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Bloodborne Pathogens, Anaphylaxis, VNS, Tier I Diabetes & AED Albertville City Schools Health Services 2016-2017 ACS Exposure Control Plan Purpose: To safeguard the health and safety of students, school personnel and others in the school environment. ACS Exposure Control Plan Components: The Principal, Lead Nurse and School Nurse in collaboration with the School Leadership team will make exposure determination. Standard precautions will be implemented, supported, and practiced by all administrators, staff and students. All body fluids should be considered potentially infectious. Supplies and facilities will be provided, maintained and updated as needed to maintain a safe work environment. ACS Exposure Control Plan Hand washing facilities (running water, soap, paper towels and/or hot air dryers) will be readily accessible to employees and students. Antiseptic hand cleansers will be provided when hand washing facilities are not available (field trips and school buses). Puncture proof, disposable, labeled containers will be used to dispose of needles, syringes, and sharps. Disposable, single use gloves will be provided to all staff, regardless of their potential for exposure ACS Exposure Control Plan Other personal, disposable, single-use protection equipment will be provided as required by specific tasks Appropriate disinfectants, supplies and equipment to clean surfaces and waste receptacles will be provided. Disposable plastic liners will be provided for waste receptacles, including those placed inside bathroom stalls. ACS Exposure Control Plan The following work place practice behaviors will be required by the principal and practiced by all staff: All employees will immediately wash their hands after removal of disposable gloves or other personal protection equipment; after assisting with toileting of students; and before handling food. All employees will wash their hands and any other body surface with soap and water or flush mucus membranes with water as soon as possible when coming in direct contact with blood or other potentially hazardous materials. ACS Exposure Control Plan Protective equipment such as disposable gloves will be worn when handling any contaminated surface or body fluid and discarded after each use. Contaminated needles, lancets and other sharps will not be recapped or bent. Plastic liners will not be reused in waste receptacles. ACS Exposure Control Plan Employees will immediately report all exposure incidents involving students to the school nurse who will then notify their administrator, Lead Nurse and parents/guardian. Employees will report all exposure incidents occurring to self to the school nurse, Lead Nurse and principal within 24 hours. Annual training will be provided for all school personnel to improve their knowledge and work practice controls regarding prevention and avoidance of exposure to bloodborne pathogens in the school environment. ACS Exposure Control Plan Hepatitis B vaccine will be made available for all employees that have been determined to be at risk of occupational exposure due to an incident. The Hep B series can be obtained at our local health department for no charge to any employee that has been exposed. Documentation of exposure incidents, training, Hepatitis B vaccinations, and Health Professional’s written opinion will be documented and stored according to state guidelines. Training records will be kept for a three-year period. Hepatitis B vaccination records and waivers, post-exposure incidents , and the Health Professional written opinion will be maintained 30 years post-employment. Confidentiality will be strictly protected for those involved in exposure incidents. The Albertville City Schools Exposure Control plan will be revised and updated at least annually by principal and school nurse in collaboration with the School Leadership Team. Bloodborne Pathogens o Bloodborne pathogens are bacteria or viruses that are present in human blood and body fluids and can be transmitted to other humans. o The most common bloodborne pathogens are: Human Immunodeficiency Virus (HIV) Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Modes of Transmission Sexually From mother-to-newborn at birth Sharing of needles or other sharps Accidental needle stick/cut/bite Infected person to non-infected person Blood transfusions (in the past) HIV The virus which causes the acquired immunodeficiency syndrome (AIDS) HIV attacks the body’s immune system, weakening it so that it cannot fight other deadly diseases. The virus is very fragile and will not live very long outside of the human body. There is no cure for AIDS although there are various anti-viral medications to prolong life. AIDS can be a fatal disease. Hepatitis “B” Hepatitis means “inflammation of the liver”. Hepatitis B is a virus that infects the liver. In the U.S., approximately 300,000 people are infected annually. Is a very durable virus and can survive outside of the body for at least 7 days. It is very important to clean up any blood or body fluid spills. Use a 1:10 bleach solution – which is 1 part household bleach to 9 parts water. Hep B: Prevention To prevent hepatitis B: A 3-dose vaccine series can be given at 0, 1, & 6 months intervals. 