MSDS Implementation Targets for Medical Superintendents

Transcription

1 MSDS Implementation Targets for Medical Superintendents For Any Assistant, Please contact: Dr. Ayesha Parvez

2 Table of Contents 1. Key box (DMS/AMS/MS) Waste disposal Infection control committee Infection control team Hand washing technique display Resuscitation trolley Code blue Numbering/color coding of electrical appliances Floor mapping Anti smoking, wet flooring, no mobile signages Complaint box, registers General consent form Blood consent forms Laboratory Human resource Entry, exit,emergency exit displays in lab Eye wash station with equipment and display Noxious chemical list display Portable safety exhaust hood Dry chemical fire extinguisher and fire blanket Hot plates and water baths Displays of lab safety, general procedures Safe transportation of samples Patient banding Spine boards, neck holders in wards and ambulance PBTA registration display Blood bank refrigerator Blood bank donor record register Blood bag record Mission statement SWOT analysis Equipment for QC prog in radiology department... 43

3 32. Training to phelobotomists Inhouse training on personal protective equipment Informed consent form Define sentinel events Sentinal event report Sentinel event record register Compatibility form List of professionals authorized to administer drugs/medication Chemical spill clean up kits... 49

4 1. Key box (DMS/AMS/MS) Notes:

5 2. Waste disposal WHITE BAG YELLOW BAG RED BAG USE OF SHARPS CONTAINER USED PAPER TISSUE PAPERS SYRINGE WRAPPER FLOWERS GENERAL KITCHEN WASTE EMPTY WATER BOTTLE HIGHLY INFECTED WASTE. IV TUBINGS,NGT, CATHETER (SUCTION & FOLYES CATHETER) PLASMA CULTURE GROWTH INFECTED LINEN SURGICAL GLOVES DISPOSABLE GLOVES STOMA BAGS DRESING, SWABS, USED SYRINGES OTHER INFECTIOUS WASTE PATHOLOGICAL & ANATOMICAL WASTE INFECTED LINEN WITH 1. HIV 2. HEPA B 3. HEPA C INFECTED OT KITS WITH 1. HIV 2. HEPA B 3. HEPA C BOTH CONTAMINATED & NON CONTAMINATED e.g USED NEEDLES, SYRINGES BRANNULA DISPOSE OF AFTERCUTTING IN SHARP CONTAINER LANCET & SCALPELS AFTER USE DISPOS OF IN SHARP CONTAINER DO NOT RECAP NEEDL ES NOTE SHAPRS MUST BE HANDLED BY THE PERSONE WHO USE DO NOT PASS SHARPS TO ANOT HER PERSON TO AVOID NEEDLE STICK INJURY.

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7 3. Infection control committee Wide representation from the relevant departments: e.g. a. Management (Medical Superintendent/Administrator or AMS/DMS) b. Medical Specialist c. Surgical Specialist d. Lab incharge e. Operation theatre in-charge f. Infection Control Nurse g. Pharmacist h. In Charge CSSD i. In Charge Maintenance k. In Charge Housekeeping l. In Charge Sanitary services m. Bio-Medical/Civil Engineer Responsibilities One member of the committee should be elected as the Chairperson. Must meet regularly on Quarterly basis. In case of an emergency, such as on an outbreak of disease, this committee must be able to meet earlier than quarterly on emergent basis. Appoint an ICP (healthcare worker trained in the principles and practices of infection control, eg. a doctor/physician, microbiologist or a nurse) as secretary. Secretary of the ICC will be responsible for taking notes and preparing minutes of each meeting and reminding the Chairperson to follow up on the recommendations. Oversee, monitor and evaluate the performance of the IC program and team. Enforce compliance with basic IC standards. Review and approve a yearly program of activity for surveillance and prevention. Assess and promote improved practice at all levels of the health facility. Ensure appropriate staff training in IC and safety management, provision of safety materials such as PPE and products. Oversee training of health workers.

