IPs must notify emergency workers of exposures
Hospitals required to provide info
Infection preventionists who want to keep their programs in compliance should be well aware that when emergency responders transport an incoming patient who is later found to have a potentially life-threatening disease, they need to receive prompt notification from the hospital about the exposure risk. The Centers for Disease Control and Prevention has proposed a list of the diseases for which hospitals must notify the emergency medical services.
The CDC's National Institute for Occupational Safety and Health (NIOSH) proposed list includes three categories of potentially life-threatening infectious diseases. (Newly emerging infectious diseases that fit the criteria may be added to the list.) The categories are based on the means through which emergency responders may be exposed:
- Potentially life-threatening infectious diseases routinely transmitted by contact or body-fluid exposures: hepatitis B, hepatitis C, human immunodeficiency virus (HIV) infection, rabies, and vaccinia.
- Potentially life-threatening infectious diseases routinely transmitted through aerosolized airborne means: measles, tuberculosis, and varicella disease.
- Potentially life-threatening infectious diseases routinely transmitted through aerosolized droplet means: avian influenza, diphtheria, meningococcal disease, mumps, pneumonic plague, rubella, SARS-CoV, smallpox, and viral hemorrhagic fevers.
The Ryan White HIV/AIDS Treatment Extension Act of 2009 requires the notification and calls for the U.S. Department of Health and Human Services to list the diseases covered by the act.
"If an exposure occurs, there's to be an exchange of information in a very timely manner no later than 48 hours," says Katherine West, MSEd, CIC, BSN, a consultant with Infection Control/Emerging Concepts in Manassas, VA, and an editorial board member of Hospital Infection Control & Prevention.
The importance of timely notification was highlighted in an incident in California on Dec. 3, 2009. That day an Oakland police officer responded to a 911 call to check on someone who had failed to show up for work. Finding the person unconscious in his home, the officer tried to clear his airway and called for emergency medical assistance. The officer didn't wear respiratory protection, but paramedics from the Oakland Fire Department and a local ambulance service did. By the next morning, the hospital, Alta Bates Summit Medical Center, determined that the patient had Neisseria meningitidis, but didn't notify Alameda County Public Health Department until Dec. 7, more than 78 hours after meningitis was first suspected, according to a Cal-OSHA citation. The police officer contracted meningitis and spent five days in the hospital.
Medical facilities "have an immediate responsible to notify their designated infection control officer for the emergency medical services or law enforcement" under the Ryan White Act, says West. "This law, when it came to be, was one of the most important pieces of legislation for fire rescue and law enforcement."
Infection preventionists who want to keep their programs in compliance should be well aware that when emergency responders transport an incoming patient who is later found to have a potentially life-threatening disease, they need to receive prompt notification from the hospital about the exposure risk.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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