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4-21: Protocols for special medical procedures
4-24: Reports to the public health department
4-26: Quality of health services, quality assurance
5-02: Standards for food service equipment, practices
8-02: Hepatitis B immunization for staff
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6-15 - Universal precautions; blood-borne pathogens
 

Provide school staff with education on the safe handling of blood, vomit, urine, other body fluids, and fecal material. Provide ample and convenient supplies of gloves, containers for proper disposal of needles and other sharp objects, disinfectants (including bleach), and other equipment in identified, predetermined locations, including classrooms.

   
Rationale
 

Staff trained in procedures to handle potential exposure to blood-borne pathogens and other infectious agents minimizes risk to students and other staff and alleviates unnecessary anxiety. Hepatitis B, hepatitis C, human immunodeficiency virus (HIV), cytomegalovirus, and other viral infections are readily preventable through the use of basic protocols. A blood-borne pathogen exposure control plan for schools is mandated by the Occupational Safety and Health Administration.

   
Commentary
 

Sport and playground injuries, severe bites, used needles, and many other occurrences in school can expose students and staff to blood-borne pathogens. "Universal precautions" refers to a set of protocols for handling body fluids properly (i.e., blood, saliva, urine, vomit). Body Substance Isolation (BSI) is an acceptable and alternative set of procedures to universal precautions and differs primarily in that this includes handling of all body fluids and substances.

Universal precautions include: hand washing, avoiding punctures, utilizing gloves when handling body fluids, using containers with plastic liners to dispose of contaminated tissues, having special containers for disposing of contaminated sharp objects, promptly washing blood and other human fluids from skin, and cleaning hard surfaces with a disinfectant (e.g., diluted household bleach).

Gloves, disinfectants, and containers to dispose of contaminated materials should be made available throughout the school for easy access. Vinyl and nitril (or nitrile) gloves have less risk than latex for allergic reaction. Nitril gloves have been shown to provide comparable pathogen protection to latex gloves. Masks are required for procedures where splattering to the face is a risk. Good hand washing technique is essential for preventing the spread of disease and should be taught to all staff and students. Adequate facilities for hand washing that should be available throughout all school facilities include warm water, soap or detergent, towels, waste receptacles and posted signs to instruct on hand washing technique.

   
REFERENCES
 

American Academy of Pediatrics, Committee on Sports Medicine and Fitness. Human immunodeficiency virus and other blood-borne viral pathogens in the athletic setting. Pediatrics. 1999;104:1400-1403.

Friedland LR. Universal precautions and safety devices which reduce the risk of occupational exposure to blood-borne pathogens: a review for emergency health care workers. Pediatr Emerg Care. 1991;7:356-362.

Korniewicz DM, El-Masri M, Broyles JM, Martin CD, O'connell KP: Performance of latex and nonlatex medical examination gloves during simulated use. Am J Infect Control. 2002 30(2):133-8.

Rego A, Roley L. In-use barrier integrity of gloves: latex and nitrile superior to vinyl. Am J Infect Control. 1999 27(5):405-410.

Riddell LA, Sherrard J. Blood-borne virus infection: the occupational risks. Int J STD AIDS. 2000;11:632-639.

 
          
 
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