Infection Control PPE and Disposal of body contents

Equipment needed Boot covers Coveralls Face Shields Gloves Gowns Masks N95 Respirators Shoe Covers Surgical hoods

PPE for Ebola

Costs (per unit) Boot covers-$0.60 Coveralls-$2.59 Faceshields-$0.57 Gloves-$0.08 Gowns-$0.74 N95 Respirator-$0.70 Masks-$0.07 Surgical hoods-$0.20

Cost per person $5.65 for PPE for one individual If Ebola team of 20 members, total costs would be $ per day.

Disposal of Body contents and deceased Patients (Per CDC guidelines) Hospital gurney containing three pre-opened cremation-compatible body bags with the following specifications: 1.First bag (top layer on gurney): vinyl or other chlorine-free material, minimum of 6 mil thickness (152 micrometers). To prevent any leakage of fluids, all seams should be factory heat-sealed or welded, not sewn, and the zipper should be on top. 2.Second bag (middle layer on gurney): chlorine-free material impervious to fluids that can be heat-sealed around the body to form a leakproof body bag. This bag should be specifically designed for the containment and transport of infectious bodies. The material should be precut to provide sufficient material to envelop the body and first bag. 3.Third bag (bottom layer on gurney): laminated vinyl or other chlorine-free material, minimum of 18 mil thickness (457 micrometers) with handles that are not sewn on, such as riveted handles reinforced with handle straps that run under the pouch. To prevent any leakage of fluids, all seams should be factory heat- sealed or welded, not sewn, and the zipper should be on top.

Disposal continued Thermal sealer for sealing the second bag PPE recommended for personnel entering the room of a patient with EVD Scissors for cutting excess material from heat-sealed bag Camera or mobile phone capable of securely transferring photographs electronically via Wi-Fi, , or text message U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant and wipes with a label-claim for use against a nonenveloped virus U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant and wipes Alcohol-based hand rub (ABHR) Red biohazard bag for medical waste Zip tie for locking the third bag shut at the zipper Enlarged copy of the Mortuary Guidance Job Aid: Postmortem Preparation in a Hospital Room[PDF - 1 page] and tape for posting these step-by-step guidelines to a wall in the hot zoneMortuary Guidance Job Aid: Postmortem Preparation in a Hospital Room[PDF - 1 page]

Transportation of human remains 1.Ensure that anyone handling the body bag wears single-use (disposable) gloves with extended cuffs and a long-sleeved disposable gown. 2.Minimize transportation of remains that contain Ebola virus to the extent possible. 3.Coordinate all transportation, including local transport for mortuary care or burial, with relevant local and state authorities in advance. 4.Coordinate interstate transport with CDC by calling the Emergency Operations Center at (770) Avoid transporting noncremated remains via aircraft. 6.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 ). See § (b)(14)

Mortuary care 1.Ensure that anyone handling the body bag wears single-use (disposable) gloves with extended cuffs and a long-sleeved disposable gown. 2.Do not open the body bags. 3.Do not embalm the body. 4.Do not remove any implanted medical devices. 5.Cremate the remains. An oversized cremation container may be needed to contain the bagged body for cremation. Cremated remains are no longer infectious and can be handled and provided to the family using normal procedures. 6.Consult your authorized state regulator and EPA regulations governing required cremation temperatures. Cremation and cremation temperatures may be subject to state, local, and EPA regulations.EPA regulations 7.Bury the remains in instances where cremation cannot be safely performed. For example, some crematoriums may have concerns about cremating bodies containing implanted electronic medical devices. Some of these medical devices can explode, potentially damaging the retort. Other medical devices can normally be cremated safely. Where damage to the retort is a concern, the body should be buried in a standard metal casket or other comparable burial method in accordance with state and local burial requirements. The casket containing the bagged remains can be handled without PPE.

Waste of body fluids Inactivation or incineration of Ebola-associated waste within a hospital system may be subject to state, local and OSHA regulations. On-site inactivation Ebola-associated waste may be inactivated through the use of appropriate autoclaves. Other methods of inactivation (e.g., chemical inactivation) have not been standardized and would need to consider worker safety issues, as well as the potential for triggering other Federal safety regulations.appropriate autoclaves On-site incineration Ebola-associated waste may be incinerated. The products of incineration (i.e., the ash) can be transported and disposed of in accordance with state and local regulations and standard protocols for hospital waste disposal. Ebola-associated waste disposal is subject to state and local regulations. Ebola-associated waste that has been appropriately inactivated or incinerated is not infectious and is not considered to be regulated medical waste or a hazardous material under Federal law.state and local regulations

Citations. Centura Health Emergency Response: Emergency Pandemic Plan ECRI Institute Ebola PPE Price Index Guidance for Safe Handling of Human Remains of Ebola Patients in U.S. Hospitals and Mortuaries (Centers for Disease Control and Prevention) remains.html