Emergency Extrication from Containment Laboratories
October 2, 2023
A laboratory team member has collapsed in containment. Will other team members know how to properly extricate and transfer them to emergency services?
An important part of laboratory worker safety is emergency preparedness and incident response. An emergency is typically defined as “an event that poses an immediate risk to health, life, property, or the environment.” Most emergencies require urgent intervention to prevent a worsening of the situation.
In the case of responding to a worker who has become incapacitated within a containment laboratory, rapid response is crucial. Training on the proper procedures for emergency extrication should be conducted regularly to ensure the safety of not only the injured worker, but also that of the responding worker. Most of all, laboratory workers must be confident in the procedures, know how to quickly locate rescue equipment, and know the proper calls to make to be effective.
Although the agencies involved and the procedures used may vary due to government requirements and facility layouts, there are basic guidelines that are universal. After 16 years as a First Responder, I have been on scenes where workers did not know how to respond to an emergency. Below are recommendations specifically for containment laboratory settings and tips for proper extrication to ensure the safety of all.
The first step is for the responding worker to remain calm and control their breathing. It is human nature for stress to increase in emergency situations. Providing training and keeping workers informed in emergency response will build workers’ confidence and ability to remain calm.
Alertness Level (AVPU Scale):
Upon initial contact with the patient, the responding worker should first determine if the patient is:
1. Alert and conscious?
2. Verbal (Do they look at you when you speak to them?) If not, then:
3. Pain (Do they respond to touch, such as patting hand, shaking the shoulder?) If
not, then they are:
4. Unresponsive (There is no response.)
Visual/Tactile:
• Are they breathing? Does the chest rise?
• Is the PAPR working?
Do I Perform CPR Before Calling Emergency Services?
No. Call 911 first or your country’s emergency services contact number. It is urgent that emergency services are called first to minimize response time. If there is more than one co-worker in the lab, one worker can proceed with decontamination and prepare to move the patient while the other notifies 911 and the safety team. Also, there are no AEDs in containment. Getting them to the anteroom for CPR and other lifesaving measures is crucial.
Call Script For Emergency Response Posted By The Phone.
It is also recommended to have an emergency call script posted by the laboratory phone to ensure that important information is not missed. It should include:
1. The location, including building and precise room number. Do not leave blanks. People under stress may not recall the precise location.
2. Description of the type of lab by biosafety level. Use layman’s terms for 911 call takers and fire/EMS personnel as they may not be familiar with laboratories and containment levels.
3. Has there been a breach of containment outside of the suite?
4. Describe the emergency and how many people are involved.
5. The patient status: conscious, (not) breathing, non-responsive, approximate age.
Locate The Portable Transport Unit
The portable transport unit may also be known as a portable stretcher or gurney. There are many styles and manufacturers. Instructions for use should be reviewed with workers as part of training and left with the unit inside the lab.
Unfold and prepare the unit. It may be marked to indicate where the patient’s head and feet should be placed. There may also be long drag straps at the head of the unit. These straps are used to drag the patient to minimize strain on the responder and prevent injury. These units can be used by a single responder.
Some institutions recommend decontamination prior to being placed on the stretcher. Decontaminate the patient’s first level of personal protective equipment (PPE) and remove outer gloves and booties. Then the responder decontaminates themselves to prepare to enter the anteroom. (See your institution’s procedures for decontamination procedures.)
Follow the manufacturer’s instructions on rolling the patient onto the unit. Your institution’s SOP will dictate good practice to move a patient. Remember that practice makes perfect execution.
Remember: The portable transport unit is now considered contaminated. It must not be given to First Responders. First Responders will have their own transport unit. When transferring the patient to First Responders, place the unit and all PPE that has been removed into the lab for decontamination/disposal after it is safe to enter.
Work with your local Fire and EMS to arrange for review of procedures, call numbers, and conduct demonstrations for safe extrication. World BioHazTec provides training, reviews emergency procedures, runs tabletop exercises and designs scripts for drills to ensure safe operations for laboratory workers.
