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Purpose
to provide standards for management of regulated medical waste (RMW) at Navy shore medical treatment facilities (MTF).
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BUMEDINST 6280.1B
management of regulated medical waste
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Background
concern about potential adverse environmental and public health effects of RMW.
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Non-RMW
is solid material intended for disposal, produced as the direct resuld of patient Dx, Tx, Therapy or medical research.
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RMW
is generated during Dx, Tx, or immunization of humans or animals and is capable of causing disease or would pose other adverse health rish.
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action for RMW
Commanders, CO, OIC of MTF and DTF shall comply with State and local regulations.
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Non-RMW include
used personal hygiene products (e.g. diapers, facial tissues, and sanitary napkins)
and absorbent material containing very small amount of blood or other body fluids.
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RMW inlcude
regulated waste and other infectious material.
liquid or semi-liquid blood or other potentially infectious materials.
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Potentially Infectious materials
human body fluids; semen, vaginal secretion, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid.
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Potentially Infectious Materials Cont'd
any unfixed tissue or organ (other than intact skin) from a human (living or dead)
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Potentially Infectous Materials Cont'd 2
HIV, HBV-containing culture medium or other solutions; blood, organs, or other tissues form experimental animals infected with HIV, HBV.
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9 groups of RMW
- 1. Cultures, stocks, and vaccine
- 2. pathological waste
- 3. blood and blood products
- 4/7. Sharps
- 5. animal waste(those expose to infectous agent during medical reseach)
- 6. Isolation wastes
- 8. other (fluids designated by local infection control authority)
- 9. Chemotherapy trace wastes
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Collection/Segregation
Separate RMW from the other waste at point of origin, Place RMW in containers, bags, sharps containers, and label "BIOHAZARD"
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Collection/Segregation Cont'd
line containers with plastic bags of sufficient thickness (typically 3ml), bags shall be labeled or color coded red. Do not over load bag!
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Collection/Segregation Cont'd 2
Dispose of sharps waste as well as discarded vaccines/vaccine containers in rigid, puncture resistan sharps containers.
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Packaging and Handling
1. Place Sharps Cont. in a second container(bag/rigid) which is labeled and/or color coded and treated and disposed.
2. Minimize human exposure to RMW during transport to treatment or storage areas.
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Packaging and Handling Cont'd
place all anatomical pathology waste into double-wall corrugated boxes or equivalent figid containers that are double-lined with plastic bags for transport and incineration in an infectious waste incinerator.
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Packaging and handling Cont'd 2
ethical considerations may dictate using alternate means of disposal such as cremation or burial by a licensed mortician.
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Storage
store in storage areas, Pathological wastes must be refrigerated or frozen in dedicated cold storage. non-pathological waste shall not exceed 7 days
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storage cont'd 2
RMW storage areas will be constructed to keep pest out and allow easy clean up in case of spills and the front shall be labeled RMW w/ BIOHAZARD
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Storage Cont'd 3
Pathological waste(PW) not immediately processed for treatment and disposal must be refridg/frozen if stored for more than 24hrs. only PW shall not exceed 30 days.
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Storage Cont'd 4
RMW storage will not exceed storage times, if local, State, or country rules and Reg. are more stringent, they should be followed.
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Transportation
Place RMW into rigid, leak-proor containers before transporting off-site.
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Transportation Cont'd
Comply w/ federal, state, and local law and reg.
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treatment and disposal
RMW treatment is achieved through destruction, such as by incineration, or through inactivation by heat, chemicals, or radiation.
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treatment & disposal Group 1; Cultures, Stocks, and Vaccines.
Separate microbiologic waste such as cultures and stocks of etiologic agents from general waste for decontamination.
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treatment & disposal Group 2; PW
Dispose of PW inside a RMW container with a plastic bag or double bag in RMW bags.
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treatment & disposal Group 3; Blood and Blood products
In accordance with local, State or hosting-nation laws, dispose blood or bodily fluids via sanitary sewer. blood products shall be disposed in a rigid, puncture-resistant, leak-proof containers.
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treatment & disposal Group 4/7; Sharps
Group 4 Used/Group 7 unused sharps. Discard all sharps directly into sharps containers immediately after use.
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treatment & disposal Group 5; animal waste
animal waste must be managed as RMW and incinerated.
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treatment & disposal Group 6; Isolating wastes
isolated waste shall be handled in accordance with facility infection control directives.
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treatment & disposal Group 8; Other
fluids that are designated as RMW by the Local infection Control authority. they may include but not limited to semen, vaginal secretions, cerebrospinal fluid..etc.
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treatment & disposal Group 9; Chemotherapy trace waste
do not mix Chemo waste with non-chemo waste. place chemo waste in yellow containers and consult facility chemotherapy drugs protocol or IC committee and/or safety office for additional guidance.
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Manifesting and recordkeeping
all MTF/DTF must develop and document a system to monitor disposal of RMW per local, Sate, and Federal reg. Records must be keep 2 yrs. tracking must include; type, amount, and disposition
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Manifesting and recordkeeping Cont'd
RMW is transported off-site, receiving facility shall provide written documentation. MTF will maintain record of RMW disposal
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Training
all shall receive training prior to beginning work and annually thereafter, and receive supplemental training whenever new processes, procedures and or new processes.
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cleanup of spills
clean up spills immediately
post staff while gathering materials to cleanup spill to prevent potential spreading of infectious material.
members shall wear PPE
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