8 4. Infection control team one Ward Nurse other suitably trained Paramedic from (but it will vary with the type, needs, and resources of the facility.) each ward/department, sanitation staff waste disposal staff Responsibilities i. required to enforce approved IC practices directly by the ward/departmental staff as needed and enjoy a direct daily/incidental reporting relationship with senior administration. ii. The team is responsible for the day-to-day functions of IC, as well as preparing the daily/monthly/quarterly/yearly work plan for review by the ICC and administration. iii. These teams/individuals should be notified/put on rosters by the HCE and should have scientific and technical support/responsibilities, e.g. surveillance and research, developing and assessing policies and practical supervision, evaluation of material and products, overseeing sterilization and disinfection, ensuring the sound management of medical waste and the implementation of training programs. Notes:

9 5. Hand washing technique display

10 6. Resuscitation trolley Item Pocket mask with oxygen port Oxygen mask with reservoir Self-inflating bag with reservoir Clear face masks, sizes 3, 4, 5 Oropharyngeal airways, sizes 2, 3, 4 Nasopharyngeal airways, sizes 6, 7 (and lubrication) Portable suction (battery or manual) with Yankauer sucker and soft suction catheters Supraglottic airway device with syringes, lubrication and ties/tapes/scissors as appropriate Oxygen cylinder (with key where necessary) Oxygen tubing Magill forceps Stethoscope Tracheal tubes, cuffed, sizes 6, 7, 8 Tracheal tube introducer (stylet) Suggested availability Immediate Immediate Immediate Immediate Immediate Immediate Immediate Immediate/ Immediate Immediate Immediate Immediate Immediate/ Immediate/

11 Laryngoscope handles (x 2) and blades (size 3 and 4) Spare batteries for laryngoscope and spare bulbs (if applicable) Syringes, lubrication and ties/tapes/scissors for tracheal tube Waveform capnograph - with appropriate tubing and connector Immediate/ Immediate/ Immediate/ Item Defibrillator Manual and/or automated external defibrillator Pacing function ifneeded Adhesive defibrillator pads Razor ECG electrodes Intravenous cannulae (selection of sizes) and 2% chlorhexidine/alcohol wipes, tourniquets and cannula dressings Adhesive tape Intravenous infusion set Suggested availability Immediate Immediate Immediate Immediate Immediate/ Immediate/ Immediate/ 0.9% sodium chloride (1000 ml) Immediate/ Selection of needles and syringes Intra-osseous access device Central venous access - Seldinger kit, full barrier precautions (hat, mask, sterile gloves, gown) and skin preparation (2% chlorhexidine / alcohol) Ultrasound / echocardiography Immediate/ Item Clock/timer Gloves, aprons, eye protection Nasogastric tube Suggested availability Immediate

12 Sharps container and clinical waste bag Immediate Large scissors 2% chlorhexidine / alcohol wipes Blood sample tubes IV extension set Pressure bags for infusion Blood gas syringe Blood glucose analyser with appropriate strips Immediate/ Drug labels CARDIAC ARREST DRUGS - FIRST LINE for intravenous use! Item Suggested availability Comments Adrenaline 1mg (= 10 ml 1:10,000) as a prefilled syringe x 3 Amiodarone 300mg as a prefilled syringe x 1 Immediate Number of syringes depends on access to further syringes. 1mg needed for each 4-5 min of CPR First dose required after 3 defibrillation attempts CARDIAC ARREST & PERI-ARREST DRUGS for intravenous use! Item Suggested availability Comments Adenosine 6 mg x 5 Atropine - 1mg x 3 Adrenaline 1mg (= 10 ml 1:10,000) prefilled syringe Amiodarone 300mg x 1 Calcium chloride 10 ml 10% x 1 Chlorphenamine 10 mg x 2 Further syringes should be accessible for prolonged resuscitation attempts If decision is made to give further doses of amiodarone Calcium gluconate can be used as an alternative. Note: 10 ml 10% Calcium chloride = 6.8 mmol Ca2+ 10 ml 10% Calcium gluconate = 2.26 mmol Ca2+ Second-line treatment for anaphylaxis, can also be given intramuscularly

