Communicable Diseases PDF Policy - Chesapeake Fire Department

Policy 903 Chesapeake Fire Department Policy Manual Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 1 Communicable Diseases 903.1 PURPOSE AND SCOPE This policy provides general guidelines, pursuant to the re...

Policy 903 Chesapeake Fire Department Policy Manual Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 1 Communicable Diseases 903.1 PURPOSE AND SCOPE This policy provides general guidelines, pursuant to the requirements of federal and Virginia law, to assist in minimizing the risk of department members contracting and/or spreading communicable diseases. 903.1.1 DEFINITIONS Definitions related to this policy include: Communicable disease - A human disease caused by microorganisms that are present in and transmissible through human blood, bodily fluid, tissue, or by breathing or coughing. These diseases commonly include, but are not limited to, hepatitis B and C viruses, HIV and tuberculosis. Designated Infection Control Officer (also known as Exposure Control Officer (ECO)) - A liaison between the medical facility treating the source patient and the exposed member. This person shall be formally trained for this position and knowledgeable in proper post-exposure medical follow-up procedures, and current regulations and laws governing disease transmission (12 VAC 5-31-10). Diseases of Public Health Threat (DoPHT)- diseases defined by the Centers for Disease Control (CDC) and the Virginia Department of Health (VDH). Exposure - When an eye, mouth, mucous membrane or non-intact skin comes into contact with blood or other potentially infectious materials, or when these substances are injected or infused under the skin; when an individual is exposed to a person who has a disease that can be passed through the air by talking, sneezing or coughing (e.g., tuberculosis), or the individual is in an area that was occupied by such a person. Exposure only includes those instances that occur due to a member’s position at the Chesapeake Fire Department (see the exposure control plan for further details to assist in identifying whether an exposure has occurred). 903.2 POLICY The Chesapeake Fire Department is committed to providing a safe work environment for its members. Members should be aware that they are ultimately responsible for their own health and safety. 903.3 EXPOSURE CONTROL OFFICER The Health and Safety Officer shall serve as the department’s Exposure Control Officer (ECO). The ECO shall develop an exposure control plan that includes: (a) Exposure-prevention and decontamination procedures. (b) Procedures for when and how to obtain medical attention in the event of an exposure or suspected exposure. Chesapeake Fire Department Policy Manual Communicable Diseases Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 2 (c) The provision that department members will have no-cost access to the appropriate personal protective equipment (PPE) (e.g., gloves, face masks, eye protection, pocket masks) for each member’s position and risk of exposure. (d) Compliance with all relevant laws or regulations related to communicable diseases, including: 1. Responding to requests and notifications regarding exposures covered under the Ryan White law (42 USC § 300ff-133; 42 USC § 300ff-136). 2. Exposure control mandates in 29 CFR 1910.1030 (16 VAC 25-60-30; 16 VAC 25-90-1910). 3. Ensuring that procedures are established to notify receiving facilities when a person transported by this department is known to have a communicable or infectious disease (Va. Code § 32.1-116.3). 4. Implementing universal precautions to be followed by members to reduce exposure to communicable or infectious diseases (Va. Code § 32.1-116.3). 5. Notifying the Office of Emergency Medical Services (OEMS) who the designated ECO is and any change in status of the ECO (12 VAC 5-31-10; 12 VAC 5-31-570). The ECO should also act as the liaison with both OEMS and Virginia Occupational Safety and Health (VOSH) and may request voluntary compliance inspections. The ECO should periodically, at a minimum annually, review and update the exposure control plan and review implementation of the plan. 903.4 EXPOSURE PREVENTION AND MITIGATION 903.4.1 GENERAL PRECAUTIONS All members are expected to use good judgment and follow training and procedures related to mitigating the risks associated with communicable disease. This includes, but is not limited to (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910): (a) Stocking disposable gloves, antiseptic hand cleanser, CPR masks or other specialized equipment in the work area or department vehicles, as applicable. (b) Wearing department-approved disposable gloves when contact with blood, other potentially infectious materials, mucous membranes and non-intact skin can be reasonably anticipated. (c) Washing hands immediately or as soon as feasible after removal of gloves or other PPE. (d) Treating all human blood and bodily fluids/tissue as if it is known to be infectious for a communicable disease. (e) Using an appropriate barrier device when providing CPR. Chesapeake Fire Department Policy Manual Communicable Diseases Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 3 (f) Using a face mask or shield if it is reasonable to anticipate an exposure to an airborne transmissible disease. (g) Decontaminating non-disposable equipment (e.g., laryngoscope, firefighting gloves, clothing, portable radio) as soon as possible if the equipment is a potential source of exposure. 1. Clothing that has been contaminated by blood or other potentially infectious materials shall be removed immediately or as soon as feasible and stored/ decontaminated appropriately. (h) Handling all sharps and items that cut or puncture (e.g., needles, broken glass, razors, knives) cautiously and using puncture-resistant containers for their storage and/or transportation. (i) Avoiding eating, drinking, smoking, applying cosmetics or lip balm, or handling contact lenses where there is a reasonable likelihood of exposure. (j) Disposing of biohazardous waste appropriately or labeling biohazardous material properly when it is stored. 903.4.2 IMMUNIZATIONS Members who could be exposed to hepatitis B due to their positions may receive the hepatitis B vaccine and any routine booster at no cost (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910). 