City of Winter Park Fire-Rescue Standard Operating Guideline Title: Personal Respiratory Protection Date Issued: December 6th, 2005 Date Last Revised: October 5th, 2010 Revision Number: I Total Pages: 3 Purpose: The purpose of this guideline is to help min imize significant exposure to Tuberculosis and other airborne diseases. Scope: All members of this department shall follow this guideline. Only department issued, or otherwise approved, equipment will be utilized for the personal protection of employees from airborne medical contamination, unless guidelines deem it absolutely necessary for the life safety of the patient that procedures be initiated. The EMS Supervisors shall be responsible for the administration of this program throughout the agency. General: The following guideline is to be followed by all department employees to assist in the prevention of airborne contamination during patient care. This guideline will clarify how respiratory protection should be taken for all emergency scenes. The risk of health care providers acquiring respiratory borne diseases from their patients has greatly increased in recent years. Pre-hospital caregivers are particularly at risk. Often, little or no information is available upon initial patient contact concerning their medical history. Furthermore, patients often present themselves in small, poorly ventilated areas. Once enroute to the hospital, these patients remain confined in the back of an ambulance in close proximity to the caregivers. SAFETY NOTICE!
AIRBORNE DISEASES HAVE BEEN PROVEN TO BE DIFFICULT TO TREAT AND IN SOME CASES DEADLY.
330.02.01. High Risk Patients Patients considered as HIGH RISK for transmitting airborne diseases may present with: SOG 330.02 Personal Respiratory Protection Revision: NEW
Productive or persistent cough, night sweats, anorexia, unexplained
Known HIV infection with cough and fever even if recent TB and PPD
Pulmonary or systemic signs or symptoms that were attributed to other
etiological but have not responded to treatment.
A HIGH INDEX OF SUSPICION IS WARRANTED FOR ANY PATIENT
THAT HAS BEEN PRESCRIBED THE FOLLOWING DRUGS:
ISONIAZID (INH) STREPTOMYCIN RIFAMPIN ETHAMBUTOL PYRAZINAMIDE (PZA) AZT
330.02.02. Respiratory Precautions
The donning of infectious control type gloves and the department approved
mask whenever in the proximity of an at risk patient or in an enclosed area where such a patient is, or has been. Masks must be of the type approved by the Department’s EMS Supervisors.
Disposal of all masks and gloves will be according to established biohazard
waste guidelines outlines in the department's Exposure Control Program.
When transporting all high-risk patients, the on-board exhaust fans shall
Whenever possible, high-risk patients presenting themselves in a confined
area shall be moved to a better ventilated area without delay.
SOG 330.02 Personal Respiratory Protection Revision: NEW 330.02.03. Respiratory Precautions All personnel prior to performing the following procedures shall take respiratory precautions:
the use of oral pharyngeal airways initiation of breathing treatment use of bag valve ventilation ET intubation any other procedure dealing with respiratory management
Required Documentation
When an exposure occurs, all precautions taken shall be clearly documented in the run report and the EMS Supervisor notified.
330.02.04. Employee Exposure Reporting
When necessary, all suspected patients deemed would be reported to the
EMS Supervisor of the shift for follow-up.
Any personnel exposed to airborne respiratory diseases must complete the
necessary forms under the City Personnel Policy Manual and the Fire Department's Exposure Control Program.
All reported employee exposures would be logged in the “Personnel”
section of the Fire Programs electronic management system.
The Deputy Fire Chief shall be responsible for the final management of
employee exposures, including the storage and filing of all documentation.
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Prospektive Erfassung des Polyomavirus Infektion bei nierentransplantierten Patienten Seit 1995 verursachen Infektionen mit Polyomavirus BK zunehmend Funktionsstörungen in transplantierten Nieren. In retrospektive Untersuchungen wird die BK Virus Nephropathie mit zirka 5% der Patienten beziffert. Bei mindestens 75% kommt es in der Folge zu einem Transplantatverlust. Fast alle dieser Pati