13 Hydrocortisone 100 mg x 2 Glucose for intravenous use 20% lipid emulsion 500 ml Primary and Secondary Healthcare Department Immediate/ Second-line treatment for anaphylaxis, can also be given intramuscularly For use in areas where large doses of local anaesthetic are used for regional blocks, according to Association of Anaesthetists Guidelines. Lidocaine 100 mg x 1 Inclusion to be determined locally Magnesium sulphate (2 g = 8 mmol) x 1 Midazolam 5 mg in 5 ml x 1 Naloxone 400 microgram x 5 NPSA Alert Formulation to be determined locally. Potassium chloride Sodium bicarbonate 8.4% or 1.26% OTHER DRUGS Potassium chloride concentrate solutions. Patient safety alert. The National Patient Safety Agency. July Volume and concentration according to local policy Item Adrenaline 1mg (1 ml 1:1000) Suggested availability Immediate Comments First-line treatment for anaphylaxis mg intramuscular injection in adults. Aspirin 300 mg and other antithrombotic agents Furosemide 50 mg IV x 2 Flumazenil 0.5 mg IV x 2 Glucagon 1 mg IV x 1 GTN spray Ipratropium bromide 500 microgram nebules x 2 (and nebuliser device) For acute coronary syndrome according to local policy

14 Salbutamol 5mg nebules x 2 (and nebuliser device) and IV preparation for infusion 0.9% sodium chloride or Hartmann s solution 1000 ml x 2 cooled to 4 C For induction of therapeutic hypothermia as part of postcardiorerspiratory arrest care Notes:

15 7. Code blue PURPOSE: To provide immediate life saving measures in case of life threating emergencies The purpose of the Code Blue team is to assure the prompt and skilled cardiovascular and cerebral resuscitation of persons who suffer a cardiopulmonary arrest. Saving lives at the moment notice. To provide a plan for response to medical emergencies. DEFINITION: It s an event utmost emergency, a mode of alerting all medical, nursing, paramedical, and security staff. Code blue is a term hospital and medical professional use to describe a situation where a patient will need to be resuscitated. Code blue is announced when a patient is unresponsive, meaning him or her not breathing or heart stop beating. Medical Emergency: An event requiring the rapid assessment and intervention of trained medical personnel which may include but is not limited to serious injury, unconsciousness, serious respiratory symptoms, symptoms of cardiac crisis. EQUIPMENT/MATERIAL: Cardiac monitor with pulse oxymeter. Defibrillator. Ambu bag. Air way Air way maintaining equipment.( air way, LMA, ETT,etc). Oxygen flow meter with Humidifier. Suction Regulator with suction bottle and suction catheter. Emergency crash cart with all medical supplies and Emergency Drugs. For documentation (Patient files, Resuscitation form, Code blue monitoring form). STAFF RESPONSIBILITY: Employees who witness or are first on the site of a medical emergency will immediate action, including CPR and basic First Aid if trained to do so, summon medical assistance and assist as directed. Code Blue announcement will be made by Charge Nurse or by the doctor who discover patient irresponsive. Announcement includes (Dept., Bed no, Sex, & Floor or Area). RN will take the Emergency Med Cart or medicine tray and ensure that emergency equipment is transported to Code site.

