Transcript Health Science Core Chapter 1, 2, 3, and 4

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Emergency Medical Technician - Basic
Health Science Core
Infectious Disease
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Exposure Types
Non-Significant – Occupational exposure
that have little to no risk of transmission of
disease known at the time.
Significant – Occupational exposure that has
increased risk transmission and acquiring
of disease
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Significant Exposure based on contact with
bodily fluid and injury
Fluids
• Blood, serum, or plasma
• Pleural, amniotic,
pericardial, peritoneal,
syovial, or cererospinal
fluid
• Vaginal secretions or
semen
• Saliva
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Injuries
• Percutaneous – needle
stick, laceration,
abrasion, or bites
• Mucous membrane –
eyes, nose, or mouth
• Skin – cut or abraded
skin (not intact)
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Significant Air or Droplet Exposure
Combination of a subject
showing signs or
symptoms of suspected
airborne illness and
performing activity that
exposed the EMT to
droplet or airborne
contaminants.
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Activity
• Gag/cough reflex
• Manual suctioning of
naso-pharyngeal airway
• Insertion of nasogastric,
supraglottic, or intubation
tube
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Post Exposure
• Provide first aid (if necessary, for example)
– Remove contaminated clothing
– Flush site contaminated fluid
– Clean site with soap/water or antiseptic
• Notification and relief of duty
• Obtain medical attention at medical facility
• Document
• Possible need to do follow-up testing months
later
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HIV/AIDS
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HIV
Human Immunodeficiency Virus
A virus that attacks
and destroys the
immune system
making the
patient vulnerable
to any infection.
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AIDS
Acquired Immune Deficiency Syndrome
A specific group of
diseases or
conditions which are
indicative of severe
immunosuppression
related to the HIV
infection.
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HIV/AIDS
• Normal T-cell count for a healthy adult is between 8001000 T-cells per cubic millimeter of blood.
• A patient infected with the HIV virus usually has a T-cell
count less than 200 T-cells per cubic millimeter of blood.
• HIV then attacks, enters, and destroys these T-4 cells.
• Without T-4 helper cells, the elimination process cannot
occur.
• The patients defense system known as the immune
system, is now destroyed and unable to prevent further
illnesses.
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HIV/AIDS
• America’s first case was diagnosed in 1981
• Many cases are just not reported
• 50% of those that are infected with HIV will generally
develop some signs and symptoms within 5 years
• The most recent reports of AIDS/HIV cases suggest that:
• ½ cases are among men who have sex with other men
• ¼ cases are among intravenous drug use
• ¼ cases are among heterosexuals
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HIV/AIDS
• Mortality is high upon progression
of disease.
• 80-90% of patients diagnosed with
AIDS, will die within 3-5 years of
diagnosis due to complications
associated with the disease.
• With advancements in medications
and treatments, early intervention
can increase the quality of life and
possibly increase the longevity of
those infected.
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HIV/AIDS
Transmission
• Sexual contact with an infected
person
• Blood to blood
• intravenous drug use (IDU)
• Pregnancy and breastfeeding
• Transfusions, but since blood
screening in the early 90’s, risk
has been greatly diminished.
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Bodily Fluids with HIV
• Transmittable amounts:
• Blood
• Semen
• vaginal secretions
• breast milk
• Non-transmittable amounts:
• Saliva
• Urine
• tears
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HIV/AIDS
Not Transmitted by:
•
•
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•
•
•
casual contact
handshaking
hugging
kissing
animals
insects
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HIV/AIDS
Signs / Symptoms
• fatigue
• continuos flu-like
symptoms
• weight loss
• night sweats
• grayish-purple lesions
called Karposi’s
Sarcoma
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HIV/AIDS
Protection
• Gloves
• Double gloves to prevent cross contamination.
• Mask due to possible associated airborne
diseases
• Isolation gown for rescue personnel that have any
open wounds
• Hands washed with a anti-microbial agent.
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Tuberculosis
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Tuberculosis
• A bacterium that infects the
alveoli
• Not everyone infected develops
the full-blown disease, latent TB
infection is most common.
