphtheria. The risks and benefits of immunization will be explained. The
member will be encouraged to contact their family physician in regard to
immunizations of the aforementioned diseases.
E. Members may request work restrictions for reason of infection control. These
may be temporary or permanent. An example may be open skin lesions or
cuts which may present an increased risk to the member or patient due to
exposure.
F. Any member returning to work following a debilitating injury or illness or
communicable disease will be required to have written statement from
attending physician, clearing that member to resume emergency response
duties.
G. Medical records will be kept confidential and will not be disclosed without
written consent of the member. These records will be kept for the duration of
the member’s employment plus 30 years. These records are not to kept with
personnel records. There will be no exceptions.
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STANDARD OPERATING PROCEDURES MANUAL
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DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 4 OF 10
5. INFECTION CONTROL POLICY
A. TRAINING
1. Members of the Fire suppression and Emergency Medical Service
bureaus will be required to complete training in infection control. This
training will include but not limited to the following.
a. Explanation of the epidemiology, symptoms and the modes of
transmission of infectious diseases.
b. Explanation of the department’s exposure control plan and receive a
copy of this in the members departmental manual.
c. Information on types and locations of personal protective equipment, its
proper use, handling, removal and disposal of this equipment.
d. Explanation of procedure to follow if an exposure occurs and who to
contact.
e. Explanation of the basis for selection of personal protective equipment.
f. Information on post exposure evaluations, including filling out of forms
and who to contact.
g. Explanation of signs, labels and color coding required for biohazard
materials.
h. Information on disposal and storage of biohazard materials.
i. Opportunity for questions and answers.
j. Training sessions will be conducted by the Department's medical
director or person who is knowledgeable in the subject matter that is
covered in training.
k. Training on infection control shall be annual.
6. STANDARD OPERATING GUIDELINES
1. The following operating procedures are intended to assist members of the
Fire Department in making decisions concerning the use of personal
protective equipment. No standard operating guideline can cover all
situations. Common sense must be used. When in doubt, select maximal
rather than minimal personal protective equipment.
A. GLOVES
1. Disposable Nitrile gloves will be worn by Department members during any
patient contact when the potential exists for contact with blood or other
bodily fluids, non-intact skin or other infectious material. Members are
encouraged to carry an extra pair of Nitrile gloves.
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STANDARD OPERATING PROCEDURES MANUAL
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
#: 1
DATE: 05/05/2004
PAGE: 5 OF 10
2. Disposable gloves will not be reused and will be disposed of in a
hazardous waste receptacle.
3. When possible gloves will be changed between patients in multiple
casualty incidents.
4. In situations where sharp objects or glass are likely to be encountered,
such as extrications. Nitrile gloves will be worn under structural firefighting
gloves. The firefighter gloves are to prevent the nitrile gloves from being
torn or ripped. When the likely hood of fire exists, nitrile gloves will not be
worn under firefighting gloves.
5. While wearing protective gloves, avoid handling personal items, such as
combs, pens, and contact lenses.
6. After gloves have been contaminated, the gloves should be removed as
soon as possible, avoiding any contact with exterior skin. Hands are to be
washed after removal of gloves. If no running water is present, A
waterless hand sanitizer is to be used, until water is available. An
approved soap is to be used when washing hands.
7. Gloves should be disposed of at the receiving emergency department in
the proper container.
8. If a glove is torn or punctured, the glove should be removed and a new
one put on as soon as possible.
B. MASKS AND EYE PROTECTION
1. Facial protection will be used in any situation where splash contact is likely to
occur as in arterial bleeding or where large amounts of blood or other bodily
fluids are present. Eye protection and mask will always be worn together.
a. Examples when full facial protection is required:

When a patient has massive bleeding.

When a patient is combative and the likelihood of blood or
bodily fluids being thrown about is possible.

Child birth.

Intubation.
2. When treating a patient with a suspected or known airborne transmittable
disease, face masks will be worn. The first choice is to mask to patient; if this
is not feasible, the members of the fire department are to masked.
3. Face shields on structural firefighting helmets will not be used for infection
control purposes.
