Module TM1: 08 Understanding

Clinical & Biomedical Terminology

Engr. Rene G. Aparri
Outline of Contents
• Introduction

• Clinical Terminology

• Biomedical Terminology
Introduction
• You need to be aware of potential dangers to
help protect your health
• Potentially infectious material in a healthcare
setting:
• Body fluids
• Saliva
• Any body fluid visibly contaminated with blood
• Unfixed tissue or slices
• Cell, tissue or organ cultures
• Blood or organs from experimental animals
Introduction
• Responsible organizations should keep patients,
staff and visitors safe by having systems to
ensure that all reusable medical devices are
properly decontaminated
• Staff handling used medical equipment should
assume that it is contaminated and take
precautions
• The use of personal protective equipment
should always be considered
Introduction
• Decontamination is a series of process to
remove or destroy contamination so that
infectious agents or other contaminants cannot
reach a susceptible site in sufficient quantities to
start infection or any other harmful response
Basic Concepts
• Blood borne pathogens
o A disease causing microorganism found in
blood, blood products and other body fluids.
For example:
• Human Immunodeficiency Virus (HIV)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
Hazards to BMEs
• Occupational exposure – anticipated skin, eye, mucous
membrane or parenteral contact with blood or infectious
material when performing your job
o Parenteral: piercing mucous membranes or the skin
barrier through such events as needle sticks, bites, cuts
and abrasions

• Universal or Standard Precautions – an approach to

infection control that considers all blood and body fluids
infectious
Hazards to BMEs
• Splashes or splatters of blood or infectious material
• Contact between an individual’s open wound and a source
of blood or infectious material
• Sharp-object injuries (needle sticks, scissor or scalpel cuts
and nicks)
• Handling contaminated medical equipment
• Cleaning blood or body fluids that have entered medical
equipment
Hazards to BMEs
• A whole range of hazards
Infection Control Practices
• Have an Exposure Control Plan (ECP)
o ECP provides policies and procedures that:
• Help prevent accidental exposures
• Provide means to report exposure incidents
• Provide instructions for performing post-exposure
follow-up and appropriate treatment
• Identifies labels and signs indicating infectious
materials
• Identifies necessary records- who, what, where,
when and how
Infection Control Practices
• Follow Universal Precautions
o The practice of assuming all blood and potentially
infectious material are infectious.

• Use engineering and work practice controls

o No eating, drinking or applying cosmetics in an area
with blood or potentially infectious materials
o Disposing of all used sharps (contaminated or not) in
sharp containers
Infection Control Practices
• Use appropriate PPE
• Personal Protective Equipment includes items such
as gloves, masks, eyewear, face shields, gowns and
other items a person wears to protect themselves
against exposure
• Wear PPE anytime you may contact infectious
material (including contaminated equipment)
• Wear PPE if you are doing a task that may cause
blood or fluids to splash or splatter
Infection Control Practices
• Use appropriate PPE
o Gloves
• Variety to choose from, including latex-free
varieties
• Check for small holes, puncture marks etc. before
using

o Face shields and gowns

• Put them on before starting to work
• Do not remove them wearing “dirty” gloves or
hands
Infection Control Practices
• Use appropriate PPE
o Always wash hands after removing gloves
o All contaminated PPE should be disposed of into
“biohazard” waste containers
• Get training
o Proper training is important in ensuring your safety
and the safety of those around you
o Make sure you have received adequate training
concerning possible exposures and precautions
o Exposure training is also important when working
around patients to prevent the spread of nosocomial
infections
Infection Control Practices
• Get immunized
o Immunizations for hepatitis could be a good
preventive measure

• Hand Hygiene
o Wash your hands before and after handling medical
equipment
 Activity Break
• Individual
o List down 3 personal protective equipment (PPE)
a biomedical engineer should use when
performing repairs

• Group
o Explain, with examples, the “Universal
Precaution”.
Establishing Decontamination
Policies
• Medical devices should be decontaminated and stored
in accordance with best practice requirements

