AUTOMATIC EXTERNAL DEFIBRILLATORS (AEDs)
Automatic External Defibrillators (AEDs) are located near the Human
Resources Office in the front lobby of Holloway Hall, near the
Cashier’s Station in the Commons, and Maggs Center lobby, pool,
training room and fitness center and University Police vehicle.
Certain individuals are trained in their use, but these units
are designed to be used by anyone in the event of an emergency.
In case of a medical emergency that involves the sudden stoppage
of heart fibrillating activity, initiate the following emergency procedures:
Exposure to bloodborne pathogens is possible whenever contact with blood or
body fluids takes place. Exposure may occur when providing first-aid to a
co-worker or handling waste that is soiled with blood or body fluids. Saliva or
vomit mixed with blood due to an injury may pass to the caregiver during CPR.
Handling waste contaminated with body fluids may allow a virus to pass to the
worker. You and your supervisors should review tasks and identify actions that
may cause contact with body fluids. Precautions you take should match the
potential for possible exposure to body fluids. Although not all body fluids
will cause infection, universal precautions can prevent exposure to fluids that,
on rare occasion, may contain Hepatitis B or HIV. Wear personal protective
equipment (PPE) that will protect you from illness.
The Following Steps Are To Be Taken After Each Exposure
Employee will be administered first aid.
Each incident is to be reported to the supervisor
The supervisor and the employee will complete an Employee’s
Incident Report as soon as possible after the exposure incident (see EHS or
HR Web site).
Each incident is to be evaluated by a licensed health care
professional at Peninsula Regional Medical Center.
When the source individual is known, the source individual’s
blood may be tested for the Hepatitis B virus. The individual may also be
tested for HIV once informed consent has been obtained. The result of the
evaluation will become a part of the employee’s medical record and shall be
confidential. The employee shall be given information pertinent to the
source individual as needed to make an informed decision concerning
appropriate follow up measures.
When appropriate, the exposed employee’s blood will be
tested for Hepatitis B and for HIV. Peninsula Regional Medical Center will
provide the test results to the exposed employee and provide counseling as
medically indicated, including referral to an infectious disease specialist,
Precautions You Can Take:
Look out for sharp objects or sharps (e.g. - razors,
needles, broken glass, etc.).
Use caution when cleaning and handling laundry. Sharps may
be found dropped in sheets, down drains, or other places. Gloves may be used
when handling trash bags. In all situations, grasp the bag and lift it away
from yourself. Watch for objects sticking out of the bag.
Do not handle sharps that are contaminated with blood.
Health care workers are not even allowed to recap, bend or break scalpels
and needles. Make sure you dispose of all sharp objects properly with
minimal handling. Do not throw them into regular trash or leave them lying
around. Dispose of sharps contaminated with blood in appropriate containers.
Containers should be puncture- and leak-proof. Use a secondary container if
leakage is possible. Fill sharps containers no more than ĺ full and tape
Properly label any containers or objects that may contain
infected waste or blood. Containers holding the blood must be labeled with
the biohazard symbol. It must be fluorescent orange or red with letters in
contrasting colors. Contact Environmental Health & Safety Office for
Wash hands and other skin surfaces after removing gloves or
when contact with contaminated articles occurs. Use soap and water and wash
for two minutes. Clean, disinfect and sterilize all reusable first-aid
equipment. Disinfect Items (e.g., splints) contaminated with blood before
Clean and decontaminate blood spills as soon as possible.
Wear gloves to clean up blood. Wipe up blood with disposable towels and
dispose of the towels in a properly labeled container. Use an EPA-approved
germicide or a 10 percent mixture of household bleach (9 parts water to 1
part household bleach) to disinfect surfaces. For large spills, use the
bleach straight from the bottle, if practical. Since bleach loses
concentration with time, don’t allow the mixture to stand for several weeks.
Allow enough contact time, approximately 20 minutes, to disinfect. Rinse
tools with water after disinfecting and wear appropriate PPE (and ventilate)
while disinfecting since bleach is corrosive and has a strong odor.