16 RN will ensure that the Code event is recorded and that equipment is ready for use. Emergency medications and equipment will be inventoried and Re-stocked on a weekly basis and following a Code. Shift Supervisor will ensure emergency medications and equipment are inventoried and restocked on a weekly basis and following a Code. ( or an emergency Kit may be ready in ICU after announcement of code blue team member from ICU will reach at location with emergency KIT. Code Blue must be announced for all the Department. Team who are responsible to run the code blue includes. TEAM MEMBERS : Team who are responsible to run the code blue includes. 1. ICU specialist ( ACLS certified ) 2. ICU Nurse. (Assigned for Code team BLS or ACLS certified). 3. Department on call MO. 4. Primary Consultant (if on duty during code). 5. H/N or Registered Nurse on duty from Department 6. Nurse supervisor. 7. Security. 8. Pharmacy staff.( If Available for medicine preparation 9. Lab technician. (to take urgent samples for ABGs etc.) 10. Support staff ( Ward Boy,Ward Helper ). Respond to the Code site to assist with assessment of the patient/victim, determination of severity of the emergency, and provision of emergency care and treatment. Medical Superintendent, Deputy Medical Superintendent and Nursing Services will ensure review of each Code to identify opportunities for improvement. POLICY: Hospital will follow this policy/procedure in providing for the emergency medical needs of patients, staff and visitors. PROCEDURE: The first person on site recognizing an emergency medical situation will follow the basic guidelines for assessing the situation, summoning assistance and starting Cardiopulmonary Resuscitation (CPR) as appropriate and/or rendering First Aid. A nurse at the site will Assess the situation and determine the severity of the emergency. 1. Stay with the patient/victim if the situation is life-threatening and requires direct emergency care. 2. Call or delegate a staff member to call on to instruct the staff to announce a Code Blue for the specific Dept., Bed no, Sex, & Floor or Area).and intimated by mike. 3. This announcement is to be made regardless of the time of day. 4. Assure all member of the code blue team are present as soon as code called. 5. Take the Emergency cart to the site, and equipment required. 6. Upon arrival ICU Nurse will assist Code leader for intubation and medication administration. 7. Follow ACLS guidelines to administer medicines and other treatment as per patient condition.

17 8. To continue code depends on the patient response to the treatment.at least minutes. 9. If patient revive shift to ICU after making necessary arrangement in ICU ( e.g availability of bed, Ventilator, etc.). 10. Nurse supervisor will record, or delegate RN, to record the event on the Emergency Response Sheet. The Emergency Response sheet will be placed in the patient record and copy forwarded to quality assurance Department. 11. Following the use of the cart, replace all used items and notify the pharmacy to arrange for the timely restocking of medications. To be ready for next use. 12. Convey information and/or seek assistance regarding the Code situation with the Nurse Supervisor. 13. Do not forget to attach cardiac monitor and defibrillator for recharging. 14. Portable oxygen cylinder for refilling. Notes:

18 Patient name: RESUSCITATION FORM Age/Sex: MR NO Diagnosis: Department: B.No: Attending consultan: Time of arrest: Date of arrest: Time resuscitation start: Time resuscitation end Resuscitated by (Dr. Name) Total Duration Resuscitation: Type of Arrest: Drugs / IV fluids Time Route sign Remarks Others: DC shocks Ventilation Result patient: Revived: Yes / No Expired: Disposal to: ICU / Morgue 1. Attending Doctor Name Signature: 2. Attending Doctor Name Signature:

19 8. Numbering/color coding of electrical appliances

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21 9. Floor mapping

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23 10. Anti smoking, wet flooring, no mobile signages Notes:

24 11. Complaint box, registers 12. General consent form 13. Blood consent forms 14. Laboratory Human resource Designation Laboratory manager Technicians Technologists Phlebotomist Typist / administrative staff Cleaning staff Qualification MBBS with higher qualification in pathology, PHD, FCPS, MRCPath, M.Phil or some equivalent degree, diploma in clinical pathology (DCP) Diploma in Lab technology/bsc/msc Diploma in Lab technology/bsc/msc In house training In house training Notes:

25 15. Entry, exit,emergency exit displays in lab Notes:

26 16. Eye wash station with equipment and display Eye Wash Station Requirements There are two types of Eye Wash Stations: Plumbed Eye Wash Station: An eye wash unit permanently connected to a source of potable water Gravity-Feed Eye Wash Station: An eye wash device that contains its own flushing fluid and must be refilled or replaced after use Heads o o o o Valves o Positioned 33" 45" from floor Positioned 6" from wall or nearest obstruction 0.4 gallons per minute (GPM) for 15 minutes for plumbed units shall provide flushing fluid at 30 PSI 0.4 gallons per minute (GPM) for 15 minutes for gravity-feed units Activate in 1 second or less o Stay-open valve (leaving hands free) Installation o Eye wash station shall be located in an area that requires no more than 10 seconds to reach. *Consult a medical professional to determine the appropriate distance for harsh acids and caustics (high hazard=closer distance) o o The location of the eye wash station shall be in a well-lit area and identified with a sign Eye wash stations shall be on the same level as the hazard Maintenance and Training o o o A plumbed eye wash station shall be activated weekly to verify proper operation All employees who might be exposed to a chemical splash shall be trained in the use of the equipment All eye/face wash stations shall be inspected annually o

