Phlebotomy Precautions and Safety

 
Blood Spills or Other Contaminations with Potentially Infectious Material

The article below is a modified version of the article as originally published at http://rehs.rutgers.edu/bbpath2_appndx6.html titled:

Rutgers University Procedures for Cleaning and Disinfecting Spills of Blood or Other Potentially Infectious Material. It has been modified to better suit the needs of the Phlebotomy Pages' visiting audience, and is reprinted in its new, slightly changed version with the kind permission of Rutgers University, Environmental Health & Safety Office. The Rutgers team and I hope you find it useful! Thank you, Rutgers!

Spills Cleanup...

Attention: Always use safe and clean equipment, and never carelessly handle or discard used needles and vials. Watch this short video clip!

 ATTENTION: Please realize that this video (published from YouTube) is NOT HERE TO TEACH you phlebotomy techniques, but merely to show you different scenarios of the phlebotomist's daily routine. The video may contain techniques, or procedures that do not conform to proper, and/or safe venipuncture protocol. 

Cleaning and Decontaminating Laboratory Spills of Potentially Infectious Microorganisms

Because phlebotomists and laboratory technicians are involved in the collection, culture, growth, and manipulation of blood, bodily fluids, and other potentially infectious material (PIM) they must be adequately prepared and trained for the event where the unexpected happened and blood or concentrated cultures of potentially infectious microorganisms have spilled.

When spilled, blood or cultured microorganisms present a risk of disease transmission to phlebotomists and laboratory workers. Spillages should be dealt with as quickly as possible. All laboratories (research, diagnostic, or other) working with potential pathogens must have a written plan for dealing with spills or other releases of such materials! All work locations where employees may be reasonably anticipated to come into contact with blood or other potentially infectious material must have equipment available to safely and effectively clean up these spills.

Spill kits specifically designed for the clean-up and decontamination of biological spills in laboratories are commercially available. They must be supplied by the employer who obtained them through a laboratory supply catalog. At a minimum this equipment should include written directions for use and contain the following:

Disposable Personal Protective Equipment (PPE):

• domestic or latex gloves
• protective eyewear
• face mask
• gown or plastic apron
• antiseptic towelettes

 

Spill Clean-Up Equipment should consist of:

• disposable absorbent material such as paper towels or lab table soakers
• red biohazard waste bag for disposal
• appropriate germicidal solution
• forceps or other mechanical means for picking up broken glass and soaked paper towels

A variety of spill kits are currently available commercially. The pre-packaged spill kits are particularly well suited for use in a medical office or clinic! Regardless of the type of spill kit used, the steps described below, should always be taken when cleaning and decontaminating spills of blood or other potentially infectious materials.

Cleaning blood spills and other potentially infectious fluids:

1. Put on appropriate personal protective equipment (PPE) including double gloves, gown, protective eyewear, and face mask.
   
2. Control the area. Prevent people from walking through affected area and thereby spreading the blood or other potentially infectious material.
   
3. Contain the spill. Cover the spillage with hypochlorite granules (presept). Use paper towels or other absorbent materials to cover the spill. Let it sit until the bulk of the spill is soaked up.
   
4. Never touch contaminated spills with your hand, even when wearing disposable gloves. Always usemforceps, plastic scoop, dustpan or oher tools to remove any broken glass or sharp objects from the spill area. Take care not to create aerosols. Place these items into a small cardboard box, thick walled plastic bag, or other container that will prevent them from puncturing the red bag (or your hand). Place the contained sharp items into the red bag for disposal. Do not seal bag.
   
5. Apply appropriate disinfectant. To avoid creating aerosols, never spray disinfectant directly into spilled material. Instead, gently pour disinfectant on top of paper towels covering the spill or gently flood affected area first around the perimeter of the spill, then work disinfectant slowly into spilled material.
   
6. Allow several minutes of contact time with disinfectant; but at least 2 minutes minimum!
   
7. Pick-up all absorbent material and place carefully in red bag for disposal. Do not seal red bag.
   
8. Clean affected area again with disinfectant and new paper towels. Place used paper towels in red bag for disposal. Do not seal red bag.
   
9. Dry area. Place used paper towels in red bag for disposal. Do not seal red bag. Many commercially available spill kits are equipped with a powder that solidifies the spill and a small plastic scoop used to pick-up the solidified spill. If you are using such a kit follow the directions that come with the kit. Avoid creating aerosols when cleaning blood spills regardless of the type of spill kit used.
   
10. Once spill is completely cleaned, place all used spill control equipment in the red bag for disposal. Do not seal red bag.
    
11. Remove PPE and place in red bag for disposal. Remove PPE in the following order:
    
    - Remove soiled gown
    - Remove outer pair of disposable gloves
    - Remove face mask and protective eyewear
    
    Do not remove PPE from face with soiled gloves. Remove soiled outer gloves first and place them in the red bag for disposal. Use clean inner glove to remove PPE from face. This prevents the introduction of blood or other potentially infectious material to the mucous membranes of the face via a contaminated glove.
    
12. Once all used PPE, spill control equipment, and other potentially contaminated items are in the red bag seal bag securely for disposal. Observe the proper disposal of regulated medical waste in your community.
    
13. Was hands, reglove, wash surface with water and detergent.
    
14. When done, discard gloves, wash hands!