Postmortem preparation in a hospital room The following points are important considerations for postmortem preparation of human remains containing Ebola virus: ● Ensure that workers handling the body and the trained observer wear the recommended PPE and follow all of the procedures in the CDC’s “Guidance on Personal Protective Equipment for Healthcare Workers.” ● Follow the cleaning and disinfecting recommendations found in the CDC’s “Guidance for Environmental Infection Control in Hospitals for Ebola Virus.” According to this guidance, PPE surfaces, equipment, or patient care area surfaces postmortem preparation of the body in a hospital setting. The size and weight of the body being prepared and the ability of the workers to lift the body and assist with managing the body bag will determine the number of workers needed for the process. For the death of an average size adult, for example, a minimum of three healthcare workers or other workers properly trained in handling infectious bodies should assist with the process: two to lift the body and one to hold the body bag open. CDC recommends posting an enlarged copy of the following step-by-step guidelines in the hot zone. The workers should read the guidelines aloud as they perform each step of the procedure. ● Turn on the thermal sealer to allow it to warm up during the initial preparation of the body. This sealer will be used to seal the second body bag. ● Use the digital camera or mobile phone to take a photograph of the decedent’s face for identification purposes. The photograph should be securely transferred via Wi-Fi, e-mail, or text message to the pre-identified site manager. The camera or mobile phone must be decontaminated before being removed from the hot zone or reused. If not decontaminated, the camera or mobile phone should be discarded along with other medical waste. ● Position the gurney with the three pre-opened body bags next to the hospital bed with the body. ● Pull the bed sheet(s) that are under the body up and around the front of the body. Do not wash or clean the body. Do not remove any inserted medical equipment such as IV lines or endotracheal or other tubing from the body. ● Remove the first bag from the gurney. Gently roll the body wrapped in sheets while sliding the first bag under the body. ● Complete the transfer of the body wrapped in sheets to the first bag and zip up the bag. Minimize the amount of air trapped in the bag. ● Disinfect gloved hands using ABHR. If any areas of the PPE have visible contamination, disinfect with an EPA-registered disinfectant wipe. ● Disinfect the outside of the first bag with an EPA-registered hospital disinfectant applied according to the manufacturer’s recommendations. ● Transfer the first bag with the body in it to the gurney, placing it on top of the second bag material. ● Disinfect gloved hands using ABHR. ● Fold the second bag material around the first bag, and heat- seal approximately 2 inches from the edges while removing as much air from the second bag as possible. Heat-seal the bag a second time approximately 1 inch below the initial seal and then heat-seal diagonally across the corners. Use scissors to trim off any excess material along the seam. Turn off or Transportation of human remains The following points are important considerations for staff when transporting human remains: ● Ensure that anyone handling the body bag wears single-use (disposable) gloves with extended cuffs and a long-sleeved disposable gown. ● Minimize transportation of remains that contain Ebola virus to the extent possible. ● Coordinate all transportation, including local transport for mortuary care or burial, with relevant local and state authorities in advance.
that become visibly soiled should be decontaminated immediately using a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for use against a nonenveloped virus. ● Place all waste produced during postmortem preparation and decontamination into red biohazard bags in the hot zone, following the CDC Guidelines for Ebola-Associated Waste Management. Highlights from these websites are included in this course. unplug the thermal sealer to allow it to cool. The thermal sealer must be decontaminated before being removed from the hot zone or reused. ● Disinfect the outside of the second bag with an EPA- registered hospital disinfectant applied according to the manufacturer’s recommendations. ● Disinfect gloved hands using ABHR. ● Work the third bag around the second bag, and then zip up the third bag. If possible, zip tie the zipper shut. ● Disinfect gloved hands using ABHR. ● Wheel the gurney to the decontamination area. ● Decontaminate the surface of the body bag with an EPA- registered hospital disinfectant applied according to the manufacturer’s recommendations. Begin by applying the hospital disinfectant to the top of the bag and any exposed areas of the gurney’s cot. Roll the bag to one side to decontaminate half of the bottom of the bag and the newly exposed portion of the gurney’s cot. Repeat with the other side of the bag and gurney. When performing decontamination, remove any visible soil on surfaces of the bag or gurney with the EPA-registered disinfectant wipe. After the visible soil has been removed, reapply the hospital disinfectant, and allow sufficient contact time as specified by the manufacturer of the disinfectant. ● Disinfect the surfaces of the gurney from the handles to the wheels with an EPA-registered hospital disinfectant applied according to the manufacturer’s recommendations. ● Disinfect gloved hands using ABHR. ● Push the gurney gently so that only the gurney and the decontaminated body bag enter the cold zone. The workers in the hot zone should not enter the cold zone. Another set of workers should receive the body in the cold zone and transport the body for disposition (see “Transportation of Human Remains” below). ● Proceed to the PPE removal area and follow the procedures in CDC’s Guidance on Personal Protective Equipment for Healthcare Workers. The trained observer should provide instructions on the decontamination and removal of PPE. At this point, the body bag has been decontaminated, and the potential for further contamination has been eliminated as long as the body is handled carefully. Workers who handle the body bag from this point until the body is cremated or placed into a metal casket should wear single-use (disposable) gloves with extended cuffs and a long-sleeved disposable gown; other PPE is optional. If there is no evidence that the body bag has been compromised by a tear or puncture or liquid coming from the bag, surfaces that contact the body bag should not be considered contaminated, and gloves and disposable gowns used for transport can be disposed of as regular trash. ● Coordinate interstate transport with CDC by calling the Emergency Operations Center at (770) 488-7100. ● Avoid transporting noncremated remains via aircraft. ● Human remains transported for interment, cremation, or medical research at a college, hospital, or laboratory are excepted from the U.S. Department of Transportation’s Hazardous Materials Regulations (49 C.F.R., Parts 171-180). See §173.134(b)(14).
CDC step-by-step Mortuary Guidance Job Aid for postmortem preparation These step-by-step guidelines, listed as the Mortuary Guidance Job Aid, are intended to protect workers involved in the
Page 44
Book Code: FFL1223
EliteLearning.com/Funeral
Powered by FlippingBook