The Tupelo Fire Department recognizes the potential exposure of its fire fighters, in the performance of their duties, to communicable diseases. To minimize the risk of exposure, the Tupelo Fire Department will implement an infection control program.

The infection control program will include standard operating procedures, initial training and continuing education in infection control practices, a vaccination program, the provision of proper infection control clothing and equipment, decontamination procedures for clothing and equipment, procedures for disposal of medical waste, a system for reporting and managing confidentiality, monitoring of compliance with the

Standard operating procedures, the design of future fire department facilities to minimize the risk of infection, and a public information campaign.

In the emergency care setting, the infectious disease status of patients is frequently unknown by fire department personnel. All patients must be considered infectious. Blood and body fluid precautions must be taken with all patients.

Members with infections that constitute, in the course of performing their duties, a risk of infection to patients or other members should be evaluated to determine the functions they can perform.

Members with extensive skin lesions or severe dermatitis on hands, arms, head, face, or neck shall not engage in direct patient contact, handle patient care equipment, or handle medical waste.

Members who are pregnant shall not engage in emergency medical operations due to the dangers to both the member and the fetus because the type frequency, and severity of infectious exposure is uncontrollable and unpredictable.

The fire department shall conduct periodic training regarding infectious disease control during emergency medical operations, including personal protection precautions, proper disposal and decontamination procedures, and methods of transmission and prevention for various infectious diseases.

The assistant chiefs shall be designated as the infection control liaison for the shift he supervises. Responsibilities include but are not limited to:

Maintaining communications between the fire department and various health care facilities and professionals.

Shall investigate the report of any possible exposure, and notify all the members who were potentially exposed, and ensure that follow-up medical supervision is provided.

Shall ensure that standard operating procedures are followed by all members.

The fire department shall make available to all personnel who wish to participate, access to a immunization program, including a vaccination against Hepatitis B.

Exposures:

Should any member of the fire department sustain an exposure, the exposed area shall be thoroughly washed immediately using water on mucous surfaces, and soap and running water on skin surfaces. If soap and running water are not available, alcohol or other skin cleaning agents that do not require running water shall be used until soap and running water can be obtained.

Should any member of the fire department be exposed to an infectious disease he shall notify the infection control liaison within three (3) hours of the exposure.

The infection control liaison shall provide and complete the infectious exposure form. The report shall include a description of the tasks being performed when the exposure occurred, the means of transmission, the portal of entry, the infection control garments and equipment utilized, and the disposition of medical management. For a example of this form see the appendix of chapter 5 of the SOG manual. (EXPOSURE FORM)

This report and follow-up medical guidance, counseling and testing shall be confidential.

The infection control liaison shall ensure that the exposed member receives medical guidance, evaluation, and any appropriate treatment as soon as practical, but within 48 hours.

The exposure data shall become a part of the member's personal health data file.

Assistant chiefs shall be designated as infection control officer for members under his command.

Prior to any contact with patients, members shall cover all areas of abraded, lacerated, chapped, irritated, or otherwise damaged skin with adhesive dressings, provided the member is not constrained, due to other infections or medical guidance.

Members engaging in any emergency patient care shall don medical gloves prior to initiating such care. Medical gloves shall be a part of standard emergency response gear.

Medical gloves shall be removed as soon as possible after the termination of patient care, taking precautions to avoid contact with the exterior surface of the glove.

Structural fire fighting gloves shall be worn by members in any situation where sharp or rough surfaces are likely to be encountered, such as extrication.

Cleaning gloves should be used to protect against contact with body fluids and disinfectants when disinfecting clothing or equipment used in emergency medical operations.

Members shall not eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses while wearing gloves.

Masks, splash resistant eyewear, and fluid resistant clothing shall be donned prior to any patient care situations, by members providing treatment, during which large spills of body fluids can occur, such as spurting blood and childbirth.

Artificial respiration equipment shall be single patient use type and swapped with the ambulance if at all possible. Non-disposable equipment shall be used only if necessary.

All members involved in patient care where sharp instruments or devices are present shall take precautions to prevent injuries by the devices. All such devices used in patient care shall be considered contaminated. Do not recap any needles.

Dirty or contaminated medical equipment shall not be cleaned or disinfected in the kitchen, living, sleeping areas. Until future changes can be made areas within the stations should be designated for equipment cleaning and disinfecting.

These areas shall be isolated from additional personnel during the disinfection process and all surfaces shall be disinfected immediately after cleaning the equipment.

The department is making every effort to end the need to disinfect medical equipment by using single patient use items however, occasionally this is not possible. When cleaning and disinfecting medical equipment the same or greater precautions should be utilized as when having patient contact.

Special precautions while cleaning medical equipment shall include but not be limited to:

• Avoid splashing by cleaning solutions
• Protection against splashing eye and mucous membranes
• Hand protection against the cleaning solution
• Avoid contact with run-off of cleaning solution
• Equipment, clothing, or supplies in need of cleaning shall be stored separated from clean equipment. Contaminated items shall be isolated as soon as possible after patient care is terminated.
• Skin surfaces that were not covered by clothing, protective clothing equipment, or infection control garments shall be washed after patient care is terminated.

Hands shall be washed after:

• Each emergency medical incident
• Cleaning and disinfecting emergency medical equipment
• Cleaning protective clothing or equipment
• Any station cleaning function
• Using the bathroom

• Handling food or cooking utensils
• Cleaned and disinfected emergency medical equipment
• Hands and contaminated surfaces shall be washed with soap and water by lathering the skin and rubbing vigorously all lathered surfaces for 10 seconds, followed by thorough rinsing.
• Hands and contaminated skin may be cleaned on the scene by using a waterless, disinfecting hand cleaner.

Protective clothing and station wear contaminated with large amounts of body fluids shall be placed in leak proof containers and stored for cleaning. Such items should not be taken home for the purpose of cleaning.

All mattresses shall be covered with a sheet prior to sleeping on the bed. The sheet shall not be shared by another person.

Recommended cleaning methods:

• All visible soil must be removed prior to any disinfection or sterilization process.
• For reusable instruments which contact mucous membranes:
• Immersion in an EPA-registered sterilant for 10 to 45 minutes, or according to the manufacturer's recommendations.
• For surfaces that come in contact with skin and have been visibly contaminated with body fluids. Surfaces must be precleaned:
• Use an EPA-registered hospital disinfectant, chemical germicide that has is labeled as turberculocidal, commercially available hard-surface germicide, or a solution of 1/4 cup of chlorine bleach per gallon of tap water.

For removal of soiling in the absence of visible body fluid contamination and routine housekeeping:
 

• Epa-registered hospital disinfectant

The following cleaners are recommended to spot clean protective clothing.

• Liquid spray and wash
• Liquid tide
• Liquid shout

The following recommendations should be followed when washing protective clothing:

While the machine is filling with hot water, add ½ cup of oxygenated bleach (liquid chlorox 2 or liquid vivid) and 1 cup of liquid detergent (liquid wisk, liquid tide, liquid cheer or liquid fab).

Fill washer to the highest water capacity, set for normal cycle, cotton/white, or similar setting, add the clothing to be washed. Set the machine for double rinse or a complete second cycle can be run without adding detergent or oxygenated bleach.

Remove the garments and hang in a shaded area for drying.