96% of people who take the vaccine will develop antibody (protection) against the hepatitis B virus. A vaccine titer (measures the amount of immunity) should be drawn after the vaccine series to insure protection. Hepatitis “C” Hep C or HCV is another cause of viral hepatitis. It is usually slow-spreading and silent, but lasts a long time. It is one of the major causes of cirrhosis in the U.S. It is a major cause of liver cancer worldwide. Approximately 8-12,000 people die annually from hepatitis C-related disease. There is no vaccine for HCV. Anti-viral medications are available for treatment for some HCV-infected persons. Standard Precautions Consider the blood and body fluids of everyone to be potentially infectious. Be careful when providing first aid or dressing the wounds of others. Always keep sores or open wounds covered with a band-aid or dressing. Standard Precautions Immediately clean up any spills of blood or body fluids and always wear gloves while doing this. Carefully clean household items such as doorknobs and handles when someone is ill in the home. Hand-washing is the #1 priority to prevent spread of potential bacteria or viruses. Anaphylaxis Anaphylaxis Severe allergic reaction Involves more than one bodily system. For example the skin and respiratory tract or gastrointestinal tract Can be potentially life-threatening and should be treated immediately. Anaphylaxis Epinephrine, or adrenaline, is the medication of choice for handling anaphylactic reactions. Benadryl can also be used initially for minor reactions. Reactions can be caused by almost anything but the most common are: Foods Insect stings Medications Latex EpiPen EpiPen contains a medication called epinephrine. Epinephrine is used in the treatment of allergic emergencies or anaphylaxis. EpiPen EpiPen is typically kept in a locked cabinet. However, there may be special circumstances where you (teacher/staff) may be required to keep an EpiPen in your classroom/gym, on your person at all times or carry one in your emergency backpack while on field trips. EPIPEN It is very important for everyone to be trained and feel comfortable administering an EpiPen injection during an allergic emergency. EpiPen Jr (0.15 mg) = Green Label 33-66 pounds EpiPen (0.3 mg) = Yellow Label 66 pounds and over Directions For Use: EpiPen Auto-Injector ① Remove the EpiPen Auto-Injector from the plastic carrying case. ② Pull off the BLUE safety release cap. ③ Swing and firmly push the ORANGE tip against mid-outer thigh. It is ok to inject through clothing if necessary. ④ Hold for approximately 10 seconds. ⑤ Remove and massage the area for 10 seconds. ⑥ CALL 911 EpiPen Video You MUST watch the video below EpipPen trainers that do not contain medication or needles are available for practice if needed. https://www.epipen.com/about-epipen/how-to-useepipen **The hyperlink will only connect in slide show view. Access the link. Scroll up the page and you will see the video link. This video shows you how to selfadminister but it is the same concept if giving to another person. Vagus Nerve Stimulator (VNS) The vagus nerve belongs to a system which controls functions of the body that are not under voluntary control, such as the heart rate. Vagus Nerve Stimulator (VNS) Vagus nerve stimulation is a procedure that stimulates the vagus nerve with electrical impulses that are sent to the brain. This can be used to treat epilepsy or seizures when other treatments, such as medications, have not worked. Vagus Nerve Stimulator (VNS) There is one vagus nerve on each side of your body, running from your brainstem through your neck to the chest and abdomen. A VNS is a device that is surgically placed or implanted under the skin on the chest. A wire is threaded under the skin connecting the device to the vagus nerve. When activated, the device sends electrical signals along the vagus nerve to the brainstem, which then sends signals to certain areas of the brain. Vagus Nerve Stimulator (VNS) The VNS is programmed to be on for a certain period of time and then go off for a specified time frame. The person is usually unaware that the VNS is operating. Special magnets can be used to trigger the device for a burst of stimulation outside the programmed settings. These are used for those that know or have warning signs before a seizure is about to occur. Using the magnet to stimulate the device can help stop the seizure. VNS Device VNS Magnets Managing Diabetes in the School Setting Alabama State Department of Education Alabama Board of Nursing Diabetes Mellitus: Type I Diabetes Previously called Insulin-dependent or Juvenile Onset Diabetes Pancreas does not make enough insulin (a hormone secreted by the pancreas) If the body has too little or no insulin then glucose cannot enter the cells of the body to be used for energy Symptoms include: Fatigue Increased thirst Frequent urination Treatment includes: Blood glucose monitoring Administration of long and/or rapid-acting insulin Diet, exercise and rest Diabetes Mellitus: Type II Diabetes Previously called Adult Onset Diabetes Insulin resistance Decreased ability of insulin (a hormone secreted by the pancreas) to move glucose (blood sugar) from our bloodstream into our cells. Risk factors include: Family history Lifestyle choices (diet, exercise, obesity) Treatment includes: Blood glucose monitoring Diet management and exercise Oral medications (Glucophage, Actos, etc.) Insulin Hypoglycemia (Low blood sugar) Blood glucose less than or equal to 80 mg/dl OR symptoms Usual symptoms of hypoglycemia: Shaky or jittery Sweaty Hungry Pale Headache Blurry vision Sleepy Dizzy Hypoglycemia (low blood sugar) Can occur