Provider Wellness Podcast

Highlights of interview on decontamination following a COVID-19 hospital shift

March 31, 2020 Matthew Zinder, CRNA Season 1 Episode 3
Provider Wellness Podcast
Highlights of interview on decontamination following a COVID-19 hospital shift
Show Notes Transcript

As promised, this episode is a 15 minute version of the previous episode on decontamination procedures following a hospital shift in a coronavirus hospital.  This is a succinct version of the interview where you will hear Matthew and the hazardous material expert, Ray Pierson, only discuss decontamination procedures.  This shorter podcast will hopefully offer an easier and digestible way to reference those procedures.  Please pass this on to anyone that could benefit from the information. 

COVID19- Onsite Decontamination Materials
Supplies needed:
•Spray bottle 10% bleach
•Spray/squeeze bottle of soapy water (Large)
•Spray/squeeze bottle of clean water (Large)
•Gloves Paper towels (Several rolls)
•Duct or painters tape
•Garbage bags (large kitchen or sim)
•Changes of cloths wrapped in ziplockbags
•Optional:
•3x medium size cardboard boxes (for organization, optional)
•Gloves and extra masks
•A BUDDY!

Steps:  
If it is not possible or practical to perform these steps at the facility, perform them at home and clean the car upon exiting.  Make no stops from your facility to home if you are unable to decontaminate at the facility.  
(Note this works best if you have a buddy, in which case do one at a time with a buddy helping)

•Wear your gloves and mask out building. If needed put a second set on before exiting building.

•Open the trunk of car and remove the bleach spray bottle 

•Spray down anywhere you touched your car to access drunk or bleach, Spray gloved hands down and rub to get the bleach everywhere (clock out +30 seconds rubbing)

•Open two garbage bags, put bag in small box or tape to car to keep its mouth open for easy dumping. One is for stuff you want to keep, and the other is trash.

•Remove any and all potentially contaminated items: (masks, caps and gloves last)

•DO NOT PULL ANY ITEM OVER YOUR HEAD (always wear clothing with buttons or zippers)

•Pull all items you with to keep in the “keep” bag and anything in the “trash” bag

•Remove cap, hat or bouffant and discard

•Soak a large group of paper towels in soapy water.

•Wipe yourself down with soapy towel, pay special attention to areas that was exposed during work including your hair (use spray for hair if needed), do your face last.  Discard towels in trash

•Remove mask and all sets of gloves and discard in trash

•Repeat wipe down again with a second set of towels and discard

•Rinse yourself thoroughly with clean water and dry with clean paper towel.

•Grab a bag with clean clothing and walk around other side of car (dry area) to change into them.

•Grab a new garbage bag from your trunk and open it so you can place over the top of your trash bag/box without touching it. Seal the bag with trash inside. Toss in closest bio-trash bin.

•Repeat process with “keep” bag, but place these in the truck of your car.

•Wash hands with soap and water again to complete.

•Optional: Put on fresh set of gloves and mask


Be sure to read and download the transcripts to this episode. Click on the tab above.

Check back often for more episodes pertaining to health and wellness and issues concerning the COVID-19 pandemic.

Please send your questions to goingviralpodcast@gmail.com

Website:  https://goingviral.buzzsprout.com/

Thanks for listening and please share this episode. 


spk_0:   0:05
Hello and welcome to the going viral podcast. I'm Matthew's ender, a certified registered nurse anaesthetist. I'm in Advanced Practice Nurse that specializes in the practice of anesthesia. Scope of this podcast will explore health and wellness from the broad to the specific. My aim is to educate while offering a unique perspective, Thank you for joining me today and let's get right to the show. So welcome to this third episode. And, as promised, I have cut down the 43 minute episode of the decontamination procedures with Ray Pearson, and I've cut that down to, uh, less than 15 minutes, and I just wanted to have a very quick and CeCe inked episode on just the procedures. I hope the shorter amount of time allows people to reference it a little bit easier. Also, please remember to go to the show notes, and Ray has written out in step form decontamination procedures and just remember to do them wherever it is practical for you, whether it be at the hospital or in the parking lot, as Ray Head suggested for a moment and uh, all the way through to getting home. Also, remember that in ah following episodes we will be talking about stress management as we all know how stressful things are right now. Ah, and also I have some interviews lined up, one with an infectious disease physician out of the University of Maryland Medical System. And also I will be talking to an individual who was diagnosed with Cove it. 19. He lives in New York City, and he is currently on quarantine and living through it, and it does look like he will make a recovery. But he will describe his symptoms and how he believes he caught it. So please tune in and check back often for some of these episodes. And I hope that Ah, these informational podcasts are helping you and please share with us many people, as you think, could benefit. So here is thesis inked version of my interview with hazardous materials expert Ray Pearson on decontamination procedures following ah hospital shift taking care of cove it 19 patients. So let's get into that whole concept of Di Khan. How do we decontaminate ourselves at the end of a shift in order to not bring it home to our families, or even to the physical structure of our home car for your car. Well, that might to me, that might be inevitable. You might just have to learn toe, clean it really well. Each and every time you get into it after a shift,

