Having established OSHA mechanical and physical controls, implementation of personal barrier protective measures becomes a major part of infection control. Routine use of universal precautions is essential to the operators’ best protection against opportunistic unknown nosocomial hazards. Lax practices of the past do not meet the needs of the modern practitioner. Preventative measures are designed to provide each practitioner with maximum protection against opportunistic transmissions of airborne and blood borne pathogenic organisms as well as other dangerous microbes.
The Personal “barrier” attire includes: disposable poncho, shoe covers, removable gloves; disposable sleeves, head cover, mask, eye protection; disposable smock gowns or coveralls; hood, face shield and/or mask; knee high shoe covers; disposable moisture proof apron provides a primary barrier over personal barrier attire. Bottom should be folded to form reservoir cuff to prevent splashed fluids from dripping onto the floor/shoe cover etc; disposable charcoal mask for odor control; respirator; disposable hair and beard covers.
Reduction of potential health hazards is everyone’s responsibility. One broken link can be hazardous to all. As practitioners employed in funeral service, you are at risk through exposure from direct body contacts or body fluids. Pathogens are not selective to their host, they are opportunistic.
A pathogenic organism must enter a host; reproduce within the blood and body fluids around the cells and tissues. Each organism obtains its nutrients from the host; they grow and cause diseases within specific organs. Their waste (toxins) attacks each organ causing illness and death. If the practitioner is healthy they are able to fight off many diseases, but if the immune system has been weakened illness brings about changes as well as the body’s ability to fight off various disease processes.
Chemical disinfection means to destroy by the use of chemicals those microorganisms that are capable of producing disease or infection. When articles required for use in the embalming process cannot be sterilized by heat (autoclaving), other methods must be used to make the articles bacteriologically safe for the practitioner to handle.
Rubber and polyethylene tubing in the prep room can be a source of infection to the practitioner as well as a vehicle of cross contamination between dead bodies. All tubing must be thoroughly cleaned, the lumen flushed and the air bubbles released. Disinfectant solution must contact all surfaces of any articles being immersed in it. Sharp cutting instruments such as dissecting or suture scissors and eyed suture needles are made of stainless steel and can be steam sterilized. A small number of cutting-edge instruments are made with high carbon steel and tend to dull, corrode or pit when steam sterilized. Suture needles are probably the most abused item in the preparation room. After they are used, they are rinsed in tap water and stuck in a piece of foam. Hypodermic needles used for injection of preservative fluid or tissue builders are rinsed in water or solvent, disinfected and stored for next use. Seldom are they disinfected or sharpened and this is an on-going concern.
Most accidents are caused by using dull instruments. The practitioner has control when using sharp instruments which is limited when using dulled instruments. Failure to disinfect exposes the practitioner to needless hazards.
Dull and contaminated needles, scissors and trocars are a potential source for cross-contamination, body to practitioner and body to body.
Part 10 will continue with personal barrier protection, chemical disinfection and discuss the components of disinfectants.