Guidance Note H1402 Packaging and Transport of waste from suspect

Transcription

1 uid Guidance Note H1402 Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus Revision: 1.0 Date: 21/10/2014

2 Contents 1 Purpose Introduction Regulations PROTEC620 packaging Alternative Packaging General Provisions: Packaging type Assembly of packaging Additional packaging and handling procedures Labelling of packaging Storage Collection Revision /10/2014 Page 2 of 16

3 1 Purpose This document is intended to provide hospitals and healthcare professionals with key information about the safe handling and disposal of medical waste generated from the care of persons with suspect and confirmed cases of the Ebola virus. 2 Introduction Packaging used for the transport of waste from patients with Ebola must meet the requirements of transport of dangerous goods by road regulations. There are two types of packaging available for waste from persons diagnosed with or suspected of having the Ebola virus: 1. PROTEC620 packaging This packaging is the Mauser WIVA PROTEC620 packaging. Guidance associated with this packaging is outlined in section 4 of the report. 2. Alternative packaging The Health and Safety Authority have granted an exemption whereby alternative packaging can be used for the packaging of waste from suspect and confirmed cases of the Ebola virus. Guidance associated with this packaging is outlined in section 5 of this report. Note: Either type of the above packaging can be used in healthcare facilities for waste from persons with suspect or confirmed cases of the Ebola virus. Appropriate general and personal protective clothing and equipment must be provided and used by staff involved in the handling of the waste and waste packaging. 3 Regulations Category A Ebola waste must be consigned nationally by road according to the following dangerous goods transport regulations: ADR European Agreement concerning the International Carriage of Dangerous Goods by Road European Communities (Carriage of Dangerous Goods by Road and Use of Transportable Pressure Equipment), 2011, S.I. No. 349 of European Communities (Carriage of Dangerous Goods by Road and Use of Transportable Pressure Equipment) (Amendment) Regulations 2013, S.I. No. 238 of To comply with the above regulations the waste from patients with the Ebola virus must be packaged in line with this guidance document. If you have any queries regarding this guidance document, please contact your Dangerous Goods Safety Advisor. Revision /10/2014 Page 3 of 16

4 4 PROTEC620 packaging This section outlines instructions for the use of the Mauser WIVA PROTEC620 packaging for waste from persons with suspect or confirmed cases of the Ebola Virus. Step 1 The outer box should be opened and the drum removed outside of the treatment room. Open the Box by folding the flaps outwards. Step 2 Remove the drum from the cardboard box and plastic packaging. Secure the cardboard box in a secure, safe, location outside the treatment room. Note: this cardboard box and outer plastic bag is not for disposal. This packaging is required for the safe transportation of the waste from the healthcare facility. Step 3 Line the drum with the 2 inner bags and fold back around the drum. Place granule pouch provided in the bottom of the inner plastic bag. The drum is now ready for use and can be brought to the treatment area. Step 4 Once the drum is ¾ full, secure the 1 st inner plastic bag with tie provided. Please note there are 3 cable ties provided on the lid of the drum. Secure the 2 nd inner plastic bag with the second tie provided. Revision /10/2014 Page 4 of 16

5 Step 5 Fold both bags inwards. Cover the bags with the polystyrene disc. Step 6 Place the lid on top and secure with the ring clamp. Step 7 Place the blue seal in opening on the clamp band. Please note this seal is provided on the back of the lid. Decontaminate external surface for the blue drum with 10,000ppm hypochlorite solution before it is removed from the treatment room. Step 8 Remove the drum from the treatment room. Retrieve the cardboard box from the secure location. Step 9 Place at the drum in the outer plastic bag and secure with the third cable tie provided. Revision /10/2014 Page 5 of 16

6 Step 10 Place the sealed drum in the cardboard box and close flaps in sequence 1 to 4 whilst removing adhesive strips. Affix the infectious substance label to the box. Remove the package to a secure facility pending collection. Revision /10/2014 Page 6 of 16

