Proper
Handling of Body Fluids Using OSHA Standards
by
Jill Garrett
Introduction
This is a process description of
how a child care worker handles body fluids according to Occupational Safety
& Health Administration (OSHA) standards. Exposure to any type of
bodily fluid results in the possible transmission of blood-borne pathogens,
which could lead to disease or death. Many occupations, such as those of
child care workers or nurses, are highly exposed to potentially infectious
materials.
INFECTIOUS BODY FLUIDS
(1) Blood
(2) Saliva
(3) Semen
(4) Vaginal Secretions
This paper uses the example of a
boy in a child care setting who has fallen, hit his mouth on a shelf, and is
bleeding from the cut he received. The procedure for handling the situation is
outlined in the following six steps: Removing the injured child, moving other
children away from the injured child and contaminated area, protecting the
child care worker’s body, cleaning and disposing of the infectious
materials, cleaning the shelf, and completing a post-evaluation and follow-up.
Step 1: Removing the Injured Child
First, the child care worker
removes the injured child from the play setting. When at a child care,
there are usually many children playing together in one area. When a
child falls and is bleeding, he/she then becomes a potential danger to all
other children. Therefore, it is of absolute necessity to isolate a
bleeding child.
When the child is led away from
the others, the child care worker is careful to not touch the blood. The
child care worker picks the child up and holds him away from her body so as to
not become contaminated. The child is then taken to a setting where the
child care worker has access to all necessary materials, such as personal
protective equipment. OSHA standards require that employers provide
"gloves, gowns, masks, and mouthpieces and clean, repair, and replace
these when necessary."
Step 2: Removing Other Children from the Contaminated Area
The child care worker then keeps
the other children away from the contaminated shelf. It is of absolute
necessity to keep the other children away from the shelf on which the child
hurt himself. If a child were to go and touch the blood on the shelf,
they too would be contaminated.
Keeping the children away from
the shelf usually requires another child care worker, aside from the one
assisting the injured child. The second child care worker takes care to
make sure that no children touch the shelf or the surrounding area. She
then moves all the children to the other side of the room to keep them away
from the shelf. Another alternative is for the second child care worker
to take the other children to a different room. Only when the shelf has been
properly cleaned may the other children come and resume their activities
around the shelf.
Step 3: Protection of the Child Care Worker
The child care worker then
protects her body, because she is also potentially harmed when dealing with
the blood. She takes universal precautions, which involves treating all
body fluids or materials as if they are infectious. After she has the
bleeding child in a safe setting, she places gloves on her hands so the
child’s blood will not come in contact with her skin. The following
types of gloves are acceptable.
EXAMPLE OF RECOMMENDED GLOVES
(1) Latex Gloves
(2)
Non-latex Gloves
(3) Rubber gloves
The worker may choose to wear
more than one pair of gloves. After she feels properly protected, the
child care worker proceeds to clean the child.
Step 4: Cleaning the Child
The child care worker then
cleans the child’s wound and properly disposes of any materials which
contain blood. Infectious materials that contain blood are put into a
bag that is able to be tightly closed. Instead of bags, some employers
have a special container specifically marked for hazardous materials labeled
biohazard.
With gloves on, the child care
worker takes a washcloth and holds it on the affected area until all bleeding
stops. She then throws the washcloth into a bag and seals it securely.
The child has blood on his shirt, therefore the child care worker removes the
shirt from the child’s body, taking care to not let the blood touch skin or
clothing. The soiled shirt is placed in another tightly saleable bag,
different from the one containing the washcloth. The child care worker
removes her gloves and places them in a third, separate bag. To ensure
that there is no blood on her hands, she then proceeds to a sink and washes
her hands with warm water and soap for thirty seconds. A clean shirt is
found for the child and he also washes his hands.
Step 5: Cleaning the Shelf
After the child is taken care
of, the child care worker prepares to clean the shelf and surrounding area.
She also disposes of any hazardous materials left. She puts on another
pair of clean, unused gloves. Next, she fills a bucket with warm, soapy
water and uses a washcloth for the cleanup. When cleaning the shelf, she
makes sure to scrub the area where there is blood. She also looks
thoroughly to see if there is blood anywhere else.
After cleaning, she disposes of
the gloves and washcloth, using the same technique as before. Then, she
pours the soap and water mixture down the sink. She then takes a mixture
of bleach and water and sprays the shelf to kill any body fluid still present.
The bleach is allowed to air-dry and/or wiped off after two minutes. The
bags containing the soiled materials are placed in an outside garbage
container and clothes are put on a shelf to be sent home with the child.
Now that there are no dangerous body fluids present in the room, all other
children come back into the room and are able to be near the shelf.
Step 6: Evaluation of Incident
Finally, the child care worker
completes forms and evaluates the incident, otherwise known as the evaluation
and follow-up procedure. If the child care worker wishes to do so, she
can have laboratory testing if she fears she was contaminated during the
process. According to the OSHA fact sheet, the child care worker’s
"confidential medical evaluation documents the circumstance of exposure,
testing of blood, counseling, and evaluation of reported illness."
Also, the child care worker writes an account of the incident in a health log
kept by her employer. The following diagram illustrates the necessary
information and the sequence in which it is gathered:
INFORMATION FOR HEALTH LOG
