NBC Building Response-Rockefeller Plaza
In late September 2001, employees on the third floor of 30 Rockefeller Plaza in New York City were exposed to anthrax. The New York City Department of Health (NYC DOH) jumped right into action and, along with the Centers for Disease Control (CDC) began to investigate and treat exposed persons. Laboratory testing indicated that persons who spent time on the third floor between September 19 and 25 may have been exposed. The NYC DOH collected nasal swabs from these individuals and asked that they complete a full course of antibiotics.
SAMPLES FOR LABORATORY TESTING
(Dry material only)
Packaging Material Needed
- Three zipper-lock bags per specimen
- Biohazard label
- Chain of Custody Form
- One-gallon paint can with lid, or a small plastic container with a secure lid
Procedure for Packaging
- With the appropriate precautions, place the suspected environmental material in the zipper-lock bag and seal completely.
- Place the zipper-lock sealed envelope in a second zipper-lock bag and seal completely.
- Place the double sealed zip lock in a third zipper-lock bag and seal completely.
- Affix a Biohazard tape on the outer zipper-lock bag.
- Place the triple bagged sample into the airtight container and seal container firmly.
- Affix a Biohazard label on the outer seal.
- ill the Chain of Custody Form and place around the container with a rubber band.
Place the container in a plastic bag and seal.
- Affix on the outer plastic bag a Biohazard label.
- A single sample per incident is adequate.
- Minimal amount of material is necessary--no more than a few ounces; in the case of a letter or envelope, package the whole item.
Responsibility for Transport
- Local law enforcement is responsible to arrange for specimen transport.
Most of the procedures that have been developed for smallpox response are geared to EMS personnel who will be transporting a suspected case of smallpox or for a hospital. What happens prior to your response, say if a patient is in a doctor's office or a corporate health center? Education of all health care professionals is important so that suspected cases of smallpox are handled properly. It is important that al health care professionals understand that they need to look at a patient's signs and symptoms of rash and fever as closely as possible.
Patients found to be exhibiting signs of symptoms of a rash or fever should be placed into isolation, in a room that is away from everyone in the main part of the health center. The patient should be given a facemask to wear. Some areas have predetermined EMS crews that will respond to transport the patient. Other areas will dispatch responders from the local health department.
Changing Times Require EMS Changes
We are living in a changing world. EMS across the country must learn to change as the responses we are called to change. In the past two years we have overcome new challenges and adapted. EMS is all about adapting, and I think this goal has been achieved. Today's EMS professionals, both paid and volunteer, must stay current with all new developments. They must stay current with equipment and information.
While this article is being written, our EMS community and that of corporate and occupational medicine have a new challenge. This new challenge is SARS (Sever Acute Respiratory Syndrome). Corporate medicine physicians and health center personnel are looking at ways of protecting themselves as well as protecting the community they serve. Those EMS workers who have their heads in the sand are not giving quality service to their communities. Seek out your EMS program agency and determine if you are responding in the correct manner. In most states, the Department of Health has written or assisted the local EMS agency in preparing a proper response to a biological emergency. There are many Web sites, including www.fema.gov, that offer on-line self study courses. Look for them and learn.
For more information, see www.health.state.ny.us/nysdoh/ems/main.htm.
Drew Fried is a New York State emergency medical technician instructor, is a retired NYS peace officer, and is currently the EMS/health services coordinator for a corporate medicine company. He is also the executive director of Pre-Hospital Care Concepts, an EMS information service.
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