Workplace Safety and Emergencies

This is Unit Ten of Medical Assistant Prep. Unit Nine kept instruments and surfaces safe. This unit keeps the workplace safe: the federal rules on blood and chemicals, safe lifting and transfers, fire, and the emergencies that call for help at once. Carry one idea through this lecture. In an incident, the order of actions matters as much as the speed, and practicing routines in calm moments is what makes them automatic. A constructed afternoon at the end puts two routines to the test. By the end you will be able to name what the bloodborne rules require of an employer and of you. To respond to an exposure in the right order. To read chemical labels and handle waste. And to move patients, respond to fire, and recognize an emergency.

Eight entries on the bloodborne pathogens rules: the plan, the vaccine, protective equipment, sharps, containers, labels and food.

Blood and chemicals.

MAS 226 Federal Rules Protect Workers Too

Federal workplace safety rules protect health care workers from bloodborne infections and hazardous chemicals. The bloodborne pathogens standard covers anyone with occupational exposure to blood; the hazard communication standard covers the chemicals used at work. Both rules give you rights as well as duties, and the employer owes you protection.

Written, and findable.

MAS 227 The Exposure Control Plan

Every employer whose workers have occupational exposure to blood must have a written exposure control plan. The plan describes how the workplace eliminates or reduces exposure: the equipment, the work practices and the steps to follow after an exposure. Learn where your practice keeps its plan before you need it.

Offered, and offered again.

MAS 228 The Hepatitis B Vaccine

Employers must offer the hepatitis B vaccine series to every worker with occupational exposure. It must be offered after training and within ten working days of starting the assignment, unless the worker is already vaccinated or immune. A worker who declines can still accept the vaccine later, and it must then be offered.

At no cost.

MAS 229 Protective Equipment at No Cost

When exposure is possible, the employer must provide the right protective equipment at no cost to the worker. That includes gloves, gowns, face shields, masks and eye protection; the employer also cleans, launders, repairs, replaces and disposes of it. Protective equipment is not optional for you either; wear it when the task calls for it.

Never bent or recapped.

MAS 230 Never Bend or Recap a Used Sharp

Contaminated needles and sharps must not be bent, recapped or removed. The only exceptions are when no alternative is feasible or a specific procedure requires it, and then only by an approved method, never two-handed. The safe habit is simple: never recap, and drop the sharp straight into the container.

Built for sharps.

MAS 231 Sharps Containers

Used sharps go into containers designed for them. A sharps container must be closable, puncture-resistant, leakproof on the sides and bottom, and labeled or colored as a biohazard. Do not let a container overfill, and keep it upright and within easy reach wherever sharps are used.

Orange warning.

MAS 232 Biohazard Labels

Containers of regulated waste, and of blood or other infectious materials, carry biohazard warning labels. The labels are fluorescent orange or orange-red, with lettering and the biohazard symbol in a contrasting color; red bags or containers can serve instead. The label warns everyone who handles the container, including people outside the practice.

Not where exposure is possible.

MAS 233 No Eating or Drinking Where Exposure Is Possible

Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where exposure is reasonably likely. Food and drinks are never kept in refrigerators, freezers or on counters where blood or specimens are stored. Keep lunch in the break room, never in the lab or the specimen fridge.

Five entries on exposure follow-up, training, safety data sheets, chemical labels and waste handling.

Wash, report, evaluate.

MAS 234 After an Exposure Incident

An exposure incident starts steps that protect the worker's health. Wash the area at once, flooding eyes, nose or mouth with water and cleaning any wound with soap and water. Report immediately, following the exposure control plan. The employer offers a confidential medical evaluation and follow-up at no cost. The route and circumstances are documented. The source person's blood is tested, with consent, for hepatitis B and HIV as soon as possible. The worker gets the follow-up the evaluating provider recommends. Report now, not at shift's end, because none of this can begin until someone knows.

Free, and on work time.

MAS 235 Safety Training on Work Time

Workers with occupational exposure must receive bloodborne pathogens training at no cost and during working hours. Training covers the plan, the risks, the controls, the protective equipment and what to do after an exposure, and it is repeated regularly. Ask questions during training; the trainer must be able to answer them.

One for every hazardous chemical.

MAS 236 Safety Data Sheets

Employers must keep a safety data sheet for every hazardous chemical used in the workplace. The sheets must be readily accessible to workers in their work area during every shift, on paper or electronically, as long as nothing blocks immediate access. Read the safety data sheet before using an unfamiliar disinfectant or chemical.

Pictogram, signal word, statements.

MAS 237 Reading a Chemical Label

Hazardous chemical labels follow a standard set of elements: a pictogram, a signal word, hazard statements and precautionary statements. There are eight standard pictograms; the signal word "danger" marks the more severe hazards, and "warning" the less severe. Never use a chemical from an unlabeled container.

