ppe

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Biosafety Levels 1-4

We’ve known that breathing in or touching infectious/infected material is probably bad since before germ theory, but it wasn’t until 1943 that our first formal guidelines and laboratories for technician separation from the infectious agent were set up. It was the 1960s before the first conference to standardize personal protection equipment (PPE) guidelines. 

These days we have 4 basic safety levels when working with biological agents: Biosafety Levels (BSL) 1-4

BSL 1 includes well-understood agents not known to regularly affect adult humans, and which present a minimal level of hazard to the technician. Canine hepatitis, non-pathogenic strains of E. coli, and other non-infectious bacteria. Aside from standard healthy-living procedures (washing with soap etc), laboratory equipment is decontaminated via autoclave between uses, protective gloves, and sometimes protective goggles are required.

BSL 2 includes many of the milder infectious diseases that we know about, such as Salmonella, measles, mumps, MRSA, C. difficile, and hepatitis A, B, and C. These are sometimes serious illnesses, but are not easily aerosolized in a laboratory setting. When aerosols may be formed, biological safety cabinets are used, extreme care is taken with sharps, access to the laboratory is limited during work, and all technicians are trained in pathogen handling procedures.

BSL 3 includes dangerous pathogens that can cause potentially lethal infection, such as Yersinia pestis (black plague), rabies, SARS, tuberculosis, tularemia, and yellow fever. Laboratory personnel have specific training in handling pathogenic and potentially lethal agents, and are supervised by competent scientists who are experienced in working with these agents. All procedures involving the manipulation of infectious materials are conducted within biological safety cabinets, specially designed hoods, or other physical containment devices, or by personnel wearing appropriate personal protective clothing and equipment. The laboratory usually has special engineering and design features, such as restricted access, double-door entrances, and sealed penetrations. BSL 3 laboratories are sometimes called warm zones.

BSL 4 includes the most lethal and exotic agents that there are no cures or vaccines for, such as Ebola, Lassa, Argentinian hemorrhagic virus, and smallpox (smallpox for its extreme virulence, despite its vaccine availability). When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply, is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release. Agents with a close or identical antigenic relationship to biosafety level 4 agents are handled at this level until sufficient data is obtained either to confirm continued work at this level, or to work with them at a lower level.

Members of the laboratory staff have specific and thorough training in handling extremely hazardous infectious agents and they understand the primary and secondary containment functions of the standard and special practices, the containment equipment, and the laboratory design characteristics. They are supervised by qualified scientists who are trained and experienced in working with these agents. Access to the laboratory is strictly controlled by the laboratory director.

The facility is either in a separate building or in a controlled area within a building, which is completely isolated from all other areas of the building. A specific facility operations manual is prepared or adopted. Building protocols for preventing contamination often use negatively pressurized facilities, which, even if compromised, would severely inhibit an outbreak of aerosol pathogens.

BSL 4 labs are hot zones.

British Marine Samuel Giles William Alexander survives a gunshot to the head thanks to his helmet.

Sadly, he would later die in Afghanistan, earning Britons top honor, the Victoria Cross, while valiantly defending his platoon by firing every piece of ammo he could find.  When he ran out of bullets, he picked up the next gun he saw on the ground and continued fighting.  His bravery saved the lives of two of his wounded men. https://www.gov.uk/government/fatalities/lieutenant-oliver-richard-augustin-and-marine-samuel-giles-william-alexander-mc-killed-in-afghanistan

Kit from last night’s train up. First Tactical pack housing a Team Wendy ballistic, TNVC Sentinels, and support gear. BCM carbine. PMAGs with Magpods. Various Glock mags. Prototype T.REX ARMS warbelt with various pouches. Flagrant Beard blade. PACT timer. MSA Sordins.

@firsttactical @tnvc_inc @ferroconcepts @coyotetacticalsolutions @redbackone @magpod @pactinc @flagrantbeard

#kit #gear #trexarms #trexarmskydex #teamwendy #nvgs #nods #atpialc #nightvision #pmag #glock #glock19 #surefire #cat #tccc #warbelt #trexwarbelt #pacttimer #ppe #sd3g #sordins #slingster #multicam #mismatch #rangergreen #trainhard #shootfast #shootaccurate #raisestandards

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Have you suddenly discovered the INCREDIBLE world of arts and crafts? Love getting your fingers dirty with some HANDS ON CRAFTING? Don’t forget your PPE!