27 17. Noxious chemical list display Examples are: 1) Picric acid 2) HCL 3) Acetone 4) Xylene 5) Formaline 6) Methanol Notes:

28 18. Portable safety exhaust hood Notes:

29 19. Dry chemical fire extinguisher and fire blanket Fire extinguisher with numbering Fire blanket Inspection list Display of use

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31 20. Hot plates and water baths 10 Safety Tips to keep in mind when using a hot plate: 1. When heating material in a bath, make sure the glassware s heat resistant. Also, you should inspect the glassware for cracks visible to the naked eye. Never place a glass flask, soft glass, or jars directly on a hot plate, and make sure the surface of the hot plate is larger than the object being heated. 2. When you are bringing liquids to a boil, adding boiling stones will help facilitate the process. 3. Be careful when condensing the material in a vessel until it s completely dry. If there is too little moisture and the vessel remains exposed to heat, it will eventually crack. 4. For liquids, including water, it s a good idea to use either the medium or medium high setting. Low boiling liquids should not be heated at the high setting, which can produce surface temperatures as high as 540 C (1004 F). 5. It s advisable not to heat a metal pan on a hot plate, which can damage the hot plate and maybe even pose a shock risk. 6. When removing objects from a hot plate, use tongs or rubber coated, heat resistant gripping devices. The same holds when true when pouring hot liquids. 7. Do not store volatile or flammable materials in the vicinity of a hot plate. 8. Limit the use of older hot plates for flammable materials. 9. Check for corrosion of thermostats, which can create a spark hazard.

32 10. Perhaps the most important thing of all is to remember to turn the hot plate off. Hot plates that have been left on are the source of most hot plate related injuries. 21. Displays of lab safety, general procedures Work carefully and cautiously in the laboratory, using common sense and good judgment at all times. EATING, DRINKING AND SMOKING ARE PROHIBITED in the laboratory and in the laboratory space of a combined lecture/laboratory room. Long hair must be tied back during laboratory sessions. No sleeveless tops are permitted. Thighs and midriffs must be covered with protective clothing while working in the laboratory. Lab coats must be worn when directed by the instructor. Identify the location of all exits from the laboratory and from the building. Be familiar with the location and proper use of fire extinguishers, fire blankets, first aid kits, spill response kits and eye wash stations in each laboratory. Note the location of the red phones (if available) that provide direct access to the Office of Management. In the event of an emergency, pick up the red receiver and state the location and the nature of the emergency. Identify the location of the nearest desk phones. Report all injuries, spills, breakage of glass or other items, unsafe conditions, and accidents of any kind, no matter how minor, to the instructor immediately. Keep sinks free of paper or any debris that could interfere with drainage. Lab tables must be clear of all items that are not necessary for the lab exercise. Wash hands and the lab tables with the appropriate cleaning agents before and after every laboratory session. Notes:

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35 22. Safe transportation of samples Three layer packaging system 1. Primary receptacle. A labelled primary watertight, leak-proof receptacle containing the specimen. The receptacle is wrapped in enough absorbent material to absorb all fluid in case of breakage. 2. Secondary receptacle. A second durable, watertight, leak-proof receptacle to enclose and protect the primary receptacle(s). Several wrapped primary receptacles may be placed in one secondary receptacle. Sufficient additional absorbent material must be used to cushion multiple primary receptacles. 3. Outer shipping package. The secondary receptacle is placed in an outer shipping package which protects it and its contents from outside influences such as physical damage and water while in transit. Specimen data forms, letters and other types of information that identify or describe the specimen and also identify the shipper and receiver should be taped to the outside of the secondary receptacle. All laboratory specimens are potentially hazardous. Transport of Samples using Courier Services a. Samples must always be carried in closed boxes, which are clearly marked as Biological Substance. b. Two storage boxes will be provided for each surgery or clinic, one for holding blood specimens and one for non-blood specimens. c. On collection by the couriers, the samples will be transferred by the couriers into two separate transport boxes, one for blood, and one for non-blood, lined with a clear plastic bag containing absorbent material and which can be secured with a cable tie when full. d. Where a patient's pathology request requires both blood and non-blood samples, these should be placed in the non-blood containers. e. Blood and tissue slides should be regarded as sharps and placed in an appropriate plastic slide

