PODMEDExamIREVIEW with infectious control - Podiatric...

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P o d i a t r i c M e d i c i n e I R E V I E W © 2 0 0 8 b y S t a m p e d e | P a g e 1 Infection Control Mandated training related to infection control- every 4 years OSHA - intent is to protect employees ; does not address disease transmission from patient to patient - Pathogen - biologic agent capable of causing disease - Susceptible Host - person/animal lacking resistance to a particular infectious agent - Transmission - mechanism by which a pathogen is spread - Direct - patient to patient (horizontal), mother to baby (vertical) - Indirect - most common cause in hospital infection (mechanical transfer from hands of health care worker o Vehicleborne (contaminated food, water, or biologic fluids) o Vectorborne (insect, arthropod) - Respiratory , Fecal-Oral , Bloodbourne - Reservoir - any person, animal, arthropod, plant, soil, or substance which infectious agent normally lives and multiplies - Fomite - infectious agent has not established home, example is countertops/doorknobs - Blood Borne Pathogen - pathogenic organisms present in human blood and can cause disease (Hep B, Hep C, HIV, malaria, syphilis, CJD) o Hep B ; incubation of 6 weeks- 6 months, may shorten lifespan 10-20 years, cases 50% last 10 years square4 Can be transmitted- blood to blood, sexual contact, perinatal o Hep C ; incubation of 6-7 weeks, 16% of Hep cases, 70% develop liver cancer square4 Can be transmitted- blood to blood, transfusions, 50-60% from IV drug usage, 2% occupational - Chain of Infection ; breaking the chain- Eliminate reservoirs of pathogens, interrupt transmission, prevent entry o Elimination - Immunization, quarantine, Culling (killing- seen in mad cow dx), control arthropods/insects, air filtration, disinfection, sterilization o Hepatitis B vaccine ; must be offered to employees who are at risk, 3 injections (2 nd = 1 mo, 3 rd = 6 mo) Interupt transmission; handwashing, barriers (gloves, gowns, masks, eye protection) - Decontamination - removes disease causing organism - Sterilization - destroyed all forms of life including spores - Disinfection - eliminates many organisms, but NOT sports - Level of Disinfection : o Not Critical low level disinfection ; objects that do not require sterilization (stethoscope, table top) square4 Disinfectants ; cannot be relied to kill tubercile bacilli, fungi, viruses o Semi-Critical 1 high level disinfection ; anything that touches mucous membranes (endoscopes) square4 Disinfectants ; sterilize if proper conditions/time are allowed, ethyl alcohol , free chlorine , sodium hypochlorite, calcium hypochlorite – wait 20 minutes for disinfection o Semi-Critical 2 intermediate level ; hospital disinfectant (thermometer) square4 Disinfectants ; isopropyl alcohol will kill tuberculosis, not all viruses, NOT spores – wait 10 minutes o Critical sterilization (surgical instruments) square4 Gluteraldehyde (6-10 hours), Boiling (12 hours), Dry heat (1 hour @ 170°) + increased pressure (autoclave) square4 Monitoring sterilization – spore testing: B. stearothermophilus – MOIST HEAT B. subtilis – DRY HEAT, ethylene oxide B. atrophaeus – ethylene oxide B. pumilus – IRRADIATION
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