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Who regulates purity of medical gases? FDA: US pharmacopia.
Who regulates chemical germicides? FDA.
Who regulates disinfection/sterilization devices and procedures? FDA/EPA.
Who regulates gas containers and cylinders? DOT(department of transportation).
Who regulates safety and health of employees/employee exposures? Department of Labor-->OSHA.
What does ATSM stand for? American Society for Testing and Materials.
The ATSM does not enforce compliance, but many of its standards are mandatory. What does it regulate? Tracheal tubes.
This organization Offers broad recommendation for infection transmission and prevention. Does NOT regulate only makes recommendations. The CDC.
What does OSHA stand for? The Occupational Safety & Health Administration.
OSHA is a part of the US Department of... Labor.
Congress created OSHA in 1970 as a part of what legislation? Occupational Safety and Health Act.
“To assure the safety and health of America’s workers by setting and enforcing standards; providing training, outreach, and education; establishing partnerships; and encouraging continual improvement in workplace safety and health.” OSHA's mission statement.
True or false: OSHA can write standards and conduct inspections but has no powers of enforcement? False. OSHA can enforce with fines.
What does NIOSH stand for? National Institute for Occupational Safety and Health.
NIOSH is part of the US Department of... Health and Human Services.
True or false: NIOSH helps assure safe and healthful working conditions for working men and women by providing research, information, education, and training in the field of occupational safety and health. True.
Exposure to trace amounts of anesthetic gas in the air can cause increased... Spontaneous abortions, involuntary sterility, birth defects, cancer rates, kidney/liver failure.
Anesthesia providers can come down with impaired performance ability, decreased B12 synthesis, and impaired bone marrow DNA from exposure to what? Air pollution from excess anesthesia gas in the air.
What are some factors associated with waste gas concentration? 1. Length of anesthetic 2. Equipment used for measurement 3. Cuff vs uncuffed ETT 4. Ambu bag vs anesthesia machine circuit 5. Effectiveness/proper fx of scavenging system 6. Technique.
How is trace gas measured? Parts per million.
What's the maximum trace N2O allowed in the air? 25ppm.
What's the maximum trace N2O with volatile agent allowed in the air? 0.5 ppm.
What's the maximum trace halogenated agents alone allowed in the air? 2ppm.
Hospital biomed dept or external contractors samples air for trace gas how often? Every 3-6 months.
What are 4 ways we control gas levels? 1. Scavenging system, 2. Work practices, 3. Soda lime, 4. Rebreathing of exhaled gases.
What are some work practices we can employ to help control gas levels? 1. Proper mask fit/technique, 2. check N2O briefly, 3. 100% O2 at end of case, 4. avoid liquid spills, 5. low-flow technique, 6. control leaks, 7. OR ventilation system
How does administering 100% O2 at the end of the case help control gas levels? To wash out anesthetic (prevent diffusion hypoxia).
About how many people in the US are HIV positive? Just over 1 million.
About how many new HIV infections each year? 40,000 +.
About how many people worldwide are HIV positive? 42 million.
What are the types of HIV? HIV-1 and HIV-2.
What type of HIV is most common in the US? HIV-1.
What type of HIV is less common and found mainly in West Africa? HIV-2.
True or false? American HIV tests currently test for both forms of HIV? True.
HIV is a Retrovirus. What does this mean? RNA and reverse transcriptase structure.
HIV binds to what kind of immune cells? CD4 T-helper cells.
What happens as a result of HIV binding to CD4 T-helper cells when it replicates RNA and takes over cell? Cell mediated immunodeficiency.
When can HIV seroconversion be detected? Only after the HIV infected person's immune system recognizes the virus as foreign and produces antibodies.
What does ELISA stand for? Enzyme-linked immunosorbent assay.
ELISA is highly sensitive for HIV-1, however we need one more test to confirm... Western blot assay.
What is HIV's primary target? CD4 T-helper cell.
How low does the CD4 count have to be for HIV to be classified as AIDS? Below 200 cells per cubic millimeter.
We start treatment for HIV when the plasma HIV RNA level reaches what? 100 or greater.
What do we need to do before testing for HIV? Obtain consent(written or verbal--document).
True or false: it is mandatory to inform the county health department of all positive HIV results. True.
True or false: anonymous HIV testing is available. True.
True or false: pre-test counseling is required before testing for HIV. False.
True or false: if you get stuck with a dirty needle, you can test a patient's blood which has already been drawn for HIV without his consent. True.
If you've been stuck with a dirty needle and the patient refuses HIV testing and there is no available blood in the lab to test, how can he be tested? Blood can only be drawn against a patient's consent with a court order.
What body fluids are considered infectious even if there is no visible blood? Cerebrospinal, synovial, pleural, peritoneal, pericardial and amniotic fluids.
What body fluids are NOT considered infectious if there is no visible blood. Feces, nasal secretions, saliva, sputum, sweat, tears, urine, and vomitus.
If an employee is exposed to a potentially infectious substance, what should he immediately be tested for? Baseline HIV status.
Post-exposure prophylaxis(PEP) for HIV exposure is most effective if given within what time frame? Within the first 24-36 hours.
Post exposure prophylaxis with either a 2- or 3-drug antiretroviral regimen as outlined in the CDC recommendations is indicated to be given for how many days? 28 days.
Post-exposure to potentially infectious substance, how often should the employee be tested for HIV? 6 weeks, 3 months, and 6 months.
What else should the employee be tested for after exposure to HIV? Hep B and C.
What is the risk for seroconversion after needle-stick exposure to HIV? 0.3%.
What are the risks for conversion to Hep B and C after needle-stick exposure? HepB ~30%/HepC ~4%.
What is the risk for seroconversion after mucous membrane exposure to HIV? Approximately 0.09%.
Most common HIV treatment is a combination of 3-4 agents known as HAART. What does this stand for? Highly active antiretroviral therapy.
What are the reverse transcriptase inhibitors? AZT, didanosine, zalcitabine, stavudine, lamivudine.
What are the protease inhibitors? Saquinavir, ritonavir, indinavir, nelfinavir.
What are some of the SE of HIV treatment? Anemia, n/v, diarrhea, hepatitis, peripheral neuropathy, bone marrow supression.
Protease inhibitors increase levels of what drugs? Opioids and Benzos.
What cardiac drug is contraindicated when pt is on Protease inhibitors? Amiodarone.
AZT increases levels of these four drugs: 1. Benzodiazepines 2. Ca channel blockers 3. Quinidine 4. Methadone
What is one particular medication that should not be mixed with HIV drugs? Midazolam(Versed).
What are some airway complications as a result of HIV? Candida, Kaposi’s sarcoma.
What are some common pulmonary complications you can find in a patient with HIV? P. carinii, TB, Other pneumonias
What are some common CNS complications found in the HIV positive patient? Infections, tumors, dementia, electrolyte/blood glucose imbalances.
What are some CV complications found in the HIV patient? Infection (myocarditis), arrythmias.
What organ is particularly prone to failure in the HIV patient? Kidney.
HIV patients are prone to these two liver problems: Failure, hepatitis.
What hematological problems do HIV patients often have? Anemia, thrombocytopenia.
How do you kill blood-borne pathogens on surfaces? 1:10 bleach solution, 70% isopropyl alcohol.
How long does OSHA recommend that we leave the surface wet with disinfectant before wiping? 30 seconds for HIV-1 and 10 minutes for HBV.
Created by: 1592042303