By Michael Cendoma, MS, ATC, ACLS
Bloodborne pathogens (BBP) are pathogenic microorganisms that are present in human blood and can cause disease in humans. But, infection may also result from other potentially infectious materials (OPIM). Historically, the greatest risks of infection are from HIV and Hepatitis B and C. Typical BBP policies found throughout athletics only address the universal precautions approach to infection prevention of BBP. The Centers for Disease Control (CDC) has always recommended that standard precautions be implemented for the care of all patients, regardless of their diagnosis or presumed infection status. Today, however, infection fears are centered on transmission of COVID, requiring transmission-based precautions. Interestingly, the on-going debate regarding implementation of appropriate COVID protocols always seems to reduce down to reflect long standing CDC exposure control guidelines that recommend that transmission-based precautions be added to standard precautions for patients with known or suspected to be infected or colonized with epidemiologically important pathogens that can be transmitted by airborne or droplet transmission or by contact with dry skin or contaminated surfaces. In this edition of the Sports Emergency Care Digest we offer a foundational exposure control strategy that sports medicine team medical can use to inform their comprehensive approach to infection control.
Sample Exposure Control Plan For Sports Medicine Team Medical
In the event of an injury resulting in bleeding or exposure to OPIM, participants should be removed from the even as soon as practical, responding medical personnel should don appropriate PPE and begin immediate and aggressive measures to stop bleeding, cover any open wounds or skin lesions, and contain any OPIM.
During injury care, the following procedure shall be followed:
1. Don appropriate PPE;
2. Apply appropriate PPE to athletes unless otherwise contraindicated;
3. Immediately replace any PPE that becomes damaged or if their ability to function as a barrier is compromised during care;
4. Replace all PPE every 10min during injury care;
5. Properly doff all PPE and place in appropriate biohazard waste container or bag;
6. Wash hands thoroughly.
Following injury care, the following cleaning procedures shall be followed:
1. Don latex gloves and other appropriate PPE;
2. Use paper towels to absorb all fluids and OPIM;
3. Discard paper towels in biohazardous waste container;
4. Properly doff PPE and place in biohazardous waste container;
5. Don another pair of gloves and appropriate PPE;
6. Clean the contaminated area with a fresh 1:10 bleach-water solution or other appropriate disinfectant by saturating the area with solution and allowing solution to soak for 10-20 minutes;
7. Wipe down the area using paper towels;
8. Discard paper towels in biohazard waste container;
9. Properly doff PPE and place in biohazardous waste container;
10. Wash hands thoroughly.
Return to Play
Return to play for athletes is determined by appropriate medical staff. Open wounds must be covered by a bandage sturdy enough to withstand the demands of participation. If a participant’s uniform is saturated with blood or OPIM, appropriate medical personnel should assess the need to treat or change the participant’s uniform prior to returning to allowing the participant to return to the event.