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Infection Control, Vital Signs, Oxygen & Medical Emergencies Warning: blood and guts to follow ! Infection Control • Microorganisms • Infectious Disease • Chain of Infection • Nosocomial Infection • Disease Control • Environment Microorganisms that cause disease Bacteria Viruses Fungi Protozoa Can grow in or on an animal or plant and cause diseases. Host: animal or plant that provides life support to another organism. Microorganisms Disease: Any change from the normal structure or function in the human body. Infection: Growth of a microorganism on or in a host. Disease • Disease occurs only when the microorganism causes injury to the host Pathogen A disease producing microorganism. Multiply in large numbers and cause an obstruction Cause tissue damage Secrete substance that produce effects in the body Exotoxins ( high body temp, nausea, vomiting) Bacteria Strep Throat Bacterial Pneumonia Food Poisoning Protozoan • Trichomonas Vaginalis • Plasmodium Vivax – Malaria Viruses • Common cold • Mononucleosis • Warts Fungi • Athlete’s Foot – Tinea pedis • Ringworm 6 Steps of Infection Encounter Multiplication Entry Damage Spread Outcome Chain of Infection Host Infectious Microorganism Mode of Transmission Vector/ Fomite Reservoir Nosocomial Infections Infections originating in the hospital; an infection not present before admittance to the hospital. Nosocomial Infections Iatrogenic Infection Compromised Patients Patient Flora Hospital Environment Bloodborne Pathogens Third Degree Burn Universal Precautions Since there is no way you can know if a person is infected, you should ALWAYS use universal precautions: Wash your hands Wear gloves Handle sharp objects carefully Properly clean all spills Wear mask, eye protection, and apron if splashing is a possibility. Airborne Precautions Patients infected with pathogens that remain suspended in air for long periods on aerosol droplets or dust. TB, Chickenpox, Measles Respiratory protection must be worn when entering pt room. Pt should wear mask. Droplet Precautions Patients infected with pathogens that disseminate through large particulate droplets expelled from coughing, sneezing, or even talking. Rubella, Mumps, Influenza Surgical mask must be worn when within 3 feet of the pt. Pt should wear a mask. Contact Precautions Patients infected with pathogens that spread by direct contact with the pt or by indirect contact with a contaminated object (bedrail, pt dressing). Methicillin-resistant staphylococcus aureus (MRSA), Hepatitis A, Varicella, Flesh-eating Virus All PPE should be used and equipment must be disinfected after use. Controlling the spread of Disease • Chemotherapy • Immunization • Asepsis – Medical – Surgical • Disinfectants Physical Methods of Controlling Diseases • Handwashing • Standard Precautions – Gloving – Gowns – Face masks – Eyewear Handwashing Single most important means of preventing the spread of infection. 7 to 8 minutes of washing to remove the microbes present, depending on the number present. Most effective portion of handwashing is the mechanical action of rubbing the hands together. Types of Nosocomial Infections Iatrogenic Infection – related to physician activities Compromised Patients - weakened resistance; immunosuppressed Patient Flora - microbes in healthy people Contaminated Hospital Environment Bloodborne Pathogens – Hepatitis B and HIV So What, and Who Cares? Students and Techs are challenged both physically and mentally by the microbial world. In this world of newly found, lifethreatening diseases, education has become the key to survival. Health care providers must be committed to infection control so that diseases can be conquered! Syphilis in the eye Infection Control per JCAHO Fingernail Compliance No more than ¼ inch long No artificial nails No chips on nail polish When do you wash your hands? When hands are visibly soiled Before and after patient contact After removal of gloves After using the toilet After blowing or wiping the nose Upon leaving an isolation area When do you wash your hands? Before Eating How long do you wash? 10-15 Seconds When should sharps boxes be emptied? When they are 2/3 full What are some examples of proper usage of gloves? Wear gloves when you anticipate possible contamination When handling chemicals like disinfectants for cleaning Remove gloves immediately after performing task and performing hand hygiene Hallways should be considered a “glove free zone” When do you use disinfectant jell? Before and after patient care when hands are not visibly soiled Before performing invasive procedures for hand decontamination To decontaminate hands after contact with patient’s intact skin, i.e., after taking vital signs What can you use for cleaning equipment and surfaces? Disinfectant wipes How do you know equipment is clean? Clean equipment is covered with plastic A clean bed or