Bag laundry at the location of use and label appropriately.
Soiled laundry should be handled as little as possible. Place soiled laundry
and PPE in leak-proof bags while wearing gloves. Clean soiled laundry with
detergent in normal laundry cycles (hot water at 160 degrees for 25 minutes)
according to manufacturer’s instructions. PPE should be cleaned and dried
according to the manufacturer’s instructions.
Dispose of all contaminated waste in appropriate containers,
as described within the current version of Salisbury University’s Exposure
Additional information is included within Salisbury University’s
Exposure Control Plan and is available at the Environmental Health and Safety
(EHS) Web site or by request (Ext. 66485 or 410-546-6485).
Services, as an agent for Salisbury University, monitors communicable disease
cases that may affect the well-being of students, faculty and staff. In
the event of a communicable disease event, Student Health Services consults with
and receives guidance from the local and state health departments, as well as
the Center for Disease Control. The consulting agency is determined by the
disease presented, the number of cases and other guidelines established by state
and federal laws and recommendations. Disease events are co-managed by SHS
and the consulting agency to ensure the safety of individuals and the campus
community. As an agent for the University, SHS may require quarantine or other
action, as recommended. SHS informs the University administration, faculty,
staff and students, as needed, to provide education to limit the impact of a
communicable disease event. SHS works with the offices of Public
Relations, the President and Student Affairs to create methods of communication
such as the use of e-mail, faculty announcements, awareness statements for
coaches and other administrative staff, articles for student and campus
newspapers, and residence hall awareness campaigns, as determined to be prudent
or as mandated by a consulting agency. Communicable diseases are defined
as those that can be transmitted from one human to another and include
tuberculosis, meningitis, chicken pox, SARS and others. Individuals
contracting a communicable disease should report the case to SHS immediately at
Ext. 36262 or 410-543-6262. (See also Mass Immunization)
EMERGENCY PSYCHIATRIC EVALUATIONS
University Police officers are authorized to take persons into custody and
petition for emergency psychiatric evaluations.
In addition, State law HG10-622 grants authority to the county health officer or
designee of the county health officer to petition for emergency evaluations.
This law gives the same authority to a "clinical nurse specialist in psychiatric
and mental health nursing and psychiatric nurse practitioner."
In accordance with this law, Judith A. Sensenbrenner, M.D., M.P.H., who serves
as the Health Officer for Wicomico County has named the below listed Salisbury
University employees as Wicomico County Health Department designees for
Veronica Correa, M.S.W.
Nancy Jane Hubbell, CFNP
Cynthia McCready, Ph.D.
This law gives these individuals authority to
complete Petition for Emergency Evaluation forms. University Police are
authorized to take emergency evaluee to the nearest emergency facility after the
Petition for Emergency Evaluation form has been signed and submitted by the
designated Salisbury University employee. Note: the language used in this law is
"shall take.” This law does not require the authorized petitioner to accompany
EMPLOYEE INCIDENT REPORTING
Overview or Objective:
To facilitate the timely reporting of work injuries in a manner that will
ensure that the employee’s injury gets proper treatment, medical bills are paid
and employee is properly compensated for lost time.
Every effort should be made to make sure injury is reported in 24 hours of
its occurrence. The reporting process for the Human Resources (HR) Office takes
about 10 minutes.
Employee has injury.
Injury is reported to supervisor within 24
hours of occurrence.
Employee completes Employee’s Incident
Report form before treatment, if capable of doing so. This form (with
instructions) can be found on the HR forms Web page. Upon completion, this
form should be sent to HR via inter-office mail.
Depending on the incident, it may be advisable for the employee to complete
the form after seeking proper medical care. If the employee is unable to return
to work, the supervisor may complete the Employee’s Incident Report form via a
phone interview. He/she will check the “phone interview” box and sign and date
on the appropriate line.
