Emergencies

Introduction

It is important to have safe procedures in place for responding to a biological emergency. There must be plans for the following cases.

- Spillages (large-scale, inside a BSC, centrifuges, etc.).
- Accidental exposures (needle pricks, splashes to eyes and/or mucous membranes, inhalation of aerosols, ingestion, etc.).
- Medical emergencies (fainting, heart attacks, etc.).
- Power cuts or malfunctioning of equipment (BSC, freezers, ventilation, lighting, water, access control systems, etc.).
- Fires.
- Vandalism and unauthorised entry.

Outbreak preparedness and resilience (WHO 2020)

Percutaneous accident (small cuts, needlestick injuries, etc.)

- Remove the object that caused the accident and make the wound bleed.
- Clean the wound with abundant soap and water.
- Disinfect with Cristalmina® or another disinfectant.
- Cover the wound with a waterproof dressing.
- Wash your hands with soap and water.
- Check up on your status regarding anti-tetanus and anti- hepatitis B vaccinations, especially if the contamination was with blood or biological fluids.
- Go to the Health Care Service (SAS) and inform the person in charge of the cause of the wound and the agent involved.
- Record the accident.

Accidental ingestion of possibly biohazardous material.
- Take the person affected to the SAS, after removing his/her protective clothing.
- Do not induce vomiting.
- Inform the doctor about the agent ingested and follow the doctor's instructions.
- Record the accident.

Splashes (eyes, nose, mouth or skin).
- Wash immediately, with soap and water, all the skin surface affected or wash the eyes, nose or mouth with abundant water.
- Go to the SAS within one or two hours, providing information on the type of fluid and the possibility or certainty of biological contamination.
- Record the accident.

Inhalation of bioaerosols.
- Go to the SAS within one or two hours, providing information on the type of biological agent involved.
- Record the accident.

Spillage of a biological agent onto the body (group 1 and 2).
- Remove your contaminated clothing and put it in an autoclave bag.
- Vigorously wash the exposed area with abundant soap and water.
- Request medical attention if necessary.
- Record the accident.

Spillage of a biological agent onto the body (group 3).
- Attend to the person who has been exposed or contaminated.
- Remove contaminated clothing and put it in an autoclave bag.
- Take the person affected out of the laboratory.
- Report the incident to the supervisor and warn the laboratory to evacuate the area.
- Close the doors in the affected area.
-Vigorously wash the exposed area with abundant soap and water for one minute.
- Phone the SAS (1800 / 1900).
- Inform the emergency personnel when they arrive.

Any facility where work is done on biohazardous materials (or that receives them) must have an emergency response plan and a biological spills kit. Also recommended are eyewash, washbasins that are not manually operated, with the necessary accessories (soap, nail brush, towel) and an emergency shower if large volumes of material are handled.

The "Guía d'actuació en cas de vessaments bioperillosos" describes a range of response procedures. These are organised according to the biosafety level of the facility where a biohazardous spillage is thought to have occurred and usually coincide with the risk group of the BA involved. These procedures are of a general nature, however, and subject to changes as a result of particular risk assessments. For example, a spillage of an animal pathogen obviously does not require the same personal protective equipment as the spillage of a human pathogen. The specific response protocol depends on the agent being used, the quantities and the place where the spillage may have taken place.

Videos:

  1. Blood spill cleanup (Universitat de Yale 3:33 min)
  2. BSL-2 spill management in biosafety cabinet  (Basler&Hofmann 2 min)
  3. Cleaning Up a Spill (BSC). (Iowa State University 1:24 min)
  4. Biological spil clean-up (UC Berkeley 2:06 min)

Loss of negative pressure (BSL3)
- Secure the research materials.
- Leave the facility.
- Check that the facility is hermetically closed.
- Report the incident immediately to the CBS and the maintenance service.
- The supervisor, advised by the CBS, must define and apply the decontamination plan for the affected area (if deemed necessary) before resuming normal activity.

Power cut (BSL3)
If a power cut affects primary containment equipment (e.g. BSC), and there is no available UPS or generator, the area must be evacuated by following the steps below.

- Leave the facility, opening the door as little as possible and closing it quickly.
- Report the incident to the maintenance service and the CBS.
- A power cut continues to be regarded as an incident for at least 90 minutes, and no-one must return to the area in that period. When the 90 minutes have passed it may be necessary to initiate the emergency procedure again.
- Do not enter the laboratory until the supervisor or the head of maintenance consider it safe.
- Once power has been re-connected or the equipment is working correctly, personnel must put on personal protective equipment and clothes before entering the facility.
- Once inside the laboratory, decontaminate the surface of any area that may be affected.
- Decontaminate the whole interior surface of the BSC before resuming work.
- If the BSC was in use when the power cut happened, the incident investigation form must be completed and sent to the CBS within 48 hours.