36 transport box before packaging. Decontamination materials shall be carried in each vehicle to enable small spillages to be contained. Notes:

37 Primary and Secondary Health Care Department 23. Patient banding Name, age/ sex, MR #,diagnosis, specific procedure etc Notes: 24. Spine boards, neck holders in wards and ambulance Page 37 of 50

38 Primary and Secondary Health Care Department 25. PBTA registration display Page 38 of 50

39 Primary and Secondary Health Care Department 26. Blood bank refrigerator Refrigerator Contents list Temperature regulation sheet Thermometer Data coder placement Temperature regulation sheet Date Time temperature Signature with hosp id # Refrigerator content list Contents Assigned number Expiry date Status Refrigerator content inspection list Date Time Status Signature with hospital id Notes: Page 39 of 50

40 Primary and Secondary Health Care Department 27. Blood bank donor record register Blood type Assigned registeration number to donor Donor name Donor CNIC AGE/SEX Contact # address Date for ive Screening for hep B, C, Record of latest donations/scre ening Responsibility with id number Note: 28. Blood bag record Yearly no./monthly no. Blood group Blood type Bag # screening Expiry date Status Notes: Page 40 of 50

41 Primary and Secondary Health Care Department 29. Mission statement MISSION Sample 1 At Hospital we recognize the value of every person and are guided by our commitment to excellence. We demonstrate this by: providing exemplary physical and psychological care for each of our patients and their families; balancing the continued commitment to the care of the poor and those most in need; building a work environment where each person is valued, respected and has an opportunity for personal and professional growth. MISSION Sample 2 _ Hospital is a bedded Public Sector secondary Care Hospital. Its Mission is to provide Healthcare Services of a highly specialized nature, contribute to the Prevention and Cure of Disease and Promote Training. MISSION Sample 3 At Hospital, we are committed to provide Healthcare of the Highest Quality in a Compassionate, Friendly, and Professional Environment. MISSION Sample Hospital strives to provide Quality Treatments, Health Education, Rehabilitative and Preventive Services at par with acceptable Standards. Page 41 of 50

42 Primary and Secondary Health Care Department 30. SWOT analysis SWOT Analysis Sample Strenghts Weaknesses What are your advantages? What could you improve? What do you do well? What do you do badly? What do other people see as your What should you avoid? strengths? Opportunities Threats Where are the good opportunities facing What obstacles do you face? you? What is your competitor doing? What are the interesting trends you are Are the requirements for your service aware of? changing? Opportunities can come from: Changes Is changing technology threatening? in technology and markets, changes in policy. Do you have funding problems? Changes in social patterns, population profiles, lifestyle changes, etc. Page 42 of 50

43 Primary and Secondary Health Care Department 31. Equipment for QC prog in radiology department Sensitometer Densitometer Box of film Aluminium step wedge Brass or copper mesh screen Measuring tape Non mercury thermometer Cleaning equipment for screens, cassetes and dark room Fluoroscopic test tool Page 43 of 50

44 Primary and Secondary Health Care Department 32. Training to phelobotomists Training log sheet Trainee feedback Trainer feedback Training needs assessment and impact form Training attendance sheet Pictorial evidence 33. Inhouse training on personal protective equipment Training log sheet Trainee feedback Trainer feedback Training needs assessment and impact form Training attendance sheet Pictorial evidence Notes: Page 44 of 50

45 Primary and Secondary Health Care Department 34. Informed consent form Annexure 35. Define sentinel events Notify list of sentinel events to all departments. Examples are: Unintended retention of a foreign object events Fall-related events Suicide events Wrong patient, wrong site, wrong procedure events Delay in treatment events Criminal events (assault, rape, homicide) Operation/post-operation complication events Perinatal events Medication error events Fire-related events Intravascular gas embolism resulting in death or neurological damage Maternal death or serious morbidity associated with labour or delivery 36. Sentinal event report Annexure 37. Sentinel event record register Page 45 of 50

