Hazardous Drugs Hazardous Drugs Spill KitSpill Kit

About the Joint VentureAbout the Joint Venture

Baxter Pharmacy Services and CRG Baxter Pharmacy Services and CRG Healthcare have come together to Healthcare have come together to produce the Hazardous Drugs Spill produce the Hazardous Drugs Spill KitKit

Baxter Pharmacy ServicesBaxter Pharmacy Services

Provides aseptically prepared sterile Provides aseptically prepared sterile medications throughout Australia and New medications throughout Australia and New Zealand. Zealand.

Over 20 years experience with seven Over 20 years experience with seven compounding centres located in two compounding centres located in two countries. countries.

Offers an extensive range of drugs Offers an extensive range of drugs including; Cytotoxic, Antibiotic and Anti-including; Cytotoxic, Antibiotic and Anti-viral, Analgesic and Parenteral Nutrition viral, Analgesic and Parenteral Nutrition Solutions. Solutions.

CRG HealthcareCRG Healthcare Clean Room Garments (CRG), founded in Clean Room Garments (CRG), founded in

1970, is Australia’s number one supplier of 1970, is Australia’s number one supplier of contamination control products, apparel contamination control products, apparel and personal protective equipment (PPE).and personal protective equipment (PPE).

CRG Healthcare is a division of Clean CRG Healthcare is a division of Clean Room Garments Pty Ltd., focusing on the Room Garments Pty Ltd., focusing on the needs of the healthcare industry. needs of the healthcare industry.

CRG operated two AS/NZS ISO 9001:2000 CRG operated two AS/NZS ISO 9001:2000 accredited Administration and Production accredited Administration and Production facilities in Melbourne and Sydney, with facilities in Melbourne and Sydney, with representation in every Australian state representation in every Australian state and New Zealand.and New Zealand.

About the kitAbout the kit

Designed for containment and Designed for containment and management of hazardous drug management of hazardous drug spills, including:spills, including:

- CytotoxicsCytotoxics- RadiopharmaceuticalsRadiopharmaceuticals- AntibioticsAntibiotics

Background Background InformationInformation

What are the side effects of What are the side effects of hazardous drugs?hazardous drugs?

Cytotoxics:Cytotoxics:- Interfere with cell divisionInterfere with cell division- May cause irritation May cause irritation

- Skin- Skin

- Eyes- Eyes

- Mucous membranes- Mucous membranes- Light-headednessLight-headedness- NauseaNausea

Antibiotics Antibiotics (eg. Penicillins, Cephalosporins)(eg. Penicillins, Cephalosporins)

- May cause irritation to- May cause irritation to- Skin- Skin- Eyes- Eyes

- Possible allergic reactions- Possible allergic reactions- Rash- Rash- Itchiness- Itchiness- Uticaria- Uticaria

- Anaphylaxis (in rare severe - Anaphylaxis (in rare severe allergies) allergies)

RadiopharmaceuticalsRadiopharmaceuticals- May cause irritation to - May cause irritation to

- Skin- Skin- Eyes- Eyes

- Possible allergic reactions- Possible allergic reactions- Rash- Rash- Itchiness- Itchiness- Uticaria- Uticaria

- Anaphylaxis (in rare severe - Anaphylaxis (in rare severe allergies) allergies)

- Nausea- Nausea

What’s in the Kit?What’s in the Kit? 2 x Caution Spill Signs2 x Caution Spill Signs 1 x Procedure Form1 x Procedure Form 1 x Chemo Gown1 x Chemo Gown 1 x Pair Safegard Overshoes1 x Pair Safegard Overshoes 1 x Safety Glasses1 x Safety Glasses 1 x Hairnet1 x Hairnet 1 x Respirator Mask1 x Respirator Mask Chemosafe Purple Gloves Chemosafe Purple Gloves - Medium x 2 pairs - Medium x 2 pairs

- Large x 2 pairs- Large x 2 pairs 2 x Chemosorb Pads2 x Chemosorb Pads 4 x Towelettes 4 x Towelettes 1 x Purple Cytotoxic Waste Bag 1 x Purple Cytotoxic Waste Bag 1 x White Waste Bag1 x White Waste Bag 2 x Cable Ties2 x Cable Ties 1 x Plastic Scoop & Scraper1 x Plastic Scoop & Scraper 1 x Bottle of Water 150mL 1 x Bottle of Water 150mL 1 x Incident Report Form1 x Incident Report Form

How to clean up a hazardous How to clean up a hazardous drugs spilldrugs spill

Step 1:Step 1:

Do not panic. Stop and think. Do not panic. Stop and think. If you feel confidentIf you feel confidentthat you can correctly cleanthat you can correctly cleanthe spill, alert others to the the spill, alert others to the spill. Press emergency spill spill. Press emergency spill button in your suite. Do notbutton in your suite. Do notleave spill unattended. Remove anyleave spill unattended. Remove anycontaminated clothing. Wash any affectedcontaminated clothing. Wash any affectedskin with soap and water. Obtain nearest kit.skin with soap and water. Obtain nearest kit.