Biohazard or ordinary.

MAS 238 Handling Biohazardous Waste

Regulated medical waste is discarded according to federal rules and the practice's policy. Items soaked with blood or other infectious materials go into labeled biohazard containers; ordinary trash goes in ordinary bins. Putting regular trash in biohazard bins wastes money, while putting biohazard waste in the trash endangers people.

Five entries on moving patients and on fire: body mechanics, gait belts, locked wheels, and two memory aids.

Devices and help.

MAS 239 Body Mechanics Are Not Enough

Body mechanics means using muscles, bones and nerves together to keep balance and alignment while moving patients. Good body mechanics help prevent back injury, but evidence shows they do not by themselves prevent lifting injuries when patients are heavy or dependent. Use assistive devices and help from coworkers, as the practice's policy directs, instead of lifting alone.

Secure hold.

MAS 240 Gait Belts

A gait belt is placed around the patient's waist to give a secure hold while they stand, walk or transfer. It goes on snugly, over clothing or a gown to protect the skin, whenever a patient needs any help to move. Use a gait belt even for a patient who needs only a little help; a small wobble can become a fall.

Lock before transfer.

MAS 241 Lock the Wheels

Before any transfer, lock the wheels of every piece of equipment involved. Place the wheelchair next to the table or bed and set its brakes, and keep wheelchair wheels locked whenever it is not moving. An unlocked chair can roll away at the moment the patient sits, which is how falls happen.

Rescue, alarm, confine, extinguish.

MAS 242 Responding to a Fire

Many facilities teach fire response with four letters in order. R is rescue, which some call remove: get anyone in danger away from fire or smoke. A is alarm: shout fire, pull the nearest alarm and call for help. C is confine: close doors as you leave to slow the spread. E is extinguish or evacuate: a trained person may fight a small fire once the other steps are done, and otherwise everyone leaves by the building's plan. Fight a fire only if trained and it is small. If unsure, or one extinguisher would not be enough, evacuate.

Pull, aim, squeeze, sweep.

MAS 243 Using an Extinguisher

A portable fire extinguisher is used with four actions remembered as P, A, S and S. Pull the pin; aim low, at the base of the fire; squeeze the handle; and sweep from side to side. Aiming at the flames instead of the base wastes the extinguisher.

Four entries on emergencies: anaphylaxis, reporting reactions, warning signs, and a constructed afternoon with two incidents.

Severe allergic reaction.

MAS 244 Recognizing Anaphylaxis

Anaphylaxis is a severe allergic reaction and a medical emergency that can cause life-threatening breathing failure. Early signs include hives and itching, a feeling of a swollen tongue or throat, shortness of breath, dizziness and low blood pressure. Do not leave the patient. Call for the provider at once and follow the practice's emergency protocol.

Minor to severe.

MAS 245 Reporting Adverse Reactions

Any adverse reaction after a medication or procedure is reported immediately to the provider responsible for the patient. Reactions range from a minor skin rash to serious events such as anaphylaxis, and established protocols guide the response. Record what you saw, when it started and what was done, in the patient's record.

Help now.

MAS 246 Warning Signs That Need Help Now

Some symptoms call for immediate help, whatever the reason for the visit. Chest pain, shortness of breath, dizziness, confusion or fainting are signs to report to the provider at once and never leave for later. Stay with the patient and call for help, rather than leaving to find the provider.

A needlestick and a reaction.

MAS 247 An Afternoon With Two Incidents

A constructed afternoon pays off the opening idea. After a vaccine, the assistant reaches for the cap from old habit, stops, and drops the needle into the sharps container. Later, a needle left on a tray sticks her. She washes at once and reports to her supervisor right away. The supervisor follows the exposure plan: a confidential evaluation at no cost, the circumstances documented, and consent sought for source testing. Twenty minutes after another vaccine, a man says his throat feels tight, with hives spreading. She recognizes early anaphylaxis, stays with him, calls loudly for the provider, and follows the emergency protocol. Washing came first and reporting followed, because follow-up starts only once an exposure is known. Staying with him meant he was never alone at the most dangerous moment.

Look at what you can now do. You can name what the bloodborne rules require, from the written plan and the vaccine to sharps containers, labels and food rules. You can respond to an exposure by washing, reporting and following the plan, and you read a safety data sheet and label before using a chemical. You can move patients with devices, a gait belt and locked wheels, and respond to fire with rescue, alarm, confine and extinguish. And you can recognize anaphylaxis and the warning signs that need help now. Unit Eleven turns to the patient visit itself: identity, history and the record.