very quickly Must be treated immediately Prevention: Regular blood sugar monitoring/in classroom if necessary Meals/Snacks eaten on regular schedule/not skipped/in classroom if necessary Hypoglycemia: Treatment Treatment of hypoglycemia: If student is able to swallow and follow directions, treat with a fast-acting carbohydrate (CHO) source. Mini box of juice 8 oz. carton low or no-fat milk ½ can soda (sweetened) 3-4 glucose tablets Remain with student until he/she is able to safely resume normal activity. Hypoglycemia: Emergency If student becomes unconscious: EMERGENCY Student will be unable to swallow and follow directions Turn student onto his/her side Remain with the student until the on-site School Nurse/Trained Unlicensed Diabetic Assistant arrives OR until EMS arrives If no School Nurse of Trained Unlicensed Diabetic Assistant available - CALL 9-1-1 Treatment of EMERGENT hypoglycemia: Administer Glucagon injection (if ordered by physician) Glucagon is a hormone that when injected raises the blood sugar quickly Glucagon may only be administered by a School Nurse or a Trained Unlicensed Diabetic Assistant Students must be accompanied by a School Nurse or Unlicensed Diabetic Assistant or Parent if participating on a Field Trip or Extracurricular Activity Hyperglycemia (High blood sugar) Blood glucose greater than or equal to 300 mg/dl OR symptoms Usual symptoms of hyperglycemia: Increased thirst, dry mouth Frequent or increased urination Change in appetite, nausea Blurry vision Fatigue Hyperglycemia: Treatment Slower leading to medical emergency (diabetic ketoacidosis) Occurs when symptoms persist without treatment Prevention: Regular blood sugar monitoring/in classroom if necessary Meals/Snacks eaten on regular schedule/not skipped/in classroom if necessary Insulin/Medications taken on time Exercise on time Treatment of hyperglycemia: If student is able to swallow and follow directions, treat with the following: zero calorie fluid (i.e. water) Hyperglycemia: Emergency If student becomes unconscious: EMERGENCY Student will be unable to swallow and follow directions Turn student onto his/her side Remain with the student until the on-site School Nurse/Trained Unlicensed Diabetic Assistant arrives OR until EMS arrives If no School Nurse of Trained Unlicensed Diabetic Assistant available - CALL 9-1-1 Treatment of EMERGENT hyperglycemia: School Nurse or a Trained Unlicensed Diabetic Assistant will follow physician orders regarding administration of insulin/medication Students must be accompanied by a School Nurse or Unlicensed Diabetic Assistant or Parent if participating on a Field Trip or Extracurricular Activity AED Automated External Defibrillator An automated external defibrillator (AED) is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can stop an irregular heart rhythm and allow a normal rhythm to resume following sudden cardiac arrest. Sudden cardiac arrest is an abrupt loss of heart function. If not treated within minutes, it quickly leads to death. Most sudden cardiac arrests result from ventricular fibrillation. This is a rapid and unsynchronized heart rhythm starting in the heart’s lower pumping chambers (the ventricles). The heart must be defibrillated or shocked quickly. A victim’s chance of surviving drops by seven to 10 percent for every minute a normal heartbeat isn’t restored. Importance of AED’s Makes it possible for more people to respond to a medical emergency where defibrillation is required. They are portable and can be used by nonmedical people. Can be made part of emergency response programs, which includes calling 9-1-1 and prompt delivery of cardio pulmonary resuscitation (CPR). How Do AED’s Work? A built-in computer checks a victim’s heart rhythm through adhesive electrodes. It calculates when a shock is needed. If a shock is needed, a recorded voice tells the rescuer to press the shock button on the AED. This shock stuns the heart and stops all activity. It gives the heart the chance to resume beating effectively. Instructions guide the user through the process. AEDs advise a shock only for ventricular fibrillation or another life-threatening condition called pulseless ventricular tachycardia. Who Can Use An AED? Anyone! AED Locations There are AED’s available in each school and some schools have multiple AED’s available in case of a cardiac emergency. If you are not aware of the exact locations within your schools, you should ask your designated school nurse. AED Types ACS has two types of available AED’s but they all basically work the same. AED Demonstration Video Philips HeartStart On-site AED https://www.youtube.com/watch?v=Zw78XnpjAGU **The hyperlink will only connect while watching in slide show view** AED For questions on more specific AED training or AED questions in general, see your school nurse. Thank You! Thank you for taking the time to review the annual staff training PowerPoint. If you have any questions or concerns, feel free to ask. PLEASE remember to print and sign the certificate and return to your school nurse. Albertville City Schools **Health Training School Year 2016/2017** BloodBorne Pathogens, Anaphylaxis/Epi-Pen, VNS, Tier 1 Diabetes and AED Has been completed online or in person by ____________________________________________________________________________________________________________________ _ Employee Name/ Job Title _________________________________ Reviewed by School Nurse ___________________________________ Date