Step 2:Step 2:

Refer to procedure form from the kit. Stop theRefer to procedure form from the kit. Stop thespread of the spill by placing wipes around thespread of the spill by placing wipes around theperimeter. For liquid or powder spills, gently lay theperimeter. For liquid or powder spills, gently lay theChemosorb pad over the spill. Do not press it ontoChemosorb pad over the spill. Do not press it ontothe spill. Each Chemosorb padthe spill. Each Chemosorb padwill absorb approximately 500mls. will absorb approximately 500mls. Attempt not to touch any of theAttempt not to touch any of thespilt material. spilt material.

Step 3:Step 3:

Display the two “Caution Display the two “Caution

Hazardous Drugs Spill”Hazardous Drugs Spill”

signs at the spill’s signs at the spill’s

perimeter. This will alert perimeter. This will alert

any person entering the any person entering the

area to the fact that area to the fact that

cleaning of a hazardous cleaning of a hazardous

spill is in progress.spill is in progress.

Step 4:Step 4:

Once the spill has beenOnce the spill has been

contained with Chemosorbcontained with Chemosorb

Wipes, don protectiveWipes, don protective

clothing in the following clothing in the following

order:order:

STEP 4 cont….STEP 4 cont….Order for Donning Order for Donning Personal Protective WearPersonal Protective Wear

Respirator mask - to prevent inhalation of hazardous Respirator mask - to prevent inhalation of hazardous materialsmaterials

Safety glasses - to prevent splashing of material into eyesSafety glasses - to prevent splashing of material into eyes Hairnet (if have long hair) - to prevent it from dangling in Hairnet (if have long hair) - to prevent it from dangling in

the spillthe spill First pair of gloves (size medium or large)First pair of gloves (size medium or large) Chemo gown – ensure that the first pair of gloves remain Chemo gown – ensure that the first pair of gloves remain

underunder the gown cuff the gown cuff Overshoes - to prevent contamination of your shoes and Overshoes - to prevent contamination of your shoes and

possible spread of the spillpossible spread of the spill Second pair of gloves (size medium or large) – pull these Second pair of gloves (size medium or large) – pull these

overover the gown cuff to ensure maximum coverage the gown cuff to ensure maximum coverage

Step 5:Step 5:

- Open the white waste bag and fold it down so - Open the white waste bag and fold it down so that it is possible to place items in the bag that it is possible to place items in the bag without touching the outside of the bag. Do the without touching the outside of the bag. Do the same with the purple cytotoxic waste bag. same with the purple cytotoxic waste bag.

- Make sure that all items necessary to clean up - Make sure that all items necessary to clean up the spill are within easy reach. It is important to the spill are within easy reach. It is important to clean the spill in a careful manner so as not to clean the spill in a careful manner so as not to spread the area of contamination. Do not rush the spread the area of contamination. Do not rush the process. It is important to clean the spill process. It is important to clean the spill thoroughly. thoroughly.

Step 6:Step 6:

If the spill is in powder form, it will be If the spill is in powder form, it will be necessary to add water to the powder prior to necessary to add water to the powder prior to continuing the cleaning process. To do this, continuing the cleaning process. To do this, gently pour enough water onto the ChemoSorb gently pour enough water onto the ChemoSorb pad that is covering the spill so that the area is pad that is covering the spill so that the area is saturated. Do not flood the area. Do not pour saturated. Do not flood the area. Do not pour the water directly onto the powder as you the water directly onto the powder as you could run the risk of the powder splashing, could run the risk of the powder splashing, spreading or simply floating on the water’s spreading or simply floating on the water’s surface. surface.

Step 7:Step 7:

Allow the water to soak through the pad into the powder, thenAllow the water to soak through the pad into the powder, thenusing the plastic scoop and plastic scraper, carefully scoop upusing the plastic scoop and plastic scraper, carefully scoop upthe broken glass/powder slurry (as the pad turns powder intothe broken glass/powder slurry (as the pad turns powder intoa gel), by folding the edges of the ChemoSorb pad into itself. a gel), by folding the edges of the ChemoSorb pad into itself. Minimise using your handsMinimise using your handsdirectly, as this grossly directly, as this grossly contaminates gloves, contaminates gloves, which can easily contaminate which can easily contaminate yourself and other surfaces. yourself and other surfaces. Do not use gloved hands to Do not use gloved hands to pick up broken glass. pick up broken glass. Dispose of Chemosorb padDispose of Chemosorb padand scoop in the white waste and scoop in the white waste bag. bag.