spk_1:   3:09
let's start with like, uh, if this was if you were working with material as dangerous as Kobe 19. Ah, what you would do is again You want to be constantly moving from from dirty to clean. Everything that's on the outside of you that's been exposed to the world is assume it's dirty. And now what you want to do is start cleaning it and removing it away from you. Uh, so at the end, you end up with just you that are clean and everything that might have gotten dirty in Ah, bag, that's not near you at this point in time. Uh, but we had some garden sprayers that had, ah, bleaching water. We don't have a garden sprayer or any sort of a little, uh, spray bottle will work, and we would. First thing we would do is we come out, we spray down our hands on put on second clubs. We now know that our hands are wearing fresh gloves and they're covered with bleak. So we assume that our hands cannot touch things that will not get infected in that, that they're clean. And then we would start going through a process to where we'd be removing layers and putting it in bags. That would be to be de cond later that you're not gonna throw your clothes out. You wanna wash your clothes, go heavy on the bleach or some sort of sanitizing agent When you wash your clothes at this point in time and you go through that process to her at the end, you'd have hopefully in this deacon kit, you'd have a bag full of clean clothes when you were done taking off all your old stuff that's dirty. Uh, the last thing you would do is remove your mask. Uh, why pedal down and take a step, hopefully to the other side of your car with a bag that had all of your new clean clothes and he would pop those clothes on. There's a lot more to it, a lot more steps, and you kind of want to follow them in the way that I describe such that you're always going one layer at a time, leaving your mask and over your face. We assume that anything that you are shaking off your clothes or anything like that, you might be Riera civilizing something. So you want to have that mask on the whole time?

spk_0:   5:21
Okay, keep the mask on the whole time. That's a good point because a lot of people, I can tell you that this is something that we've never had to think about, so it's very difficult to come up with a procedure. So the recommendation is See if you can do some level of decontamination at the hospital in his safe of a room, as you can possibly think of, maybe pack in that gym bag. Ah, bag of of Clorox wipes or something equivalent and wipe down all the door knobs. And the surface is in that room that you're in and bring up, Ah, hefty bag or you are a trash bag to put all of those things that you're shedding off into and then put on the clean clothing. Obviously, taking a shower there, if you can, would be ideal as well. But it's not always practical, either, depending on what type of facilities your your hospital offers you for people who don't have that ability. And they do just have to leave and get in their car and go home. What can we What can we tell them? And we can start with. What do you do with the car?

spk_1:   6:23
If you have to get in the car, then you're gonna have to clean the card. I'll write it down, spray it down. Uh,

spk_0:   6:31
and that would be every time. Right?

spk_1:   6:33
Every time you work in a bio safety lab, though, it's almost a joke. You never bring your work home with you,

spk_0:   6:40
right? Yeah, that makes a lot of sense.

spk_1:   6:43
If you are a person that is concerned about this and wants to basically protect themselves, then protect yourself like anything else to the best of your ability. Use your head. Use your eyes making informed decision and decide where you want how you want to respond.

spk_0:   7:05
You have to get in your car and go home. You're shedding as best you can. So from what I'm getting is the recommendation is you have to clean the car every single time this happens. Clorox wipes avail are appropriate or anything different than that

spk_1:   7:19
Clark's wipes. I tend to like and you know this my spray bottle of bleach on and that's some paper towels are really good. The spray tends to go everywhere. You don't miss as much. And, uh, if you're afraid of the bleach damaging it, you can use the isopropyl alcohol I p a. Also in a spray bottle, not and just wipe everything down. Make sure that you don't leave any any stones unturned. In this case,

spk_0:   7:51
should we try to wear a mask while we're cleaning as well?

spk_1:   7:54
I would say yes.

spk_0:   7:56
So as far as Okay, so we've gotten home, we clean the car. Should they clean the car as soon as they just pull up to their driveway? Or is that something you do later, after you d con,

spk_1:   8:06
I would get out of the car, clean the car, and then I would get away from the car, and then I would go through and strip all the stuff off of me. Uh, leaving at the end. Everything that I've touched. I've just moved from the dirty state to the clean state, leaving nothing but bag full of trash that I'm gonna throw out or burn at the end of it, but I would do the car while I'm still wearing as much pp Ear protection that I have is if you went back and clean the car afterwards. Whatever closing your where you run the risk of getting it on your clothes that you're clean clothes. So you'd want to kind of still do it dirty.

