Infection Control Today

APR 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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30 ICT April 2019 www.infectioncontroltoday.com feature By William C. Henry Sr., CRCST T he times in which we fnd ourselves are fraught with peril. Disaster lurks around every corner as media outlets constantly stream images of human suffering that always seems far removed from our front door. However, disaster may very well come to your front door one day, despite feeling safe and distanced from immediate harm. Time passes as we move on to the next situation, never having properly processed the previous event. We begin to create a cognitive dissonance that must be ceased to properly prepare. It is only through preparation and cooperation that we will be able to assist those in their moment of need effectively and effciently. The term "pandemic" comes from the Greek "pan demos," meaning "all people." A pandemic is an epidemic that has spread across a large area. Infection control during pandemics of the past were totally lacking as there was little knowledge of infectious organisms. The lack of infection control continued during the U.S. Civil War (1861- 1865) that saw a lack of sterile conditions within the operating room. With very little sterile instruments available, many soldiers died from infections caused by these unsterile instruments. One of the frst recorded pandemics was leprosy, also known as Hansen's disease. This disfguring disease has affected humanity for almost 3,000 years. The Centers for Disease Control and Prevention (CDC) notes that leprosy can only be contracted through close contact with an infected person over the course of months. The disease can be treated with several antibiotics administered concurrently. The bubonic plague, also called the Black Death, frst reared its ugly head in 1331. The infection traveled from Asia across Europe and the Middle East, leaving millions of dead in its wake. The disease was spread through a fea-to-rat cycle that was fueled by unsanitary conditions that existed at the time. Once better hygiene was restored, the pandemic Instrument Reprocessing and Infection Control During Pandemics event faded. The children's nursery rhyme, "Ring Around the Rosy," has its roots during the bubonic plague; infected people often kept fowers in their pockets to dampen the smell emanating from the round, rosy-colored nodules. Ashes, ashes, we all fall down, due to the high mortality rate. The modern world faces the Ebola virus as the latest bug, having frst shown itself in 1976 in the Democratic Republic of the Congo. The recent outbreaks of Ebola have killed thousands of people, primarily in West Africa. The Ebola virus causes hemorrhagic fever in humans and mammals known as Ebola virus disease (EVD). The medical resources required to combat this pandemic is largely unavailable in African countries. The World Health Organization (WHO) has set forth standards and programs aimed at bringing an end to any outbreak. On Sept. 20, 2014, the CDC announced the frst recognized case of Ebola in the United States. A U.S. citizen traveling to Liberia returned to Dallas and was hospi- talized on Sept. 28, 2014. Two nurses were infected with the Ebola virus while caring for the patient. Although both nurses were declared to be free of Ebola eight to 14 days later, the fear level among healthcare workers skyrocketed. All things handled safely, can be safely handled. Planning for known pandemic organisms such as Ebola must begin for the feld of sterile processing. The Ebola virus has been transmitted through use of unsterilized needles, body fuids and direct contact. Understanding the modes of transmission will aid in formatting the sterile processing policy and procedures for handling events of this level. Let's examine some of the key parts in reprocessing of instrumentation. Diseases and pathogens are transmitted through fve modes of transmission: direct contact, indirect contact, vector, airborne, and droplet. All transmissions are basically direct or indirect contact methods. Vector transmission by feas, bats, rats, and mosquito are highly common. Droplet transmission by airborne means is a very potent form as well. Blood and body fuids are always to be handled with established processes. Understanding the modes pandemics take helps the direct-care provider, as well as the processor of the surgical instrumentation. Disease Vector Air Droplet Leprosy X Cholera X X Infuenza X X Typhus X Small Pox X Measles X Tuberculosis X Malaria X Yellow Fever X *HIV/AIDS *Zika X SARS X X Ebola X *Spread primarily through sex or reproduction

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