7 5 Alternative Packaging The Health and Safety Authority (HSA) has issued an exemption whereby alternative packaging can be used for waste from persons with suspect or confirmed cases of the Ebola virus. The guidance in this section must be strictly followed to ensure that the alternative packaging meets the requirements of the HSA exemption. 5.1 General Provisions: The following general provisions shall be complied with: 1. Medical or clinical wastes suspected of containing Ebola virus shall not be transported by road unless diagnosis of the patient/source has been confirmed. Pending diagnosis, the waste shall be packaged in accordance with section 5 of this document and stored in a secure location at the healthcare facility. 2. If the diagnosis is proven to be negative, the waste shall be treated as Category B waste and disposed of with standard clinical waste as appropriate. 3. If the diagnosis is proven to be positive, the waste shall be treated as Infectious Substances Category A waste. Additional packaging procedures in addition to those outlined in section 5 will be required prior to transport. The waste disposal company will advise you of these requirements. Revision /10/2014 Page 7 of 16

8 5.2 Packaging type The following packaging is permitted under this exemption from the Health and Safety Authority..Soft waste (blood/ bandages, tubing) Primary packaging Standard clinical waste bag. Secondary packaging Tertiary packaging Standard clinical waste bag (double bagging). 30/60 litre clinical waste rigid bin. Sufficient absorbent material must be placed in the bin to absorb the entire liquid contents. Sharps Waste (e.g. needles, syringes) Primary packaging Standard sharps bin. Secondary packaging Tertiary packaging Two layers of clinical waste bags 30/60 litre clinical waste rigid bin. Sufficient absorbent material must be placed in the bin to absorb the entire liquid contents. Liquid waste (e.g. urine bags) Primary packaging Standard clinical waste bag. Secondary packaging Tertiary packaging Standard clinical waste bag. (double bagging) 30 litre clinical waste rigid bin. Sufficient absorbent material must be placed in the bin to absorb twice the liquid content. The maximum quantity of liquids per bin should be 5 litres. Revision /10/2014 Page 8 of 16

9 Notes: Clinical waste bags must be in-situ within the clinical waste rigid bin prior to adding the waste. Each clinical waste bag must be closed individually using the swan neck closure mechanism and plastic tie. A minimum of one 6 litre absorbent sheet or equivalent, should be placed in the 30/60 litre rigid bin. For liquids a minimum of two 6 litre absorbent sheets or equivalent, should be placed in the 30 litre rigid bin. The maximum quantity of liquids that can be disposed of in a 30 litre bin is 5 litres. 5.3 Assembly of packaging The following is the step by step guide for the assembly of the alternative packaging for waste contaminated or suspected of being contaminated with Ebola Virus. Soft waste i.e. bandages, gloves, ppe, tubing. Step 1 Insert absorption material into the bottom of the 30/60 litre rigid bin. (Recommended: 6 litre absorbent sheet or equivalent) Step 2 Line the 30/60 litre rigid bin with the 2 inner clinical waste bags and fold back around the bin. Step 3 The bin is now ready for the disposal of soft clinical waste. Revision /10/2014 Page 9 of 16

10 Step 4 When the bin is 2/3 full close the inner bag using the swan neck closure method with a plastic tie. Step 5: Close the outer bag using the swan neck closure method with a plastic tie. Step 6: Close the 30/60 litre rigid bin with a yellow lid. Ensure that the clips on the lid match up prior to closure. Step 7: When closed decontaminate external surface of the 30/60 litre rigid bin with 10,000ppm hypochlorite solution before it is removed from the treatment room. Remove the package to a secure storage room. Revision /10/2014 Page 10 of 16

