Biomedical Engineering Reference
In-Depth Information
Adjust the planned operations as indicated by the
evolving circumstances. Possible adjustments
include:
4. Hydrate with 8-16 ounces of fluid.
5. If time allows have blood pressure (BP),
pulse, respiration rate, and temperature taken
and recorded on Medical Surveillance form.
6. Obtain appropriate sized PPE ensemble pack
or individual pieces, APR/ PAPR, battery,
and appropriate cartridges (2-3 depending on
APR/PAPR being used).
7. Layout PPE pieces and confirm they are right
size and in working order.
8. Apply appropriate type of cartridges (most
incidents will require HEPA/organic vapor
cartridge set) and remove all pull-tabs. DO
NOT OVERTIGHTEN the cartridges on
the mask.
9. Put on latex or plastic inner glove—consider
placing light circular band around top of
glove to lessen chance of premature removal
during doffing.
10. While sitting, remove shoes and place on foot
covers (foot protection should not present tear
risk to the suit nor be heelless).
11. Pull on chemical/biological protective suit to
waist.
12. Place outer booties/boots on over the foot
portion of the suit.
13. Using duct tape, seal top of booties to protec-
tive coverall (use a flap of tape at the end and
place facing front to ease removal).
14. For chemical incident, place one set of nitrile
gloves and one set of butyl rubber gloves
on hands. For biological incident, use double
plastic/latex gloves or plastic/latex and nitrile
gloves.
15. Seal seam of protective suit and gloves with
duct tape (use a flap of tape at the end and
on the front of the wrist area to ease removal
of tape).
16. Zip up protective suit to neck and close zipper
securing and covering zipper seal.
Upgrading plan: more personnel protected,
shorter rotation periods for PPE personnel, longer
soap and wash cycles for victims, obtaining assis-
tance from other hospitals or from emergency
response resources.
Evacuating or closing the facility to “shelter in
place” if the hospital is in the zone of contamina-
tion.
“Lock-down” of facility if agent, agent concen-
tration, or the number of patients exceeds the safe
operation of the plan or compromises the hospital
integrity.
Any need to isolate the decontamination
wastewater (notify authorities to remove it per prior
arrangement). Otherwise, notify “downstream”
water authorities that decontamination wastewater
is entering the sewer system.
Downgrade the plan (lesser protective clothing
and/or respiratory protection if agent is identified
as non-threatening). This should be a high priority
if possible, since safely downgrading the level of
PPE will enhance the efficiency of the decontami-
nation process.
A. Donning Procedures
Staff medical monitoring to be completed by
assigned Registered Nurse (RN) or MD (use desig-
nated medical monitoring form included in this
Annex). Use a room with privacy and plenty of
sitting space to facilitate donning of PPE.
1. It is preferable that a scrub suit be worn in
lieu of regular street clothes. Clothing should
be suitable for preserving comfortable body
temperature.
2. Remove all jewelry and leather material and
place in plastic bag with your name on it—
place it in a secure location for the Security
to maintain. Persons needing to wear glasses
or with beards or mustaches are NOT to use
a face mask device.
17.
If using PAPR, put on vest. Cinch up vest
to snug fitting around with motor unit riding
above the buttocks. Secure battery to the belt
3. Persons with long hair should apply a hairnet
or place-up in a braid.