If an injury needs medical attention (other
than basic first aid), the employee is sent to Main Street Med Center. For more
serious work injuries or injuries that occur after business hours, refer
employee to PRMC Emergency Room. Although these places are recommended, the
employee may see their private physician.
If the employee cannot transport
himself/herself to any necessary medical treatment, the supervisor or University
Police should arrange for the transportation.
The supervisor should complete the Supervisor’s
Incident Report form and submit a copy to HR. This form (with instructions) can
be found on the HR forms Web page.
If there are any witnesses to the incident, the
Witness Incident Report form will be completed and returned to HR. This form can
be found on the HR forms Web site.
As a general rule, HR has up to three days,
from time of incident, to report the information to IWIF (Injured Workers’
Insurance Fund) for further investigation. Prompt attention and completion of
each form (including the Witness Incident Report form—if applicable) will ensure
that the injury gets proper treatment, medical bills are paid and the employee
is properly compensated for lost time.
The Wicomico County Health Department has recommended that mass immunization
of the University community in case of a bio-terrorism incident be conducted on
campus. With 1,000 plus employees and more than 7,300 students, of which 1,700
live on campus and another 2,000 (estimated) live within walking distance, it is
prudent to plan for immunization on campus. Mass immunization will be
coordinated through Student Health Services with the possible assistance of the
nursing faculty. Possible sites include Maggs, Devilbiss or Henson halls. Since
Maggs is a designated shelter, Devilbiss or Henson halls may be used as
alternative locations because they are proximate to Maggs. This will make
security, servicing and resource allocation simpler to coordinate.
Supplies will be provided by the Health
Department from the Strategic National Stockpile. The estimated delivery time to
the county is 12-14 hours. The on- campus site will be identified and mobilized
within that time frame. A Health Department representative will assist in
mobilizing the selected site. Issues to consider include the necessary forms and
registration/record keeping, the actual inoculation and follow-up, and storage
and security of the vaccine. Kathleen Lanigan, Susan Battistoni and Karen Badros
from the nursing faculty have volunteered for this.
Student Health Services will maintain a list of
licensed persons who are qualified to administer the vaccine. This would include
SHS and nursing faculty, etc. Others will be identified to assist with the
administration of the inoculations, as needed, depending on the nature and
extent of the situation.
Once a specific site is identified, i.e.
Devilbiss or Henson halls, all appropriate personnel will be notified. The
necessary training will be provided during that time frame while awaiting the
vaccine to arrive. (See also Communicable Disease Management)
RESPONSE TO UNIDENTIFIED SUBSTANCE
This protocol is to be used for the Public Health component in
the investigation and response to a potential BT event such as a white powder
incident, unidentified toxic substance exposure, etc. It is meant to be used by
Public Health entities (local and state) but is also meant to be an integrative
protocol. It should be integrated and incorporated into response protocols
within Public Health agencies, Fire/Rescue/EMS/HazMat and law enforcement
The fundamental goal of public health is to prevent injury
and illness to an individual and to the community.
In the post-2001 era, public health has taken on additional
responsibility as an emergency response component and integrates further
with law enforcement and Fire/Rescue/EMS/HazMat.
Public Health has not only additional responsibilities but
also additional resources to bring to the field of response including but
not limited to investigation tools, preventative medications, public
information messages, follow-up capacity, and laboratory resources.
Public Health is within itself more formally organized than
before to respond to such incidents and, because of the increased attention
to terrorism and public health emergencies overall, is under more formal
accountability than ever before.
All response is locally driven. However, as incidents
progress and/or as experience evolves, assistance in expertise, resources
and authority may be available at the state and federal levels.
Although every attempt will be made by all parties to share
intelligence and background information, this is not always possible;
therefore continuous flow of basic information that may impact on individual
response is a necessity in an emergency response community.
Local Health Departments
Will be notified of incidents immediately or as soon as
possible in order to have necessary input into the evaluation of the
incident. Depending on local protocol this may be through the 911 centers,
units on the scene or the coordinating agency during the event. Late
notification could result in inadequate resources and flow of information
and negative outcome to the person(s) exposed.