11 Sharps waste i.e. needles, syringes, empty glass vials and bottles. Step 1 Insert absorbent material into the bottom of the 30/60 litre rigid bin. (Recommended: 6 litre absorbent sheet or equivalent) Step 2 Line the 30/60 litre rigid bin with the 2 inner clinical waste bags and fold back around the bin. Step 3 For sharps waste place the waste in the sharps bin. Ensure the sharps bin selected will fit comfortably into a 30/60 litre clinical waste rigid bin. Maintain sharps bins in the temporary closure position when being used by staff. When ¾ full or up to the manufacturer line lock the sharps bin. Sign and date upon closure. Step 4 Place the sharps bin into the 30/60 litre rigid bin. Step 5 Close the inner bag using the swan neck closure method with a plastic tie. Revision /10/2014 Page 11 of 16

12 Step 6 Close the outer bag using the swan neck closure method with a plastic tie. Step 7 Close the 30/60 litre rigid bin with a yellow lid. Ensure that the clips on the lid match up prior to closure. Step 8 When closed decontaminate the external surface of the 30/60 litre rigid bin with 10,000ppm hypochlorite solution before it is removed from the treatment room. Remove the package to a secure storage room. Note: Do not dispose of sharps bins in the same bin as soft waste. Revision /10/2014 Page 12 of 16

13 Liquid waste i.e. urine bags, blood bags. Step 1 Insert absorbent material into the bottom of a 30 litre rigid bin. (Recommended: two 6 litre absorbent sheets or equivalent) Note: The maximum quantity of liquid waste that should be disposed of in the bin is 5 litres. Step 2 Line the 30 litre rigid bin with the 2 inner clinical waste bags and fold back around the bin. Step 3 The bin is now ready for the disposal of liquid waste i.e. blood bags, urine bags. Step 4 When the bin is 2/3 full close the inner bag using the swan neck closure method with a plastic tie. Note: A maximum of 5 litres of liquid can be placed in the 30 litre bin. Step 5: Close the outer bag using the swan neck closure method with a plastic tie. Revision /10/2014 Page 13 of 16

14 Step 6: Close the 30 litre rigid bin with a yellow lid. Ensure that the clips on the lid match up prior to closure. Step 7: When closed decontaminate the external surface of the 30 litre rigid bin with 10,000ppm hypochlorite solution before it is removed from the treatment room. Remove the package to a secure storage room. Revision /10/2014 Page 14 of 16

15 5.4 Additional packaging and handling procedures Other dangerous substances shall not be packaged in the same packaging unless necessary for neutralising the hazardous nature of the infectious substances. 5.5 Labelling of packaging Each 30/60 litre rigid bin once removed from the treatment room must have a label with the following information: CATEGORY A EBOLA WASTE - QUERY CASE (Minimum dimensions 12 mm). Reference to the patient where the waste originated. Signature and date of responsible person. If the diagnosis is proven to be negative the 30/60 litre clinical waste rigid bin will have a label with the following: NEGATIVE DIAGNOSIS - Standard Clinical Waste (Minimum dimensions.12 mm). Reference to the patient where the waste originated. Signature and date of responsible person. If the diagnosis is proven to be positive the 30/60 litre clinical waste rigid bin will have a label with the following: CATEGORY A EBOLA WASTE - CONFIRMED CASE (Minimum dimensions.12 mm). Reference to the patient where the waste originated. Signature and date of responsible person. The 30 litre rigid bins containing liquid waste must have a label with the words Liquid waste (Minimum dimensions: 12 mm) 5.6 Storage The 30/60 litre clinical waste rigid bin must be stored in a locked and well ventilated covered facility on-site pending diagnosis. If the diagnosis is proven to be negative, the waste shall be removed from the storage facility and disposed of with standard clinical waste as appropriate. If the diagnosis is proven to be positive, the waste shall remain in the locked facility until the vehicle from the waste disposal company arrives for collection. Revision /10/2014 Page 15 of 16

16 6 Collection If the event of a suspect case of the Ebola virus the waste disposal company should be contacted immediately. The waste disposal company will advise on further packaging procedures to be adopted prior to transporting the waste by road. Revision /10/2014 Page 16 of 16