46 Primary and Secondary Health Care Department Yearly #/monthly # Department Victim status(name, age, sex,status) Date/time Sentinel event Estimated resolving time Possible causal factors Possible root causes Prioritizing root causes Strategies to eliminate root causes result Further analysis required 38. Compatibility form Further strategies adopted Result Page 46 of 50

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48 Primary and Secondary Health Care Department 39. List of professionals authorized to administer drugs/medication Sr. # Particulars of proessionals Authorization PMDC/PNC/PMF ETC Validity date Signatures of administrator HCE Date Notes: Page 48 of 50

49 Primary and Secondary Health Care Department 40. Chemical spill clean up kits CONTENTS OF CHEMICAL SPILL KIT 1. Absorbents o Universal Spill Absorbent universal spill pillow or absorbent pads in commercial spill kits. Alternatively, a 1:1:1 mixture of Flor-Dri (or unscented kitty litter), sodium bicarbonate, and sand. This all-purpose absorbent is good for most chemical spills including solvents, acids (NOT for hydrofluoric acid), and bases. o Hydrofluoric Acid - HF compatible spill pillow or liquid HF acid eater o Solvents/Organic Liquid Absorbent - Inert absorbents such as vermiculite, clay, sand, FlorDri, and Oil- Dri. 2. Neutralizer o Acid Spill Neutralizer - sodium bicarbonate, sodium carbonate, or calcium carbonate. o Alkali (Base) Neutralizer - sodium bisulfate. o Bromine Neutralizer - 5% solution of sodium thiosulfate and inert absorbent. o Goggles and Face Shield 3. Personal Protective Equipment (PPE) o Heavy Neoprene Gloves o Disposable Lab Coat and Corrosive Apron o Plastic Vinyl Booties 4. Tools for clean-up o Plastic Dust Pan and Scoop o Plastic Bags (30 Gallon, 3 mm thickness) for contaminated PPE o One Plastic Bucket (5 gallon polyethylene) with lid for spill and absorbent residues 5. Others o For HF: calcium gluconate gel (always check expiration date) o For mercury: aspirator bulb and mercury decontaminating powder o For alkali metals: dry sand or a class D fire extinguisher o For acid chlorides - Oil Dri, Zorb-All or dry sand. Assemble a spill kit, tailored to clean up small spills of chemicals commonly used in your lab. Page 49 of 50

50 o o Primary and Secondary Health Care Department Keep it fully stocked and easily accessible. Train personnel how to use its contents and when it is safe to clean up a spill. Get help for large or dangerous spills. o o o o Avoid breathing vapors. Quickly identify the spilled material if you can do so safely. If the spill involves a flammable liquid, turn off all ignition sources if you can do so safely. Alert people in the area and evacuate, closing all doors. o If someone has been splashed with chemicals, flush the affected area with water for at least 15 minutes seek medical attention as recommended. o o Keep people away from the spill area until responders arrive. Lock doors and post warning signs. Have someone available who is knowledgeable about the spilled material to provide information to responders. Clean up small spills safely. If you're confident lab staff can safely handle the spill, follow these procedures: Alert people in the area. Avoid breathing vapors and try to determine what spilled. If someone has been splashed with chemicals, immediately flush the affected area with water for at least 15 minutes seek medical attention as recommended. Wear personal protective equipment including safety goggles, gloves, and a long-sleeved lab coat during cleanup. Confine the spill to a small area. Use a commercial kit or absorbent material from your spill kit to absorb spilled materials. o o Place the saturated absorbent in a plastic bag. Label the bag with a hazardous waste tag and include it in the next hazardous waste collection. Clean the spill area with water. Replenish your spill kit supplies, so the kit is ready when you need it. Spill kit content display Spill kit inspection list Spill kit contents Quantity Date of inspection Time of inspection Signature with hosp id Page 50 of 50