Ebola prevention

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DR RAJESH BATLISH M.D

description

PREVENTION AGAINST EBOLA

Transcript of Ebola prevention

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DR RAJESH BATLISH M.D

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Prevention –Cure? Cause?Strain Year Human

mortalitySusp cause

Zaire 19761995

88%81%

Contaminated needles

Sudan 1976197920002004

53% Bat infested cotton factory

Reston (US) 1990 None Imported primates from Phillipines

C^ote d Ivoire 19941995

None Infected chimpanzees

Source:TB of Public Health :Maxcy,Rosenau & Last 16th Ed

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Interrupt transmission

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Prevention and Control strategy Risk reduction by avoiding contact Raising awareness by IEC &BCC Reducing human to human transmission

by use of PPE Safe disposal of the dead Controlling infection in health care settings Active surveillance – Contact tracing &

monitoring – Reporting /Notification

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PRIMARY PREVENTION Health promotion Avoid contact with

wild animals(primates) Cook meat thoroughly Avoid contact with

symtomatic indls

Specific protection Hand hygiene Use appr PPEs

SECONDARY PREVENTION ScreeningNotificationIsolationTreatment

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Principles of Inf Prevention& Control

General patient care Direct patient care * Environmental cleaning & mgmt of linen Waste mgmt Non patient care activities*

* Confirmed or suspected cases with HF

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Standard Precautions• Previously called Universal Precautions

• Assumes blood and body fluid of ANY patient could be infectious

• Recommends PPE and other infection control practices to prevent transmission in any healthcare setting

• Decisions about PPE use determined by type of clinical interaction with patient

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General patient care (Standard precautions)

Hand hygiene Gloves/facial protection/gown Prevention of needlestick injuries/sharps Respiratory hygiene & cough etiquette Environment cleaning Linen handling Waste disposal Patient care eqpt

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IEC and BCC

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IEC

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Fives of hand hygiene

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Basic principles

Avoid shaking hands Keep safe distance (1 m /3 ft) Incineration better than burial PPE not reqd if - dist maint/

- interviewing asymp indls

- no contact with environ

Contact tracers and case finders to use strict hand hygiene measures.

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Types of PPE Used in Healthcare Settings

• Gloves – protect hands

• Gowns/aprons – protect skin and/or clothing

• Masks and respirators– protect mouth/nose – Respirators – protect respiratory tract from

airborne infectious agents

• Goggles – protect eyes

• Face shields – protect face, mouth, nose, and eyes

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PPE for Standard Precautions (1)• Gloves – Use when touching blood,

body fluids, secretions, excretions, contaminated items; for touching mucus membranes and nonintact skin

• Gowns – Use during procedures and patient care activities when contact of clothing/ exposed skin with blood/body fluids, secretions, or excretions is anticipated

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PPE for Standard Precautions (2)• Mask and goggles or a face shield –

Use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

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What Type of PPE Would You Wear?

• Giving a bed bath?

• Suctioning oral secretions?

• Transporting a patient in a wheel chair?

• Responding to an emergency where blood is spurting?

• Drawing blood from a vein?

• Cleaning an incontinent patient with diarrhea?

• Irrigating a wound?

• Taking vital signs?

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What Type of PPE Would You Wear?

• Giving a bed bath?

• Generally none• Suctioning oral secretions?

• Gloves and mask/goggles or a face shield – sometimes gown

• Transporting a patient in a wheel chair?

• Generally none required• Responding to an emergency where

blood is spurting?

• Gloves, fluid-resistant gown, mask/goggles or a face shield

• Drawing blood from a vein?

• Gloves• Cleaning an incontinent patient with

diarrhea?

• Gloves w/wo gown• Irrigating a wound?

• Gloves, gown, mask/goggles or a face shield

• Taking vital signs?

– Generally none

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PPE for Expanded Precautions• Expanded Precautions include

– Contact Precautions

– Droplet Precautions

– Airborne Infection Isolation

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Use of PPE for Expanded Precautions

• Contact Precautions – Gown and gloves for contact with patient or environment of care (e.g., medical equipment, environmental surfaces)

• In some instances these are required for entering patient’s environment

• Droplet Precautions – Surgical masks within 3 feet of patient

• Airborne Infection Isolation – Particulate respirator*

*Negative pressure isolation room also required

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Key Points About PPE• Don before contact with the patient,

generally before entering the room

• Use carefully – don’t spread contamination

• Remove and discard carefully, either at the doorway or immediately outside patient room; remove respirator outside room

• Immediately perform hand hygiene

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Sequence* for Donning PPE• Gown first

• Mask or respirator

• Goggles or face shield

• Gloves

*Combination of PPE will affect sequence – be practical

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How to Don a Gown

• Select appropriate type and size

• Opening is in the back

• Secure at neck and waist

• If gown is too small, use two gowns– Gown #1 ties in front

– Gown #2 ties in back

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How to Don a Mask

• Place over nose, mouth and chin

• Fit flexible nose piece over nose bridge

• Secure on head with ties or elastic

• Adjust to fit

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How to Don a Particulate Respirator

• Select a fit tested respirator• Place over nose, mouth and chin• Fit flexible nose piece over nose bridge• Secure on head with elastic• Adjust to fit• Perform a fit check –

– Inhale – respirator should collapse

– Exhale – check for leakage around face

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How to Don Eye and Face Protection• Position goggles over

eyes and secure to the head using the ear pieces or headband

• Position face shield over face and secure on brow with headband

• Adjust to fit comfortably

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How to Don Gloves• Don gloves last

• Select correct type and size

• Insert hands into gloves

• Extend gloves over isolation gown cuffs

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How to Safely Use PPE

• Keep gloved hands away from face

• Avoid touching or adjusting other PPE

• Remove gloves if they become torn; perform hand hygiene before donning new gloves

• Limit surfaces and items touched

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“Contaminated” and “Clean” Areas of PPE• Contaminated – outside front

• Areas of PPE that have or are likely to have been in contact with body sites, materials, or environmental surfaces where the infectious organism may reside

• Clean – inside, outside back, ties on head and back

• Areas of PPE that are not likely to have been in contact with the infectious organism

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Sequence for Removing PPE

• Gloves

• Face shield or goggles

• Gown

• Mask or respirator

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Where to Remove PPE

• At doorway, before leaving patient room or in anteroom*

• Remove respirator outside room, after door has been closed*

* Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub

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How to Remove Gloves (1)

• Grasp outside edge near wrist

• Peel away from hand, turning glove inside-out

• Hold in opposite gloved hand

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How to Remove Gloves (2)• Slide ungloved finger

under the wrist of the remaining glove

• Peel off from inside, creating a bag for both gloves

• Discard

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Remove Goggles or Face Shield

• Grasp ear or head pieces with ungloved hands

• Lift away from face

• Place in designated receptacle for reprocessing or disposal

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Removing Isolation Gown• Unfasten ties

• Peel gown away from neck and shoulder

• Turn contaminated outside toward the inside

• Fold or roll into a bundle

• Discard

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Removing a Mask• Untie the bottom,

then top, tie

• Remove from face

• Discard

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Removing a Particulate Respirator Lift the bottom

elastic over your head first

Then lift off the top elastic

Discard

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STEPS OF HAND HYGIENE

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Contact tracing

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Hope over hype

SUSCEPTIBLE TO SOAP,BLEACH,SUNLIGHT,DRYING