[MCOH-EH] First Receiver/ Decon Onboarding

[Swift, Melanie D., M.D.]

Heather,
OSHA has compiled a Best Practices guide for Hospital-Based First Receivers. Section 1.2.8 covers how to monitor employee health before, during, and after the incident. This includes medical clearance prior to donning PPE, monitoring between shifts, and debriefing afterwards including mental health considerations.

https://www.osha.gov/dts/osta/bestpractices/html/hospital_firstreceivers.html

Appendix H of this document is a sample protocol for medical clearance and monitoring of decon staff.

As for who does this, it falls in the purview of occupational health; however these events unfold in such a way that the decontamination team may be activated nights/weekends/holidays and there may or may not be time to get your occ health staff in place before the first patient arrives. You should have a contingency plan arranged with in-house resources. This will differ depending on your institutional resources and structure, and could consist of ED personnel, float nurses, residents, or some other in-house staff. To assist them in getting started I recommend the following:

*         Have all potential decon personnel medically cleared for respirator use routinely.

*         Consider doing initial clearance for use of PPE with the worst-case scenario environmental conditions and work demands - this could weed out people with permanent contraindications to this work but will need to be reviewed at deployment for new medical conditions and medications.

*         Create a very simple algorithm for the occ health proxy to follow. Do not let them improvise! They will be under pressure to clear people with potential contraindications and should have clear instructions not to do this.

Hope this helps,
Melanie

Melanie Swift, MD
Senior Associate Consultant
Assistant Professor of Medicine
Division of Preventive, Occupational, and Aerospace Medicine
Phone 507.284.2560
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org<http://www.mayoclinic.org/>



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Angell Heather D.
Sent: Monday, December 03, 2018 9:37 AM
To: MCOH/EH
Subject: [EXTERNAL] [MCOH-EH] First Receiver/ Decon Onboarding

Hello,

For those healthcare organizations that perform decon:

Are you doing any different/special onboarding for the staff who will be performing the decon?  For example, medical monitoring prior to donning PPE (vital signs, skin evaluation, mental status, medical history, ect).

If so, who is performing this medical monitoring in your facility?

Any you doing any post-entry medical monitoring?  For example, vital signs, oral rehydration, IV hydration.

If so, who is performing this medical monitoring in your facility?

Is your facility utilizing a Hazmat Medical Monitoring form?

If so, what does your form look like?

Thank you for your consideration!

Heather

Heather Angell, RN, MSN
Clinic Coordinator
UWHealth  Employee Health Services
700 University Bay Drive
Madison, WI 53705
Phone: 608-263-7535
Fax: 608-262-7284

Your Health, Your Goals. Discover Wellness Options at Work<wellness.uwhealth.org>.

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