CDC recommendations to avoid secondary contamination
• To protect health-care workers caring for these patients, EDs should adhere to existing guidelines and decontamination protocols, train staff in the use of personal protective equipment, and maintain adequate quantities of antidotes. If sufficient quantities of antidote are not available, the National Pharmaceutical Stockpile at the Atlanta-based Centers for Disease Control and Prevention (CDC) maintains a mechanism to procure and deliver large quantities of pharmaceuticals to state health departments within 12 hours.
• Depending on the extent of the contamination, health care workers caring for chemically contaminated patients should use Level C protection (i.e., full-face mask and powered/nonpowered canister/cartridge filtration respirator) or Level B protection (i.e., supplied air respirator or self-contained breathing apparatus).
• The type of canister/cartridge should be appropriate to the agent; if the agent cannot be identified, an organic vapor/HEPA filter is recommended.
• To prevent dermal absorption, chemical barrier protection appropriate to the contaminant is needed; latex medical gloves are of little protection against many chemicals.
• In addition to the need for surface decontamination of patients, body fluids also must be contained to prevent dermal and inhalational exposure.
• To limit distant spread of the contaminant, the EDs ventilation exhaust should be directed away from the hospital’s main ventilation system.
Source: Geller RJ, Singleton KL, Tarantino ML, et al. Nosocomial poisoning associated with emergency department treatment of organophosphate toxicity — Georgia. Morbidity and Mortality Weekly Report 2000; 4:1,156-1,158.
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