Monday, April 12, 2010

Leakage Happens

Ten years ago at a new job at the National Institutes of Health (Bethesda, MD) I was required to take a series of safety courses. How to manage and dispose of hazardous chemicals; How to order, store, use, monitor and dispose of medical isotopes (radiation); and potentially the most toxic of all: How to fill out your tax return. (The courses were a rude introduction to Federal bureaucratic sensibilities. Step 1: Take control; Step 2: Enforce mind-numbingly dull "education" (aka threaten sanctions); Step 3: Cover your walls with self-congratulatory "Educator of the Month" placards. But I digress....).

From a Dad's perspective, the mandatory course on managing the containment and clean-up of a radioactive spill in a laboratory was eerily familiar. Personal experience from several most unfortunate events have led me to believe that this class could also have been titled:
"Chernobyl Diaper 101".

The reality is that leakage happens. If you have a baby, you are going to face this day. Here are some guidelines from a survivor (both in the lab and at home). The drill is basically the same for either material, although you use a Geiger counter for detecting one, and unfortunately, your eyes and nose for the other!
  • The Chernobyl Diaper can happen any time, but will most likely occur at the worst possible moment (as any event of this nature is immediately seared into your memory as a "worst case scenario").
  • Your first thought and reaction should be "Containment". Do not contribute to the spread of the spill, and prevent others (including the perpetrator) from spreading the spill further. Be very conscious of "tracking", ie anything that comes in contact with the spill is contaminated and should be kept withing the containment zone until secured in waste containers.
  • Clean up should to start from the cleanest areas (typically farthermost from the spill) and work its way in to ground zero. 
  • "Double containment" is an important concept, particularly with liquid waste (which, by the way, the Chernobyl Diaper is most highly associated with). This means that you should use 2 layers during final bagging, because you should be able to guess that under these circumstances at least one of the plastic bags you grab in desperation will have a hole in it.
  • Remove contaminated clothing, and bag separately (in case an attempt at decontamination will be made later by an expert), and prepare posterior decontamination equipment (waste bags, wipes etc).
  • Place perpetrator on some kind of matting (eg wipe-able plastic) and put an opened clean diaper under the contaminated one. Here's the part you need to practice under normal conditions: Hold ankles/shins with your off-hand (thumb around one ankle, index finger between ankles, and other fingers on the outside of the other shin) while elevating posterior. Remove failed device with your writing hand by flipping tabs, rolling up and placing directly in the waste bag (try to flip one tag closed one-handed, to keep it rolled up, but its more important to get it in the bag without a further breach of containment, and without allowing posterior to bottom out, so to speak). 
  • Wipe offending area excessively, with the perpetrators posterior off the surface. During this stage, the perpetrator can be balanced on his/her upper back, just below the shoulder blades. For severe events, the clean diaper may become contaminated, but keep it in place until the perpetrator is clean, as it helps keep the matting free of hazardous waste. Once the posterior is cleaned, the perpetrator can be laid down for full and careful decontamination.
  • The final steps involve replacing the temporary diaper (if needed), repackaging the decontaminated perpetrator, removing them from the containment zone, and finally the safe/secure bagging and disposal of all waste.
  • Other pointers: buy car capsules/seats that have covers that are easy to remove and wash. Have a fully stocked spill clean up kit in the carry bag that's in regular use (including plastic bags for disposal), and another in the car. Have a change of clothes for each child stashed in your car.
  • Never, and I repeat, never, be tempted to hold a child over a urinal because they say all they need to do is pee. 
Your baby and gastro. What really happens.....

    Dad U

    -be prepared

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