gurney is dressed Medical equipment is cleaned between patients or when soiled Not sure ? Always clean and disinfect. What are examples of Standard Precautions? What are examples of Standard Precautions? Use of PPE (personal protective equipment) Protective housekeeping Practicing good hygiene What are the 3 Transmission-based Isolation Precautions? Contact Droplet Airborne Review Microorganisms Disease Pathogen Bacteria Viruses Fungi Protozoan 6 Steps of Infection Chain of Infection Nosocomial Infection Controlling Disease Physical Methods of Controlling Diseases Handwashing Standard Precautions Universal Precautions Questions? • Infection Control Vital Signs Vital Signs Oxygen Therapy Oxygen Devices Chest Tubes and Lines Vital Signs Indication of Physical assessment Homeostasis Primary Mechanisms include measurement of vital signs Body Temperature Pulse Respiration Blood Pressure Mental Status Heart beat Blood pressure Body temperature Respiratory rate Electrolyte balance Body Temperature Normal average body Measuring Body temperature: 98.6 F Humans can survive between 106 F and 93.2 F. Temperature Hypothermia Axillary Hyperthermia Tympanic Oral Rectal Pulse Pulse rate: Adult = 60 to 100 beats per minute Children under 10 = 70 to 120 beats per minute Tachycardia Bradycardia Respiratory Rate Breaths per minute: Adult = 12 to 20 Children under 10 = 20 to 30 per min Tachypnea Bradypena Dyspnea Apnea Pulse Oximeter • Normal Pulse Oximeter = 95% to 100% Blood Pressure • Blood Pressure • Systolic pressure = 95-140 mmHg • Diastolic pressure = 60-90 mmHg • Hypertension • Hypotension Oxygen Oxygen constitutes 21% of atmospheric gases If O2 levels in the body drop below 21% homeostasis is altered. Hypoxia: Inadequate amount of oxygen at the cellular level. Oxygen Devices Nasal Cannula Masks Nonrebreathing mask Aerosol mask Air-entrainment mask Tent and Oxyhood Chest Tubes and Lines • Endotracheal Tube (ET) – Ventilator • Chest Tubes • Nasogastric tube (NG) • Central Lines Review Vital Signs Electrolyte balance Homeostasis Pulse Oximeter Body Temperature Oxygen Pulse Oxygen Devices Respiration Chest Tubes Blood Pressure Chest Lines Mental Status Winston Churchill "The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty." Winston Churchill Questions? • Vital Signs Medical Emergencies TRAUMA = X-RAY IS READY SPINAL INJURY PT GSW to the Abdomen Compound Fx of Femur Medical Emergencies • Definitions • What should the RT know? • Common Radiology Emergencies Medical Emergencies Definition: Sudden change in medical status requiring immediate action. For RT’s medical emergencies are rare, however as medical personnel we must be prepared to recognize emergencies. Fractured Forearm What an RT should know….. How to….. Avoid additional harm to the patient Obtain appropriate medical assistance quickly Recognize emergency situations Remain calm and confident Anaphylactic Reaction An immune response to foreign material Bronchospasm – wheezing and edema in the throat and lungs Can lead to shock Requires prompt recognition and treatment from the technologist Why do RT’s care about Anaphylactic RXN’s….? Water Soluble Iodine • High atomic # 53 • Radiopaque • Used to radiograph – – – – Vessels Arteries Veins Function of internal organs Iodine Contrast Material • Ionic Iodine Contrast – Anion – Cation + – More patient allergic reactions • Non-Ionic Contrast – Less patient allergic reactions Radiology Department Patients are usually sent to the radiology department only after they have been stabilized. However…… General Priorities Ensure an open airway Control Bleeding Take Measures to Prevent shock Attend to wounds or fractures appropriately Provide emotional support Continually reevaluate and follow up ABC • A = Air Way • B = Breathing • C = Circulation CPR • C = Cardio • P = Pulmonary • R = Respiration • Must be certified for the “Health Care Provider” • Cards good for 2 years are available. Become familiar with……….. • In your work environment: – Emergency assistance protocol (how to get help) – Emergency Cart/Crash Cart Location Important Conditions to be Aware of…… Level of Consciousness: ALOC Altered Level Of Consciousness Anaphylactic Shock: vasogenic shock Hypoglycemic/Hyperglycemia NPO – Nothing by Mouth Medical Terms to Know….. Pallor = paleness; absence of skin coloration Shock = failure of the circulatory system CPR = cardiopulmonary resuscitation For program must be for Health Care Provider Continued…………… Stroke = Cerebrovascular Accident (brain) Heart Attack = Myocardial Infarct (heart) N/V = Nausea & Vomiting Epistaxis = nosebleed Vertigo = dizziness Syncope = fainting And more…… Hemorrhage = bleeding outside a vessel Radiologic Technology • You never know when a medical emergency may occur. • Helping your patients depends on your abilities to stay calm and perform you duties! Questions? • Infection Control • Vital Signs • Medical Emergencies