spk_0:   8:41
Everything is an order. You want to do things in a certain order to go from most contaminated to least contaminated. Correct.

spk_1:   8:49
Is that sequence that you're always kind of moving from dirty to clean. Ah, and you don't want to have to go back, go back yet to clean over again.

spk_0:   8:59
Okay, so we've gotten out of the car, we clean the car. Let's say we have a place in the house. Mud room, garage, basement, walk out. Whatever. We have a set place. Do we want to keep that one same place every single time?

spk_1:   9:13
Yeah, but you get at the end when you're all done with this, you're gonna de connell that stuff again and you're gonna god again. Clean it off, make it go away, and it's in one location. You only got one location to clean?

spk_0:   9:25
Sure, so we get to that point. We shed everything into a trash bag, I guess, and then and then get ourselves into a shower. Anything in particular that one should do, cleaning themselves in a shower? Or is it just regular old soap water and shampoo?

spk_1:   9:43
Soap, water, shampoo? I mean, you shouldn't you know that soap is really, really good Killing viruses and bacteria. It's also good at keeping things from Aarhus allies ing. If you did where your D con area would be when you got out of your car, make it is close to your car as possible. So you're not smelling up. Your whole house says you're going through it and you should be What? This is in your house now. You should be leaving that area, uh, wearing either completely new clean items or very little of what you had on there, so there's no chance that you're carrying anything with you. Uh, when do you go take and then you go right to the shower.

spk_0:   10:20
So in summary of D con procedures after a shift at the hospital taking care of covert 19 patients or in a hospital that just has Cove in 19 patients, and it doesn't even matter if you took care of one. Ah, the ideal situation would be to d con at the hospital in some room that you deem is clean as possible and bring some some cleaner with you. If you need thio and change out of everything as best, you can do a clean outfit and and, ah, trash or put a trash bag all the contaminated garb be best to take a shower of the hospital. Two of possible, If that's not possible, we get into our car. We go home. Keep the mask on as long as you can in the driveway. Clean the car as best you can. After exiting the car. Go to your set spot in the house or shed everything off into a trash bag and again. Or do we still have the mask on At this point,

spk_1:   11:25
if you can dry, I would because happened. He conned yourself,

spk_0:   11:28
eh? So we're to the point now where we shut everything off. It's in the trash bag. We take that trash bag to the laundry room, dumping in, start washing the clothes and then get ourselves into the shower

spk_1:   11:38
you should make sure that before you're leaving your d con area your d con. Because if you're not, what's the point?

spk_0:   11:46
Well, there's still the concept of being in your hair and things like that. I mean, people gonna jump in the shower after that, so it's gonna be at step process where you're less d con, but not completely.

spk_1:   11:56
Yeah. I mean, my guess is if your hair is gonna be old wet piece, you just hosed it down with soapy water or poured soapy water over it to make sure that you're not gonna aerosolize anything as you're walking through your house. Ah, you're mostly taken the shower to wash any the that, the residual sanitizer that you have all over your body off at that point in time. But there should be zero concern that you have any covert 19 particles on you at this point, or you haven't done your d con right.

spk_0:   12:28
All right, well, that was a great summary of recommendations for what we can do, because I know it's not on everybody's radar, and I know that Ah, lot of people myself included, uh, just didn't realize how serious it was and how these procedures need to be a step process. And in order to keep everyone including yourself and your family safe when you are known to be exposed to it. Is there anything else that you can think of that you might want to add to any of that?

spk_1:   12:59
Yeah. I was never doing it by myself. I had a

spk_0:   13:04
great point.

spk_1:   13:05
I had a partner with me and her, and I would make sure that even if I wasn't helping her, she wasn't helping me. We were making sure we were doing it right.

spk_0:   13:17
You know, what we want to prevent is someone getting off of a shift and then going to the grocery store on the way home? Uh, you know, they have to think differently. Well, we have to. We have to assume it's on us. And we have to take the proper steps to protect ourselves and our families, especially after we go home from a shift like this. So Well, thank you very much for your time and your expertise. You Ah, you have helped a lot of people this evening.

spk_1:   13:42
Thank you, man.

spk_0:   13:43
All right. Anything else? Toe to sign off.

spk_1:   13:47
Bye. Be safe

spk_0:   13:48
All right. Well, thanks very much. So that'll do it for this episode. I hope to see you with the next one. This'd Matthews ender and the going viral podcast. Please stay safe and stay well.