Biohazard Affix Prior To Servicing Or Shipping

Fig. 16-1. Warning label. Such a label must be affixed to potentially contaminated equipment.

Wesodyne (95 mL in 20 L of water). The solutions should be made up daily with tap water to prevent loss of germicidal action during storage. The autopsy tables are rinsed after each autopsy with water, Hi-lex, and Haemosol. During cleaning, personnel should don protective gear (see below). Paper towels, gauze, and gloves used for cleaning should be disposed in biohazard bags, as described in the next paragraph. If contamination with radioactive material may have occurred, follow recommendations in Chapter 13.

If large spills occur, the cleaning crew, during clean-up, must wear face shields or safety glasses, in addition to the usual protective garments. Absorb spill with paper towels. Broken glass and other sharp objects must be removed with mechanical devices such as dust pan and cardboard pusher, never by hand. For safe disposal of these objects, see below.

Equipment used for diagnosis, research, and other applications must be decontaminated with 10% bleach (see above). It is particularly important that this is done before any equipment leaves the autopsy laboratory area. If reliable decontamination cannot be achieved, a warning label "CONTAMINATED" should be affixed to the equipment. The label should state which part of the equipment remains contaminated (Fig. 16-1).

WASTE DISPOSAL Proper organization of waste disposal may decrease the hazards as well as the costs of the autopsy service (2). Containers used to discard material should be clearly marked so that items that should be incinerated are not inadvertently placed in containers that might be intended for the laundry, for example. Thus, we collect dressings, cotton wool swabs, hair, and other loose material from deceased persons in

Fig. 16-2. Safety features of an autopsy room. Upper, This facility has two autopsy tables. The room is partially divided by supply cabinets, which also can be seen in the background. Note bright lighting throughout the room. Containers (in foreground) with biohazard plastic bags are for contaminated material (see text). Lower, Autopsy table that can be pneumatically adjusted to the height of the prosector. Two scales are visible; the one on the very left is part of a crane system for lifting and weighing deceased on a metal rack, and the one in the center, suspended over the table from the ceiling, is for weighing organs. A separate table for dissecting organs is in the background, adjacent to the autopsy table.

Fig. 16-2. Safety features of an autopsy room. Upper, This facility has two autopsy tables. The room is partially divided by supply cabinets, which also can be seen in the background. Note bright lighting throughout the room. Containers (in foreground) with biohazard plastic bags are for contaminated material (see text). Lower, Autopsy table that can be pneumatically adjusted to the height of the prosector. Two scales are visible; the one on the very left is part of a crane system for lifting and weighing deceased on a metal rack, and the one in the center, suspended over the table from the ceiling, is for weighing organs. A separate table for dissecting organs is in the background, adjacent to the autopsy table.

red biohazard bags (Fig. 16-2) for immediate incineration. Sharp objects are disposed in "sharps" containers, which are especially designed for this purpose. Infectious waste disposal containers are used to transport the biohazard plastic bags. These containers also must be cleaned regularly (at least every 6 mo) because leakage from the bags may occur.

In most autopsy facilities, paper-type protective garments, plastic aprons, surgical gloves, plastic face shields, and hair covers can be discarded after each autopsy (or series of autopsies if they were done in sequence). These items should be considered contaminated and they should be placed, together with other possibly contaminated articles in a separate bag that is labeled with a warning tag and sent for disposal in an approved incinerator.

CLEANING OF REUSABLE ITEMS Heavy rubber autopsy gloves are washed with detergent, autoclaved, and checked for leaks before they are used again. It is recommended to wear double surgical gloves underneath the heavy autopsy gloves. Pants, garments made of cloth, and towels are first washed in cold water to remove blood, then soaked in a detergent for several hours, and finally autoclaved or sent to the laundry, again in a bag with a warning tag.

Metal instruments are washed to remove all particulate matter and then are soaked in a detergent—for example, a 1:40 Hilex solution or Haemosol, 15 g/3.8 L of water. Metal instruments also should be autoclaved. They should be transported in covered stainless-steel containers. Plastic syringes and needles are placed in disposal containers designed for this purpose. These containers are discarded in the aforementioned incinerator bags when they are filled to about 3/4 their capacity.

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