BLOOD AND BODY FLUID SPILLAGE

Introduction

Health services should have management systems in place for dealing with blood and
body substance spills. Protocols should be included in procedural manuals, and
emphasised in ongoing education or training programs.

Principle

The basic principles of blood and body fluid/substance spills management are:

standard precautions apply, including use of personal protective equipment

(PPE), as applicable

spills should be cleared up before the area is cleaned (adding cleaning liquids to
spills increases the size of the spill and should be avoided)

generation of aerosols from spilled material should be avoided.

Using these basic principles, the management of spills should be flexible enough
to cope with different types of spills, taking into account the following factors:

the nature (type) of the spill (for example, sputum, vomit, faeces, urine, blood or
laboratory culture)

the pathogens most likely to be involved in these different types of spills for
example, stool samples may contain viruses, bacteria or protozoan pathogens,
whereas sputum may contain Mycobacterium tuberculosis

the size of the spill for example, spot (few drops), small (<10 cm)="" or=""
large="">10cm)

the type of surface for example, carpet or impervious flooring

the location involved that is, whether the spill occurs in a contained area (such
as a microbiology laboratory), or in a public or clinical area of a health service, in
a public location or within a community premises
 whether there is any likelihood of bare skin contact with the soiled (contaminated)
surface.

Figure: Spillage Management

A spillage kit is provided to all the required areas where there is a chance of spill is
notified

1. Alert and evacuate people in the immediate vicinity of the spill.

2. Inform the house keeping supervisor about the spillage.
3. Wear appropriate PPE by department staff. (From Pre-prepared spillage kit)
4. Prepare 1% sodium hypochlorite solution (200 ml 5% sodium hypochlorite in 800 ml of
water)
5. Pour 1% hypochlorite on the spillage from peripheral to central. (Adequate quantity)
Avoid splashing.
6. If any Broken glasses or sharp present in the spill should be removed by mechanical
means by forceps or other equipments rather than with hands and it should be disposed in
the sharp container.
7. Cover it with a piece of absorbent tissue paper or any absorbent material. Keep it there
for 10-20 minutes.
 8. With gloved wipe up the spill some edges to centre and it should be disposed in the
yellow bin glove should be disposed in red bin.
9. Mop it with separate mop. (mop should be dipped in 1 % hypochlorite for 30 minutes)
Clean the area periphery to central in a circular motion.
10. Then clean it with surface disinfectant.
11. Remove the PPE and discard properly.
12. Replenish the spill kit after every use.

Table: Management of blood or body substance spills

Spot cleaning Select appropriate PPE

Wipe up spot immediately with a damp cloth,
tissue or paper towel
Discard contaminated materials
Perform hand hygiene

Small spills (up to Select appropriate PPE

10cm diameter) Wipe up spill immediately with absorbent material
Place contaminated absorbent material into
impervious container or plastic bag for disposal
Clean the area with warm detergent solution,
using disposable cloth or sponge
Wipe the area with sodium hypochlorite and allow
to dry
Perform hand hygiene

Large spills (greater Select appropriate PPE

than 10cm diameter) Cover area of the spill with an absorbent clumping
agent and allow to absorb
Use disposable scraper and pan to scoop up
 absorbent material and any unabsorbed blood or
body substances
Place all contaminated items into impervious
container or plastic bag for disposal
Discard contaminated materials
Mop the area with detergent solution
Wipe the area with sodium hypochlorite and allow
to dry
Perform hand hygiene

Conclusion

The use of sodium hypochlorite is not necessary for routinely managing spills but it may be used
in specific circumstances. There is evidence supporting the use of sodium hypochlorite to
inactivate various blood borne and gastrointestinal viruses, and bacteria such as C. difficile (HPS
2008). The consideration to use sodium hypochlorite should be based on risk assessment of the
environment, the spill, risk of transmission of disease, and the surface area and potential hazards
with using the product.

If a disinfectant is required, particularly during the implementation of transmission-based

precautions, a TGA-registered hospital grade disinfectant must be used. The disinfectant chosen
should have label claims against the organism of concern.