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Medical personnel must protect themselves and other patients from potential exposure to hazardous substances before providing initial care of contaminated patients.
The Administrative Director/Patient Care Coordinator or designee directs the:
A. ED personnel involved in the decontamination of the patient to:
1. Report to triage for baseline vitals. Obtain personal protective equipment (PPE) supplies from the designated, locked storage area.
2. Check suit for leaks and zipper integrity.
3. Remove all jewelry, wallets, and valuables, prior to donning PPE and secure in personal locker.
4. Don chemical-resistant suit over boots.
5. Place pant leg over top of boots. Depending on the type of equipment used, secure with chemical resistant tape if necessary.
6. Don non-sterile latex or vinyl gloves (elastic of chemical suit is placed over the gloves).
7. Apply respiratory and face/eye protection.
8. Pull up hood of chemical-resistant suit and secure in place.
9. Seal hood and zipper of suit with chemical- resistant tape.
10. Apply nitrile rubber gloves over outside of suit and seal with chemical-resistant tape.
B. Plant Operations will:
1. Place plastic sheeting in area proximal to contamination area and secure area with hazard tape as directed by ED physician to protect area from contamination, if necessary.
2. Secure additional Hazmat supplies from the decontamination reduction zone (DRZ), such as salvage drums and linen cart.
C. Environmental Services will:
1. Environmental Services will bring an additional linen cart to the ER treatment area.
2. On the midnight shift, weekends, and holidays, Environmental Services will initiate setting up decontamination tent.
D. Security Officers will:
1. Divert all traffic from the contaminated area.
2. Secure additional areas with hazard tape as necessary.
1. The patient(s) will not enter the ED until they have been decontaminated.
2. If the patient(s) arrive to the ED unannounced, security will prevent the patients from entering the hospital until the DRZ is prepared for the patient.
3. If the patient(s) is still in a private vehicle and is known to be contaminated, the patient should be held in the vehicle until the DRZ is prepared. Note: If the patient(s) is in a life-threatening situation and requires immediate attention, ED staff with proper PPE should begin treatment in the ambulance, and an emergency decontamination should be performed.
4. Patient’s clothing should be removed in the ambulance (if not already removed at the scene). Note: The greatest portion of contamination is usually found on the patient’s shoes and clothing. Prompt removal of garments at the scene greatly reduce the amount of product the patient(s) and rescuers are exposed to.
5. Clothing should be placed in a clear plastic bag and labeled with the patient’s name and marked contaminated. Jewelry and other valuables should be placed in a zip-lock bag and labeled accordingly. All items may be returned to the patient(s) if the product is determined to be non-toxic. If the substance is deemed toxic, all items will be disposed of with the exception of jewelry and other nonporous items such as credit cards.
6. Patient(s) should be covered with a disposable blanket and advanced to the DRZ.
7. Patient(s) should enter shower area.
Source: St. John Northeast Community Hospital, Detroit.