• Where appropriate decontamination should always be

carried out in dedicated facilities or areas, for example:
o Endoscopes – endoscopy suite
o Surgical instruments – sterile services
• The choice of decontamination method should be
related to the degree of infection risk associated with
the intended use of the equipment
Establishing Decontamination
Policies
• Differing levels of decontamination are used depending
on the device and the procedure involved

• Common levels of decontamination are:

o Cleaning
o Cleaning followed by disinfection and or sterilization
Establishing Decontamination
Policies
• Set up protocols for decontamination activities seeking
advice from:
o Manufacturer of the medical device
o Manufacturer of equipment used for
decontamination/reprocessing
o Infection control staff
o Sterile service manager
o Consultant microbiologist or consultant in communicable
disease control or a public health doctor
o Risk assessment officer
o Device and equipment users
o Appropriate government bodies
Establishing Decontamination
Policies
• Items subject to inspection, maintenance, repair or
disposal, either on site or at the manufacturer’s or
agents premises, should be decontaminated
beforehand

• Any loaned items received or being returned to a

manufacturer or supplier should also be
decontaminated

• Once decontamination has been completed the items

should be labelled accordingly
Reporting an Exposure Incident

• Report all exposures to your supervisor or hospital risk

manager

• An exposure incident has occurred if your eyes, mouth,

mucus membranes, or open wounds have had direct
contact with blood or potentially infectious material (not
your own)

• You have punctured the skin with a contaminated sharp

object
Reporting an Exposure Incident

• Report the exposure immediately. Prompt evaluation is

important

• Ensure you are sent for a medical evaluation and

receive the necessary treatment

• Your supervisor or risk manager should provide you

with the necessary paperwork and will help document
the exposure
Other Hazards in the Hospital
 Activity Break

• Individual
o Identify who is responsible for decontamination of
medical equipment in your hospital.

• Group
o Develop a brief policy on decontamination of
medical equipment for your biomedical
engineering department.
Case Study : Decontaminating Ebola
Exposed Medical Devices
• If a patient with Ebola virus disease presented at your
facility, would you know how to properly decontaminate
the devices used in the patient’s treatment?
Case Study : Decontaminating Ebola
Exposed Medical Devices
• The Association for professionals in Infection Control
and Epidemiology cities the following recommendations
from the U.S. Centers Disease Control and Prevention
(CDC):
o Dedicated medical equipment (preferably disposable, when
possible) should be used for the provision of Ebola patient
care. All non-dedicated, non-disposable medical equipment
used for patient care should be cleaned and disinfected
according to manufacturer’s instructions and hospital policies.
Case Study : Decontaminating Ebola
Exposed Medical Devices
• On its Interim Guidance for Environmental Infection
Control in Hospitals for Ebola Virus page, CDC
states:
o Although there are no products with specific label claims against the
Ebola virus, enveloped viruses such as Ebola are susceptible to a
broad range of hospital disinfectants used to disinfect hard, non-
porous surfaces. In contrast, non-enveloped viruses are more
resistant to disinfectants. As a precaution, selection of disinfectant
product with a higher potency than what is normally required for an
enveloped virus is being recommended at this time. EPA-registered
hospital disinfectants with label claims against non-enveloped
viruses (e.g., norovirus, rotavirus, adenovirus, poliovirus) are
broadly antiviral and capable of inactivating both enveloped and
non-enveloped viruses
Case Study : Decontaminating Ebola
Exposed Medical Devices
• ECRI Institute recommends that EPA-registered
disinfectants be used if possible

• Contact the manufacturer for recommendations and

possible incompatibilities

• If manufacturer cannot offer specific

recommendations, consider using detergent and
water to remove visible contamination, and disinfect
or sterile using a method unlikely to cause damage
Module TM1: 07 Managing Safety
Engr. Rene G. Aparri