PPE stands for Personal Protective Equipment and is an essential tool in your studio. It is an important investment for your future health and will ensure many years of enjoyable pain free crafting! 

It may seem like a hassle putting on rubber gloves every time you want to clean your airbrush, or finding your mask and goggles when you just want to sand something quickly, but you and your body will thank you for it! When you sand something like resin the particles go into the atmosphere and you inevitably inhale them. Those particles can’t be processed by your lungs, and will stay there. Imagine if you inhaled loads - it gets really dangerous.

Did you know that acetone can cause central nervous system complications and put you in a COMA if you absorb too much into your skin? Short term it causes redness, irritation and dryness of the skin. It’s horrible stuff - but oh so fantastic for cleaning brushes! If you want to use acetone you need to wear a VAPOUR MASK and GLOVES! 

Maybe you don’t use acetone but use some other chemical - how can you find out information about it quickly? Well, usually dangerous materials have warning signs on the side that let you know if they are irritant, flammable, corrosive and lots of other things. You can see all of the warning signs and what they mean here! 

Looking to buy a chemical but want to know how dangerous it is first? Look for the MSDS sheet! MSDS stands for Material Safety Data Sheet, it lets you know what PPE you should wear and what all the risks are. A quick google search of “[material name] msds” should throw up a few .pdfs or webpages. Spend a bit of time reading them and learning HOW to read them - they are important! Some websites that sell chemicals have extra handy links right to the MSDS on the product page! See here, the item, how to buy and the MSDS sheet. Fantastic!

Links to places that sell PPE in the UK
Screwfix.com
MBFiberglass - Also sell a vast range of casting and moulding equipment
3M Direct - 3M are an enormous company and are available in over 200 countries.
Mouldlife.net - I buy all casting and moulding supplies from these guys and although they don’t have 3M PPE just yet they are becoming official distributors soon.
Tomps - Also casting & moulding equipment and materials.

Your shopping list:
Nitrile gloves
Barrier cream (KleenallSwarfega,Gramos/Kleenall)
Respiratory mask (Heavy duty for fumes and lightweight for dust and paint mist.
Apron
Goggles
High performance heavy duty hand cleaner (SwarfegaCTSKleenallE-POX-EE (US only).)

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How Do You Dress YOUR Trauma Team?

Over the years, I’ve seen the trauma teams at quite a few hospitals in action. One thing I have noticed is that most just don’t pay attention to what they wear. I’m talking about wearing personal protective equipment again. It’s one of those things, like hand washing, that everyone knows that they are supposed to do.

There are two reasons to put all that stuff on:

  • To keep potentially contaminated body fluids from getting on you
  • To prevent you from contaminating your patient’s open wounds

The minimum equipment that MUST be worn is a cap of some sort (to keep your hair from falling on the patient), mask and eye protection (mucus membrane protection), gown (protects your clothes), and gloves (obvious). Shoe protection is optional, in my opinion, unless you wear Christian Louboutin to work.

So you’ve been lax with your team. How do you get them to put everything on now? It’s like getting your child to wear a bicycle helmet when they are fourteen.

  • Create an expectation that everyone wear it and empower everyone to point it out. No exceptions. Physicians, this means you.
  • Put all equipment just outside the trauma room door. The farther away it is, the less likely it is to be used.
  • Assign an enforcer. Everyone entering the room must be dressed, or this person will speak up. Ideally, they should be a physician. If not, one of the docs must back this person up.
  • Occasionally, a badly hurt patient gets rolled into the room with little advance notice. In this case the fully dressed people need to relieve those who are not as soon as they dress and walk into the room.

The top picture shows part of our trauma team assembling before a trauma activation. Everyone is dressed. They know that someone will call them on it if they aren’t. Also, note the little pink sticker on the chest of physician at the head of the bed. We have a sticker for every role in the room (bottom picture). At the beginning of a resuscitation I scan the room to make sure everyone has one. It helps identify everyone and makes extraneous personnel stand out so they can be asked to leave the room.

Bottom line: Everyone has to wear their personal protective equipment on every trauma resuscitation. No exceptions.

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