About Officer Jacob “Jake” Haskell, MBA
Officer Jacob “Jake” Haskell has served as a First Responder for sixteen years. He is a police officer working for the state of Maryland. Prior to becoming a police officer, he was a firefighter for the City of Annapolis. Officer Haskell is a volunteer firefighter and officer for Kensington Volunteer Fire Department. Officer Haskell has provided EMS training for the Department of Health and Human Services, Food and Drug Administration, and the National Institutes of Health. As an American Heart Association (AHA) certified trainer, Officer Haskell provides certified training in first aid and CPR. Officer Haskell has a master’s and an undergraduate degree in business administration and has associate degrees in criminal justice, political science, and culinary arts.
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Expert consultants are experienced in tailoring their training programs to meet both your specific operational needs and strict regulatory requirements, ensuring your staff is fully equipped to handle emergencies and day-to-day challenges. CEUs and Professional Development Incentives Professional development is also a tool for employee retention. “About 80 percent of employees rank professional development and continuous learning as high priorities when job hunting. And 94 percent of employees say if an employer invested more in learning and development, they would stay longer at an organization.” [3] Another significant advantage of outsourcing BSL-3 training is the ability to offer Continuing Education Units (CEUs). If your training provider is accredited, they can award CEUs to participants which can be used to maintain certification with professional organizations. 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For most organizations, the answer is a resounding yes. World BioHazTec provides extensive professional development training. Schedule a free consultation to learn more about our customized training offerings. [1] DeFelice, R. 2021. ATD Blog. Retrieved from https://www.td.org/content/atd-blog/how-long-does-it-take-to-develop-training-new-question-new-answers [2] Allen, M. (2012). Leaving ADDIE for SAM – An agile model for developing the best learning experiences. Washington DC: American Society for Training and Development. [3] Based on survey average module length of 23 minutes, the variance was 43 to 141 hours with an average of 67 hours. These results were used to calculate times to develop a one-hour module. [4] Rozensweig, F. 2022. Retrieved from https://www.td.org/atd-blog/shift-from-onboarding-to-everboarding. [5] Rosenzweig, F. 2022. ATD blog. Retrieved from https://www.td.org/content/atd-blog/shift-from-onboarding-to-everboarding
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These facilities serve as vital hubs for research, diagnostics, and the development of therapeutic interventions. BSL-3 certification, in this context, becomes a strategic asset, signifying a commitment to being at the forefront of global health emergencies. It positions the facility to swiftly and effectively respond to emerging threats, contributing significantly to public health resilience and preparedness on a global scale. When the real test of a pandemic arrives, a certified BSL-3 laboratory signifies a prepared laboratory, with competent professionals adeptly executing their roles, ensuring a prompt and effective response to safeguard public health. 3. Creating a Safe and Secure Culture In a certified BSL-3 facility, a dedicated commitment to establishing a culture of biosafety and biosecurity is evident. This certification stands as a tangible testament to the management’s unwavering dedication to continuously enhancing biosafety and biosecurity measures. 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By fostering a culture of strict adherence to biosafety protocols, certified BSL-3 facilities systematically integrate quality management principles into their daily operations. This meticulous approach not only safeguards the well-being of personnel but also ensures the integrity of laboratory processes. As safety practices become ingrained in the laboratory’s ethos following international quality management principles, the probability of errors and contamination diminishes, leading to consistently high-quality research outcomes. In essence, the commitment to safety in a certified BSL-3 facility reinforces the crucial connection between safety practices and the reliability of scientific results. 5. International Collaboration Opportunities A certified BSL-3 facility, known for its adherence to rigorous safety and security standards, builds credibility and trust within the scientific community. 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Let World BioHazTec be your strategic partner in preparing your facility to meet our certification requirements, widely acknowledged as the gold standard in BSL-3 certification. Contact World BioHazTec (WBHT) to schedule a free 30-minute consultation or send us an email. You are a conversation away from starting down a successful pathway to meet BSL-3 facility compliance.
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We can prepare a feasibility study, develop conceptual designs with cost estimates, perform a site assessment, peer review design documents, commission/certify your animal facility, and train staff. You are a conversation away from starting down a successful pathway to meet containment compliance and sustainability.
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