CLASSIFICATION # SOP ME 01.3-2002 SUBJECT Infection Control AUTHORITY Fire Chief Medical Operations- Infection Control Policy (OFS) recognizes that the nature of emergency care provided at emergency medical incidents may expose Fire Fighters to patients with undiagnosed communicable diseases or unknown carrier states. For this reason OFS shall adopt universal precautions and provide training to protect both Fire Fighters and patients. Fire Fighters shall be provided with personal protective equipment and shall be expected to follow the necessary precautions to minimize the transfer of bloodborne or airborne pathogens and/or other communicable diseases in the performance of their duties. Purpose To provide procedures for infection control to ultimately protect all Fire Fighters, their families and the public from the acquisition and spread of communicable diseases. Scope All Suppression Members Procedure RULES Personal Protective Equipment All members shall use the appropriate PPE required for the type of incident at which they are operating. Common sense must be used. When in doubt, select maximum, rather than minimum levels of PPE. While blood is considered the single most common source of infection, first responders shall assume that all body fluids are infectious. Disposable medical gloves shall be worn during any patient contact, when potential exists for contact with blood, body fluids, non-intact skin, or other infectious material. Gloves will be replaced as soon as possible when soiled, torn, or punctured. Wash hands after glove removal. Where possible, gloves should be changed before treating each patient in multiple casualty situations. Gloves should be removed and disposed of immediately following patient contact to prevent cross contamination of other surfaces. Structural firefighting gloves will be worn over medical gloves in situations where sharp or rough edges are likely to be encountered. Issue Date: April 5, 2002 Last Revision: Page 1 of 4
Facial protection will be worn in any situation where splash contact with the face is possible. Facial protection may be afforded by using the Disposable Face Shield. This offers both eye and respiratory protection. When treating a patient with a suspected or known airborne transmissible disease, disposable facemasks shall be used. The first choice is to mask the patient; if this is not possible, mask the Member(s). Face shields on structural firefighting helmets do not provide adequate protection against infectious disease. Structural firefighting clothing (bunker gear) can be used to protect from splashes. The decision to use bunker gear should be based on the risks involved. Scene Operations Personnel should not don medical gloves until they arrive at the patient. This practice avoids rips or tears to the gloves encountered enroute. Members shall use universal precautions. When artificial resuscitation is being performed only use equipment supplied by OFS. Mouth to mouth resuscitation is not permitted. Contaminated P.P.E. shall be removed after leaving the scene, and as soon as possible placed into the appropriate disposal container and transported to the station for proper disposal or decontamination. Fire Fighters will use a buddy system to check for potential contamination of themselves and their clothing prior to leaving the immediate scene. Clothing, if contaminated, will be removed for appropriate cleaning or disposal. Fire Fighters with suspected contamination shall wash the affected area with the waterless hand wash provided. Communicable Disease Exposure When members suspect they have been exposed to a communicable disease they shall immediately notify the Platoon Office through their Supervisor. The Platoon Chief shall notify the on-duty Safety Officer. The Safety Officer shall give immediate direction to the member according to the Designated Officer's Protocol. Post Response At the completion of on-scene operations, all potentially contaminated patient care equipment will be removed for appropriate disposal or decontamination and re-use (SOP ME 01.1-2002 Medical Waste management, SOP ME 01.3-2002 Cleaning Of Medical Equipment). Members shall wash their hands: o After removing PPE. o After handling potentially infectious materials. o After cleaning or decontaminating equipment. All other non-medical equipment shall be cleaned with 9 parts water and one part chlorine. Issue Date: April 5, 2002 Last Revision: Page 2 of 4
ACTIONS 1.0 Personal Protective Equipment 1.1 If it s wet, it s infectious - USE GLOVES. 1.2 If it can splash onto your face - USE THE DISPOSABLE FACE SHIELD. 1.3 If you suspect airborne contamination- MASK THE PATIENT OR YOURSELF. 1.4 If it can splash onto your clothes - USE YOUR BUNKER GEAR. 1.5 Clean or dispose of any clothing or equipment that has been contaminated. 2.0 Hand washing 2.1 Firefighters shall wash their hands with soap and water and scrub their hands vigorously for fifteen seconds. Members shall wash their hands: After removing PPE. After handling potentially infectious materials. After cleaning or decontaminating equipment. 2.2 If soap and water are not available at the scene then use waterless handwash. RESPONSIBILITIES All Personnel shall: Take appropriate infection control and occupational health measures, and not knowingly expose themselves or their patients to any communicable disease in the course of their work or training. Adhere to post-contact infection control measures when cleaning and disinfecting emergency equipment and vehicles. Report potential exposures immediately for proper reporting and follow up. All Station Officers shall: Ensure Fire Fighters are aware of procedures; monitoring and enforcing appropriate protective actions are taken. Safety Officers (Designated Officer) shall: Ensure exposure protocols are followed. Ensure Designated Officer Protocols are followed. Provide follow-up to exposures where deemed appropriate. Attachments OFS List of Personal Protective Equipment Issue Date: April 5, 2002 Last Revision: Page 3 of 4
References and Related Areas Of Interest OFS Infection Control Manual OFS Medical Waste Management SOP ME 01.1-2002 OFS Cleaning Of Medical equipment SOP ME 01.2-2002 OFS Designated Officer Protocol Ontario Health & Safety Act o Section 21: Health and Safety Guidelines for Ontario s Fire Service NFPA 1500: Standard on Fire Department Occupational Safety and Health Program NFPA 1581: Standard on Fire Department Infection Control Program Health Education Resource for Designated Officers of Emergency Services (Original signed by Fire Chief) R. Larabie Fire Chief, Branch Community and Protective Services City of Ottawa It is understood that this procedure may not address all circumstances. Conditions may exist that require some type of deviation by the Incident Commander. Decisions should always be based on experience, the safety of the public and the safety of personnel. Issue Date: April 5, 2002 Last Revision: Page 4 of 4
SIGN OFF SHEET- STANDARD OPERATING PROCEDURES SOP#: SOP ME 01.3-2002 Infection Control A Platoon B Platoon Print Name Signature Print Name Signature C Platoon D Platoon Print Name Signature Print Name Signature (please sign after reading above noted SOP)