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STANDARD OPERATING PROCEDURES MANUAL
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DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 6 OF 10
C. GOWNS
1. Gowns or aprons will be worn to protect clothing of the member, when large
amounts of blood or bodily fluids are present. Also gowns will be worn during
childbirth.
2. Structural firefighting gear also protects clothing from splashes and is
preferable in fire, rescue or vehicle extrication. Gowns may interfere or
present a hazard while engaged in these activities.
3. Remember protective equipment should be used according to the level of
exposure components. Minor cuts do not require as much protection as
massive bleeding.
4. Members are encouraged to have an extra change of clothing at the fire
station in the event that clothes become contaminated. Contaminated
clothing will not be taken home and will be laundered at the fire station. If the
clothing or item cannot be cleaned, The Department member is replace
personnel property.
5. Surgical caps and shoe covers should be worn when gross contamination can
reasonable be anticipated.
6. Contaminated clothing will be placed in Contaminated waste receptacle that is
properly marked and labeled as to contents and its potential hazard.
D. SHARPS (CONTAMINATED NEEDLES)
1. Immediately or as soon as possible after use, contaminated needles or other
sharps shall be placed in the red sharps container that is marked. The sharps
container will be maintained in an upright position at all times.
2. Contaminated needles or sharps will not be recapped, bent or broken unless
the member can justify a need for such procedure. If a needle needs to be
recapped, this shall be done by mechanical means or a one-handed
recapping technique.
3. The handling of sharps will be done only after gloves are on. After handling
and glove removal, hands will be washed with soap and water.
4. All procedures involving blood or other bodily fluids or other infectious
materials will be done to minimize splashing, spraying, spattering and
generation of droplets of these substances.
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STANDARD OPERATING PROCEDURES MANUAL
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DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 7 OF 10
E. SUCTIONING A PATIENT
1. Mouth pipetting/suctioning is prohibited.
2. Members will wear gloves and face protection while suctioning patients.
Material suctioned will be considered infectious and disposed of in an
infectious waste receptacle.
F. CARDIOPULMONARY RESUSCITATION
1. Whenever possible disposable resuscitation equipment should be used during
CPR.
2. While performing CPR, members will wear latex disposable gloves.
3. Mouth-to-mouth resuscitation will be performed as a last resort, if no other
equipment is available. Members will be issued personal pocket masks that
should be readily available for emergencies.
4. Paramedics, Advanced EMT’s and EMT-B’s, while performing endotracheal
intubations shall wear a face shield, or goggles and mask.
G. VENIPUNCTURE
1. Members participating in a venipuncture will wear latex gloves.
2. When the possibility exists that blood or contaminated material may be
sprayed or splashed, A full face shield or goggles and mask will be worn.
3. If a glove is torn or punctured, the glove should be removed and a new one
put on as soon as possible.
4. Blood tubes will be carried, so as to prevent any breakage.
5. Contaminated gloves will be removed and disposed of in an appropriate
container. Hands are to washed with soap and water as soon as water is
available.
H. SCENE OPERATIONS
1. The blood and bodily fluids of all patients will be considered potentially
infectious and body substance isolation procedures will be used for all patient
contact.
2. Members are encouraged to use maximum personal protective equipment
rather than minimal for each situation.
3. While complete control over an emergency scene is not possible, members
will attempt to limit splashing, spraying of blood or bodily fluids.
4. Where communicable disease exposure is possible, the minimum number of
members will be used to complete the task, so as to limit the number of
personnel to the risk of exposure.
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STANDARD OPERATING PROCEDURES MANUAL
#: 1
DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 8 OF 10
5. Hand washing is the most important part of infection control. Members will
wash their hands after removing personal protective equipment, each patient
contact and cleaning and disinfecting equipment.
6. Eating, drinking, smoking, handling contact lens or applying lip balm in the
ambulance or at the scene is prohibited.
7. Drivers of vehicles will remove contaminated equipment before operating a
vehicle. This equipment will be placed in appropriate containers.
8. Upon arrival at hospital, contaminated equipment that is disposable will be put
in contaminated waste receptacles at the emergency department. If
equipment cannot be left or is not disposable, it will be placed in a leak proof
container and taken back to the station for cleaning.
9. Upon return to quarters, contaminated equipment will be removed and either
replaced or cleaned according to department disinfections procedures.
