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Safety

Emergencies, Injuries, & Exposures

Managing emergencies and exposures in the clinical laboratory requires a rigid administrative framework. This ensures that when the unexpected occurs - whether a needle stick, a natural disaster, or a chemical spill - the response is immediate, standardized, and compliant with federal law. This section focuses on the three administrative pillars of emergency management: Reporting, Planning, and Training

Reporting Requirements

Reporting transforms isolated incidents into legal records and actionable safety data. It creates the trail of evidence required for medical intervention and regulatory compliance

  • Internal & Medical Reporting: Immediate internal Incident Reports (IR) trigger the medical management of the exposed employee (e.g., HIV prophylaxis within hours of a needle stick)
  • OSHA Recordkeeping: Management must maintain the OSHA 300 Log for work-related injuries. Severe events (fatalities, amputations, inpatient hospitalization) require active reporting to OSHA within 8–24 hours. A separate Sharps Injury Log tracks device failures to evaluate engineering controls
  • External Agencies: Injuries involving medical devices may require FDA reporting, while claims for lost wages involve state Workers’ Compensation filings

Disaster Planning (Continuity of Operations)

Disaster planning prepares the laboratory to maintain essential testing functions during catastrophic system failures. This requires an “All-Hazards Approach”

  • Hazard Vulnerability Analysis (HVA): A risk assessment that prioritizes threats based on likelihood and impact (e.g., power failure, cyber-attack, flood)
  • Emergency Operations Plan (EOP): The written playbook for survival. It includes Communication Plans (redundant call trees), Utility Failure Protocols (operating on backup generators or without water), and Downtime Procedures (manual testing during LIS/Cyber outages)
  • Mass Casualty Incidents (MCI): Protocols to surge staffing and restrict test menus to trauma panels to preserve resources during a sudden influx of patients

Staff Training

Training converts the written plan into employee competence. It ensures staff can perform “Self-Rescue” and function under stress

  • Exposure Response: Training staff on the immediate “First Aid” for chemical splashes (15-minute eye flushing) and BBP exposures (immediate washing, not squeezing), followed by the correct notification chain
  • Fire & Evacuation: Hands-on drills for using extinguishers (P.A.S.S. technique) and executing evacuation routes (R.A.C.E. protocol)
  • Functional Drills: Conducting “Downtime Drills” (practicing paper-based resulting) and “Tabletop Exercises” to test the laboratory’s readiness for disasters without disrupting patient care