Step 8:Step 8:

Starting from the outside edge of the spill and Starting from the outside edge of the spill and using towelettes moistened with water, slowly andusing towelettes moistened with water, slowly andcarefully wipe in towards the spill. Discard this wipe carefully wipe in towards the spill. Discard this wipe into the white waste bag. into the white waste bag. Use a fresh wipe each timeUse a fresh wipe each timeyou move to the outside you move to the outside area of the spill. If necessary,area of the spill. If necessary,use more water and anotheruse more water and anotherChemosorb pad. Chemosorb pad.

Step 9:Step 9:

- Use any remaining towelettes to dry the area to Use any remaining towelettes to dry the area to prevent the risk of someone slipping on the wet prevent the risk of someone slipping on the wet floor. Place the towelettes inside the white waste floor. Place the towelettes inside the white waste bag. bag.

- Remove all personal protection in the following Remove all personal protection in the following sequence and carefully discard in the white waste sequence and carefully discard in the white waste bag. (Take care not to touch items already in the bag. (Take care not to touch items already in the bag or the outside of the bag. This will ensure bag or the outside of the bag. This will ensure that the inner pair of gloves do not become that the inner pair of gloves do not become contaminated.)contaminated.)

STEP 9 cont….STEP 9 cont….Order for Removing Order for Removing Personal Protective WearPersonal Protective Wear

OvershoesOvershoes Outer pair of gloves – remove these in such a Outer pair of gloves – remove these in such a

manner that you do not contaminate the inner manner that you do not contaminate the inner pair of gloves or any part of your skin during de-pair of gloves or any part of your skin during de-gowning. Outer pair of gloves are most likely gowning. Outer pair of gloves are most likely heavily contaminated. Remove very carefully and heavily contaminated. Remove very carefully and slowly to avoid dispersing particulate slowly to avoid dispersing particulate contamination into the aircontamination into the air

Chemo gownChemo gown Safety glasses Safety glasses

Note: Do not remove inner pair of gloves or Note: Do not remove inner pair of gloves or respirator at this stagerespirator at this stage

Step 10:Step 10:

Touching only the outside of the white waste bag, Touching only the outside of the white waste bag, carefully close the bag and tie it at the top using carefully close the bag and tie it at the top using one of the cable ties. Do not press the bag down one of the cable ties. Do not press the bag down as this will create aas this will create a

bellow effect, dispersingbellow effect, dispersing

hazardous particles intohazardous particles into

the air. It may alsothe air. It may also

contain glass that couldcontain glass that could

penetrate the bag. penetrate the bag.

Step 11:Step 11:

• Place the white waste bag inside the purple Place the white waste bag inside the purple cytotoxic printed waste bag without touching the cytotoxic printed waste bag without touching the outside of the purple bag.outside of the purple bag.

• Place the Caution Spill signs inside the purple Place the Caution Spill signs inside the purple bag.bag.

• Remove inner pair of gloves and mask and place Remove inner pair of gloves and mask and place them in the bag.them in the bag.

• Touching only the outside of the purple bag, close Touching only the outside of the purple bag, close the bag using the other cable tie, so that the the bag using the other cable tie, so that the white waste bag is fully sealed within the purple white waste bag is fully sealed within the purple bag.bag.

Step 12:Step 12:

Place the sealed purple cytotoxic printed waste Place the sealed purple cytotoxic printed waste bag into a solid waste container such as a purple bag into a solid waste container such as a purple cytotoxic printed waste bin, and seal. cytotoxic printed waste bin, and seal. Remember not to push the Remember not to push the bag down. This containerbag down. This containeris then placed inside theis then placed inside thecytotoxic waste bin readycytotoxic waste bin readyfor collection byfor collection byenvironmental services forenvironmental services forincineration according toincineration according toyour state legislation. your state legislation.

Step 13:Step 13:

After disposing of all the waste:After disposing of all the waste:

• Thoroughly wash your hands with soap and Thoroughly wash your hands with soap and water.water.

• Report the incident to your supervisor and fill in Report the incident to your supervisor and fill in the incident report form contained within the kit, the incident report form contained within the kit, or other such form specific to your workplace. or other such form specific to your workplace.

• Discard spill kit packaging and ensure that a Discard spill kit packaging and ensure that a replacement kit is availablereplacement kit is available

• If no replacement kit available, order a new one. If no replacement kit available, order a new one.

Replacement kitReplacement kit Do not assume that someone else will organise a Do not assume that someone else will organise a

replacement kit!replacement kit! Make sure that another one is available in case Make sure that another one is available in case

there is another spill. there is another spill. If there is no kit available the next time there is a If there is no kit available the next time there is a

spill, you will not have all of the items necessary spill, you will not have all of the items necessary to aid in the safe clean up of the spill. to aid in the safe clean up of the spill.

Ordering Code: 4004CRG

Order via phone on (02) 8437 4600, or via fax (02) 9437 4351