Will assist in the evaluation of the event. Local Health
Department personnel will assist in making determination regarding the
exposure credibility of the event per The Matrix. Determination of exposure
credibility will assist in formulating recommendations re: prophylaxis
therapy and laboratory testing.
Will assist in facilitating discussions with DHMH
Laboratories Administration personnel, as necessary, and will ensure HazMat
screening for chemicals, explosives and radiation before transport to DHMH.
Depending on local protocol, transportation of samples may be conducted by
or through the LHD. In all cases, chain of custody must be maintained
throughout collection and transportation. Referral of samples to the state
lab for testing will not be accepted unless the LHD is involved and part of
the assessment process.
Will notify DHMH BT MD On Call (410-407-6154) immediately or
as soon as possible. Notification should not be delayed beyond two hours.
Notification will include at minimum: determination of clinical and criminal
assessments, number of people potentially at risk, need for prophylaxis,
need for laboratory testing and the likelihood that the general public will
become aware of the incident. The decision regarding the need for
prophylaxis may be made in conjunction with DHMH and may be a reason for
early notification and involvement of DHMH. Public awareness may be related
to media coverage of the event, high profile location or parties involved,
Will follow any and all protocols regarding reporting and
notification internal to the LHD and local response plans.
Will follow up with response agencies regarding after action
reviews to improve response and coordination.
When laboratory results are received, will develop, as
necessary, further response strategy with the assistance of DHMH, as
DHMH BT On-Call MD
Will assist the LHD, as necessary, with determinations
regarding the exposure credibility, determination of need for prophylaxis
and laboratory testing.
Will assist the LHD and other responder agencies, through
communications with the LHD, regarding expertise specific to the potential
agents, environmental surety, etc. This expertise may be as a result of
specific knowledge or resources may be related to specific law enforcement
intelligence or other ongoing incidents, etc.
If notified of an incident prior to being notified of the
incident by the LHD, will contact the LHD through existing protocols. The
LHD and the BT On Call MD will negotiate who will follow-up on the incident.
It is always preferred that the LHD is lead for health however, in some
circumstances DHMH may take the lead.
Will notify DHMH leadership and response partners of the
event. This communication will occur in the following fashions:
According to the BT On Call Emergency Communications
Protocol for Health Alerts, Advisories, Notifications and Updates, a brief
notification via text message will be sent.
As necessary, a conference call can be set up emergently to
provide additional detailed information and to develop strategy should there
be a major response.
As necessary, a FRED alert can be posted if widespread
dissemination is necessary.
Will assure results to the LHD, BT On Call MD and the
referral agency are communicated and will assist, as necessary, in
developing strategy depending on these results.
DHMH Laboratories Administration
Law Enforcement should determine the
seriousness of the sample by assessing credible threat and credible exposure
(along with local health officials). If Law Enforcement determines
that there is both a credible threat and a credible exposure (along with the
local health officials), then the 24/7 On Call Contact Person for the
Laboratories Administration (Office of Laboratory Emergency Preparedness and
Response) should be called. The contact numbers in order are: during normal
working hours: 410-767-6096 (office), 410-471-0595 (pager), and 410-925-3121
(cell phone). After hours, the numbers to call in order are:
410-471-0595 (pager), 410-925-3121 (cell phone), and 410-408-7521 (pager 2).
The Laboratory Emergency Preparedness and
Response 24/7 On Call Contact Person will obtain basic contact information
to include: caller, agency, and contact phone number.
The Laboratory Emergency Preparedness and
Response 24/7 On Call Contact Person will then contact the appropriate
Laboratories Administration division chief (or their designee) and provide
them with the contact information for them to call and get needed
information and answer any questions that the submitter may have. The
division chiefs (or designee) will assist and make recommendations regarding
alternative testing locations or mechanisms at this time.
Laboratories Administration scientists will advise when preliminary and
final results would be expected.