903.4.3 EMERGENCY COMMUNICATIONS CENTER SCREENING With the risk of DoPHT constantly changing, the CDC recommends that Emergency Communications Centers question the caller about: (a) Signs and symptoms of DoPHT (such as fever, vomiting, diarrhea). (b) Residence in or travel to/from an area where an outbreak is occurring. (c) Other risk factors, such as having physical contact with someone who is sick with a DoPHT. (d) The Emergency Communications Center (ECC) will tell CFD members this information before they arrive on scene so they can put on the correct personal protective equipment (PPE). 903.4.4 ENVIRONMENTAL INFECTION CONTROL CFD members shall contact the Hazardous Materials Team for guidance or support of the decontamination of occupancies or vehicles, or for the over pack and disposal of potentially contaminated material from a suspected DoPHT. Environmental cleaning and disinfections, and safe handling of potentially contaminated materials is essential to reduce the risk of contact with blood, saliva, feces, and other body fluids that can contaminate the patient care environment. The Hazardous Materials Team will provide guidance with regard to members or equipment that Chesapeake Fire Department Policy Manual Communicable Diseases Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 4 is grossly exposed or for overpacking of materials. A commercial contractor should handle the collection and disposal of any contaminated waste. 903.4.5 DECONTAMINATION EMS TRANSPORT UNITS AFTER TRANSPORTING PATIENT Patient -care surfaces (including, but not limited to, stretchers, railings, medical equipment control panels, and adjacent flooring, walls, computers, communications equipment, driver’s area and work surfaces) are likely to become contaminated and will be cleaned and disinfected after transport. A blood spill or spill of other body fluid or substance (e.g., feces or vomit) should be managed through removal of bulk spill matter, cleaning the site, and then disinfecting the site. 903.5 POST-EXPOSURE 903.5.1 DESIGNATED OFFICER The Field Medical Officers may assist the designated officer with ensuring that that the Exposure Control Plan is being followed and help the employee with processing paperwork but they are not legally the agency designated officer. All notifications must go through the Health and Safety Officer who serves as the department's Agency Designated Officer. The appropriate Battalion Chief and Field Medical Officer should be notified if the exposure requires a unit to be taken out of service or impacts operations, but it is not required to disclose the details of the exposure. 903.5.2 INITIAL POST-EXPOSURE STEPS Members who experience an exposure or suspected exposure shall (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910): (a) Begin decontamination procedures immediately (e.g., wash hands and any other skin with soap and water, flush mucous membranes with water). (b) Obtain medical attention as appropriate. (c) Notify a supervisor as soon as practicable. 903.5.3 REPORTING REQUIREMENTS The supervisor on-duty shall investigate every exposure that occurs as soon as possible following the incident. The supervisor shall ensure the following information is documented (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910): (a) Name of the members exposed (b) Date, incident number, and time of the incident (c) Location of the incident (d) Potentially infectious materials involved and the source of exposure (e.g., identification of the person who may have been the source) (e) Work being done during exposure Chesapeake Fire Department Policy Manual Communicable Diseases Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 5 (f) How the incident occurred or was caused (g) PPE in use at the time of the incident (h) Actions taken post-event (e.g., clean-up, notifications) The supervisor shall advise the member that disclosing the identity and/or infectious status of a source to the public or to anyone who is not involved in the follow-up process is prohibited. The supervisor should complete the incident documentation in conjunction with other reporting requirements that may apply (see the Work-Related Illness and Injury Reporting and Illness and Injury Prevention Program policies). 903.5.4 MEDICAL CONSULTATION, EVALUATION AND TREATMENT Department members shall have the opportunity to have a confidential medical evaluation immediately after an exposure and follow-up evaluations as necessary. The ECO should request a written opinion/evaluation from the treating medical professional that contains only the following information (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910): (a) Whether the member has been informed of the results of the evaluation. (b) Whether the member has been notified of any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment. No other information should be requested or accepted by the ECO. 903.5.5 COUNSELING The Department shall provide the member, and his/her family if necessary, the opportunity for counseling and consultation regarding the exposure (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910). 903.5.6 SOURCE TESTING Testing a person for communicable diseases when that person was the source of an exposure should be done when it is desired by the exposed member or when it is otherwise appropriate. Source testing is the responsibility of the ECO. If the ECO is unavailable to seek timely testing of the source, it is the responsibility of the exposed member’s supervisor to ensure testing is sought. Source testing may be achieved by: (a) Obtaining consent from the individual. (b) Seeking testing of the source if the member is exposed to bodily fluids that may transmit HIV or hepatitis B or C viruses (Va. Code § 32.1-45.1; Va. Code § 32.1-45.2). Since there is the potential for overlap between the different manners in which source testing may occur, the ECO is responsible for coordinating the testing to prevent unnecessary or duplicate testing. Chesapeake Fire Department Policy Manual Communicable Diseases Copyright Lexipol, LLC 2023/04/01, All Rights Reserved.Published with permission by Chesapeake Fire Department Communicable Diseases - 6 The ECO should seek the consent of the individual for testing and consult the City Attorney to discuss other options when no statute exists for compelling the source of an exposure to undergo testing if he/she refuses. 903.6 CONFIDENTIALITY OF REPORTS Medical information shall remain in confidential files and shall not be disclosed to anyone without the member’s written consent (except as required by law). Test results from persons who may have been the source of an exposure are to be kept confidential as well (29 CFR 1910.1030; 16 VAC 25-60-30; 16 VAC 25-90-1910).