Biomedical Engineering Reference
In-Depth Information
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Specimens
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Label specimens in accordance with hospital policy.
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Notify the pathology department about any smallpox
specimen before it is transported.
•
The specimen cannot be labeled “smallpox” because
of patient confidentially.
•
Deliver the specimen to the pathology department
immediately.
•
Document the specimen appropriately according to
OR protocol.
Waste material
•
All waste material, including tape from doors; all
packaging, regardless of contamination; and all
unopened disposable supplies will be placed in a red
biohazard bag.
•
No clear bags will be used for waste in a smallpox-
related procedure.
Linen
•
Linen bags will be transported immediately to the
laundry service.
•
Linen should not be separated or sorted before laun-
dering (4).
•
Use water soluble laundry bags to avoid separating.
Instruments
•
Current instrument sterilization is sufficient for decon-
taminating and sterilizing instruments (4).
•
The CMS department will provide the OR with a red
soak pan half-filled with approved hospital cleaning
solution to soak contaminated reusable instruments.
•
Instruments should be kept moist until they are
cleaned and decontaminated in accordance with
hospital guidelines.
•
The instrument container should be labeled
“smallpox” before it is transported from the OR to the
CMS department. This labeling is acceptable because
the container cannot be traced to the patient.
•
The CMS department should be notified before instru-
ments are transported to the decontamination area.
Current linen standards are sufficient for decontami-
nation of smallpox-contaminated linen (4).
Completion of case
•
Linens will be bagged and labeled “smallpox.” This
labeling is acceptable because linen cannot be traced
to a specific patient.
•
The HEPA filter machine will run for one hour after
the procedure is completed or until a minimum of 15
air exchanges have taken place (3).
•
The linen department will be notified before smallpox-
soiled linen is sent to the laundry.
•
The OR then should be terminally cleaned according
to facility standards.
•
Linen should be handled with minimal agitation to
prevent aerosolization (4).
•
After terminal cleaning, contact the facilities manage-
ment department to make any adjustments or filter
changes in the ventilation system.
•
The linen cart will be covered with a clear plastic bag
for transport.
Figure 13.4
Continued.
temporarily shut off the air-handling system in the
affected area. Airflow modification is easiest to
accomplish in a single wing or building and is
specific to the particular HVAC configuration.
Anesthesia machines and ventilators will need to
be decontaminated before use on non-contaminated
patients. Infected fluids from irrigation, suction
canisters, and sponges will need to be discarded
with a higher degree of care than is the usual prac-
tice. Hospital vacuum lines are to be considered
contaminated as will the pumps that they lead to.
During transport to and from isolation, infectious
patients need masks; outflow from BVM devices
must beHEPAfiltered.All personnel attending these
patients should be in Level C protective equipment.
Linens and stretchers require high-level decontami-
nation before reuse on non-contaminated patients.
13.6 Training Drills
The most difficult aspect of training is finding the
time to practice the departmental plan in simula-
tion drills. Many ORs run close to capacity during
the day. Administrators are hesitant to cancel
blocks of well paying surgery to accommodate
un-reimbursed training. Paying staff overtime for
weekend training is also financially unappealing.
Even harder than funding training is getting busy
surgeons to participate in large numbers. However,
this is imperative if meaningful results are to be
