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OSHA/HIV
OSHA/HIV Barry
| Question | Answer |
|---|---|
| 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. |
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