● 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 while zipping. ● 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. ● 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. Trim off any excess material along the seam. Turn off or unplug the thermal sealer to allow it to cool. The thermal sealer must be decontaminated before being removed from the contaminated area 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 it closed. 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 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 human 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. Step-by-step guidelines for transportation of remains These step-by-step guidelines are intended to protect workers involved in the transportation of human remains from the clean area in the hospital to the place of final disposition. A minimum of two healthcare or mortuary workers should perform this process. A plan should be in place to transport the body safely from the hospital to the hearse or vehicle used to transport the body. For example, the plan should include a pre-identified route through the hospital that is secure and either free of or with limited patient and personnel traffic. The route should take the body directly to a pre-identified hearse or vehicle to transport the body. A hospital or public health official should be designated in advance to accompany the body from the hospital to the place of final disposition to ensure the safety of all those involved in the process. There should be protocols in place so the designated official accompanying the body knows what to do if the body bag is compromised during transport and how to safely decontaminate it. For example, this official should have a biohazard spill kit with all of the equipment needed for any situation in which the body bag is compromised, including recommended PPE, absorbent materials such as paper towels,
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 clean area. The workers in the contaminated area should not enter the clean area. Another set of workers should receive the body in the clean area and transport the body for disposition (see Transportation of Human Remains below). ● Proceed to the PPE removal area and follow the procedures in the 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; additional 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 the 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). kitty litter or a solidifier, an EPA-registered hospital disinfectant, additional body bags, and biohazard waste bags. ● A new set of workers in the clean area will receive the decontaminated body bag. ● Place patient identification and any other documents that need to accompany the body, ● including a printout of the photograph taken before the body was bagged, in an adhesive-backed pouch that is attached to the body bag. This will serve the function of toe tags. This should be done after the bagged body enters the clean area but before the bagged body is transported to the morgue or out of the hospital. ● Notify the mortuary if the body has any implanted electronic medical devices. ● Affix the following labels to the body bag before it is placed into the hearse or other vehicle used to transport the body: ○ Black and white “infectious substance” label. ○ United Nations (UN) 2814 label. ○ “Do not open” label. ○ Name and phone number of the hospital administrator.
Book Code: FTX1624
Page 93
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