The Laboratories Administration division
chief (or their designee) will then contact the Laboratory Emergency
Preparedness and Response 24/7 On Call Contact Person and inform him of the
results of their call (type and number of samples, when they expect them to
be delivered, etc.)
If there is
both a credible threat and exposure, then Laboratories Administration
personnel will arrange to meet Law Enforcement at the Central Laboratory
outside of normal business hours. Samples associated with a credible
threat and/or exposure should be sent under chain of custody and therefore
should not be entrusted to a courier. If there is not a specific
credible threat and/or exposure, and testing is still requested, then the
sample should be stored according to the local protocol developed by local
law enforcement and LHD and arrangements made to deliver the sample the next
Laboratory Emergency Preparedness and Response 24/7 On Call Contact Person
will send out an ARCH wireless message to the BT Notify Group when a
sample/specimen is going to be delivered to the Laboratories Administration.
should be screened by local Hazmat teams for chemicals, radiation, and
explosives before they are submitted to the DHMH laboratories for testing.
Although some jurisdictions may have access to a portable infra-red (IR)
instrument, these will not reliably detect small amounts of bacteria and/or
toxins. Therefore, even samples identified by IR should still be
submitted to the Central Laboratory for testing if there is a credible
threat and/or credible exposure. If only small amounts of powder are
present, the entire sample should be submitted to the DHMH Laboratories
Administration. Currently available field tests (so called “smart
tickets”) may be unreliable for the presence of bacteria and/or toxins and
therefore, these tests are not encouraged or recommended by DHMH or the
Centers for Disease Control and Prevention.
should be triple bagged so that powder is completely contained.
Miscellaneous request forms must be completed for each sample and indicate
each required test. If these are not completed prior to sending the
sample, personnel bringing the sample will be required to complete the
be smaller than 18” by 24” or wipe/powder samples must be collected by the
Hazmat team and the wipe or powder sample submitted for testing.
should be taken to the Central Laboratory as soon as Hazmat has screened the
sample(s) for chemicals, radiation, and explosives. When a sample is being
sent to the Laboratory, both the local Health Department and the local BT
Coordinator will be notified (by the BT On Call MD).
sample arrives at the Laboratories Administration, the receiving scientist
is to notify the Laboratory Emergency Preparedness and Response 24/7 On Call
Contact Person (using the same contact numbers as above). The
Laboratory Emergency Preparedness and Response 24/7 On Call Contact Person
will then send out an ARCH wireless message to the BT Notify Group that the
sample/specimen has been delivered (arrived) to the Laboratories
powder samples received by the Laboratories Administration are tested first
for the presence of Bacillus anthracis (overnight) before they can be tested
for other biological and chemical agents.
biologic and chemical agents are suspected, requests must be communicated to
the Laboratory Emergency Preparedness and Response 24/7 On Call Contact
Person (using the same contact numbers as above).
unit has completed their testing of the sample (i.e., anthrax, ricin,
chemistry), they will phone the Laboratory Emergency Preparedness and
Response 24/7 On Call Contact Person (using the same contact numbers as
above). He will send out partial results by ARCH wireless message to
the BT Notify Group.
Laboratory Emergency Preparedness and Response 24/7 On Call Contact Person
receives the Final Result, he will send out an ARCH wireless message to the
BT Notify Group.
As each unit
completes their testing of the sample, they will provide results to the
referral agency and the LHD.
The BT On
Call MD will notify the LHD (if they have not been previously notified).
Determined by LHD Law Enforcement in
conjunction with Law Enforcement
by Law Enforcement
Chain of custody important
Prophylaxis likely to be indicated.
Test the next business day
Chain of custody important
Need for chain of custody determined by law enforcement
testing unless exceptional circumstances
tested, would be tested the next business day
Prophylaxis not indicated unless exceptional circumstances
Both a credible
exposure and a credible threat analysis MUST be performed in order to make
decisions regarding the safety of the people exposed, the necessity for
prophylaxis and the appropriateness of laboratory testing.