• However, one in ten latent
infections will progress to active
TB disease, which, if left
untreated, kills more than half of
its victims.
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Multiple Drug Resistant Tuberculosis
• A form of TB resistant to antibiotics.
• Strain developed from patients that did not
finish taking the antibiotics and not killing off all
of the bacteria
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Tuberculosis
Transmission
Droplets are so small,
they remain airborne
for extended periods
of time and breathed
into the lungs
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Tuberculosis
Signs and Symptoms
•
•
•
•
•
•
•
cough for greater than 2 weeks
unexplained weight loss
night sweats
loss of appetite
fever
coughing of blood (hemoptysis)
fatigue
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Tuberculosis
Protection
• TB/Hepa protective
masks on both the patient
and yourself
• open all windows to
enhance ventilation and
reduce exposure of
airborne particles
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Tuberculosis
Testing
•
•
•
•
PPD SKIN TESTING
Mantoux PPD (Purified Protein
Derivative) skin test is an injection
of a small amount of fluid under the
skin.
results 48 to 72 hours
possible exposure - bubble swells
and hardens
verify infection - 6 months chest xrays and re-administer the test
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Hepatitis
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Hepatitis
• Effects the liver by inflammation
• Viral Hepatitis refers to several common diseases that lead
to the swelling and tenderness of the liver which includes:
• Hepatitis A (HAV)
• Hepatitis B (HBV)
• Hepatitis C (HCV)
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Hepatitis
Signs and Symptoms
• jaundice, especially in
the eyes
• fatigue
• abdominal pain
• loss of appetite
• intermittent nausea
• diarrhea
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Hepatitis A
Transmission:
• Infection contracted by food or
water contaminated by human
waste
Prevention:
• Hepatitis A vaccine
• Proper hygiene and sanitation
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Hepatitis B
Transmission:
• bloodborne pathogens
• sexual contact with an infected person
• perinatal
• contaminated needles
Prevention:
• Hepatitis B vaccine
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Hepatitis C
Transmission:
• bloodborne pathogens
• sexual contact with an infected person
• perinatal
• contaminated needles
Prevention:
• No vaccine
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Influenza
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Influenza
• Other names:
– Flu
– seasonal Flu
– pandemic Flu
• Transmission:
– airborne
• Cause mild to severe illness and/or death
• Symptoms 1-3 days after exposure
• Prevention:
– Yearly vaccination
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MRSA – Methicillin-resistant
Staphylococcus Aureus
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MRSA
• Transmission:
– skin to skin contact with infected person
– Skin contact with object that was exposed to
bacteria
• Cause minor infection to fatal bloodstream
infection
• Prevention:
– Gloves and washing hands
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Meningitis
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Meningitis
Inflammation of the protective membranes
covering the central nervous system know
as meninges.
Cause can be from infectious agent,
physical injury, cancer, or certain drugs
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Meningitis Signs and Symptoms
• Most common symptom headache (87%)
• Stiffness of the neck (83%) – unable to flex neck
forward
• High fever
• Altered mental status
• Photophobia – intolerance to bright light
• Phonophobia – intolerance to loud noise
• Irritability and delirium in small children
• Swelling of fontanelle in infants
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Meningitis –
Bacterial Meningitis
• Medical emergency and high mortality rate
• Causes are typically microorganisms of
meningococcus and pheumococcus
• Treatment various antibiotics depending on age
and type of bacterium
• Transmission – respiratory and throat secretions
from coughing or kissing
• Prevention:
– Certain strain have vaccines
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Meningitis –
Viral Meningitis
• Serious but rarely fatal with patients with normal
immune systems
• Antibiotics have no effect on virus
• Causes - enteroviruses
• Treatment – none
• Prevention:
– Washing hands
– Cleaning contaminated surfaces
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Reference
• Florida Regional Common EMS Protocols.
Jones and Bartlett. Boston: 2004.
• www.cdc.gov
• www.wikipedia.com
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