Personal protective equipment will be replaced.
10. Disposable equipment and other biohazard waste will be stored in leak proof
containers that are red and marked with biohazard sticker or label.
11. Gloves will be worn for all contact with contaminated items. Gloves and other
protective equipment will be worn during cleaning and disinfection according
to the potential for spills or splashes.
12. Disinfection will be performed with a department approved disinfectant or
with a 1:100 solution of bleach in water.
13. Any damaged equipment being sent out for repair, will be properly cleaned
and disinfected first.
14. Backboards, splints and MAST trousers will be washed with hot soapy water,
rinsed with clean water and disinfected with approved disinfectant or 1:100
bleach solution. Equipment will then be left to air dry.
15. Radios, and cardiac monitor will be wiped off with hot soapy water, then with
clean water and disinfected with approved solution. Equipment will be left to
air dry.
16. Surfaces in the patient area of the ambulance that are contaminated will be
disinfected with approved solution upon return to the station. Surfaces will be
left to air dry.
17. Contaminated structural firefighting gear will be cleaned according to
manufacturer's recommendations. Turn out gear will not be washed in the
bleach solution, as this may impair the gears flame retardant material.
18. Contaminated boots will be brush-scrubbed with hot soapy water, rinsed with
clean water and allowed to dry.
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STANDARD OPERATING PROCEDURES MANUAL
#: 1
DATE: 05/05/2004
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
PAGE: 9 OF 10
19. Contaminated clothes will be removed and exchanged for clean clothes. The
member will shower at the station if they came in contact with blood or other
bodily fluids under their clothes.
20. Contaminated clothes will be laundered at the firehouse using hot water.
Under no circumstances will contaminated clothing be taken home.
7. POST-EXPOSURE EVALUATION AND FOLLOW-UP
A. Any member exposed to potentially infectious material will immediately wash
the exposed area with soap and water or saline eye wash, if the eyes are
involved.
B. Any member having an occupational exposure will immediately report the
exposure to the receiving emergency room personnel. The member will
report this incident immediately to the Infection Control Officer.
C. Upon return to the station a infectious disease exposure report form will be
filled out.
D. The infection control officer will then evaluate the report and contact the
Hospital to where the source individual was taken. Evaluation and notification
will be no longer than 48 hours.
E. The infection control officer will perform or refer members for infection control
to medical evaluations and stress counseling. Spousal counseling will also
be available.
F. The member will have post exposure prophylaxis, when medically indicated
and evaluation of reported illnesses.
G. If feasible and legal, the source individuals test results for infectious disease
will be made available to the member reporting the exposure.
H. Only the Infection control officer and the member reporting the exposure will
have communications with the hospital and or attending physician.
I. The infection control officer will notify the receiving medical facility that a
communicable disease exposure took place, and request an infectious
disease determination, as provided under the Ryan White act of 1990. The
request for consent to test the source individual for HIV and HBV will be
made. The source patient has the right to refuse such testing under present
regulations.
J. Under the Ryan White act, medical treatment facilities will notify the infection
control officer of any patient transported by the squad with a diagnosis of an
airborne transmissible disease. When notified the infection control officer will
contact members that were present on the squad run.
K. The safety officer will assume the duties of the infection control officer in
his/her absence.
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STANDARD OPERATING PROCEDURES MANUAL
Wayne Township
CHAPTER: OPERATIONS
FIRE & EMS
SECTION: INFECTION CONTROL
#: 1
DATE: 05/05/2004
PAGE: 10 OF 10
L. All medical records are confidential and will not be released without written
consent from the member. These records are not to be released to anyone
within or outside of the Fire Department.
M. These records will be kept for the duration of employment plus 30 years.
8. Addendum
A. Every Emergency scene is dynamic, unique and poses it’s own set of
challenges. Remember to be logical and flexible. No S.O.P. no matter how
detailed can take into account any and all circumstances. At no time should
this or any S.O.P. take the place of Common Sense. If an S.O.P. will
endanger the Emergency Services Personnel, or if for some reason the
S.O.P. is determined not to be the best course of action, the S.O.P. should be
foregone in favor of a safer or more productive alternative.
Adopted: 11/04/2008
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STANDARD OPERATING PROCEDURES MANUAL