Section F: Emergency and Medical Procedures

1.  Employee Workplace Injuries

• Students are considered employees if their incident happens while receiving monetary compensation at the time of the incident.

The following procedures are to be followed for any employee incident needing medical attention.

Requirements of the OSHA laboratory Standard (29 CFR 1910.1450) involving incidents to employees involving exposure to hazardous chemicals.

All employees who work with or are potentially exposed to hazardous chemicals must be given the opportunity to receive medical attention under the following circumstances:

o Whenever an employee develops signs or symptoms associated with a hazardous chemical to which the employee may have been exposed to in the laboratory.

o Where exposure monitoring reveals an exposure level routinely above the action level (or in the absence of an action level, the PEL) for an OSHA regulated substance for which there are exposure monitoring and medical surveillance requirements.

o Whenever an event takes place in the work area such as a spill, leak, explosion, or other occurrence resulting in the likelihood of the employee being exposed to hazardous chemicals.

Reporting Workplace Injuries and Workers′ Compensation for Employees

In the event of a life threatening incident, call 323-3333 or 9-911.

Minor Injuries or Work-Related Illnesses

• In the event that an employee was exposed or potentially exposed to a hazardous chemical or sustained an injury on the job, the chair must be immediately informed as to the situation. In the event that the chair is not available, the incident must be reported to the department's secretary or the safety coordinator. Accidents during evening classes must be reported to public safety 323-3333.
  
  
• When medical treatment is needed, the supervisor must contact Compendium Services at 877-709-2667 to file a First Report of Injury and to receive authorization for treatment.  All non-emergency medical treatment must be pre-approved by Compendium Services and is provided by:
  
  

Occumed at Riverview Medical Center

1393 Celanese Road

Rock Hill, SC 29732

803-327-0033

• The supervisor must also report the injury or illness to Thadd Bridges, Workers′ Compensation Administrator at 323-2392.
  
  
• The chair is responsible for establishing the need for employee medical examination.
  
  
• The following information should be provided to medical personnel if the employee incident involves exposure to a chemical:
  
  

o The identity of the hazardous chemical to which the employee may have been exposed.

o The MSDS of the chemical

o A description of the conditions under which the exposure occurred

o A description of the signs and symptoms of exposure that the employee is experiencing, if any.

Employees should report all injuries and work-related illnesses to their supervisor no matter how minor they may seem at the time.  An employee who fails to report and injury or work-related illness may risk being denied benefits by the State Accident Fund (SAF) should medical treatment be needed at a later time.

Medical Emergencies

• In the event of a serious or life-threatening injury that requires immediate or emergency medical attention, call 9-911 for an emergency operator or call Winthrop University Campus Police at 323-3333.  Compendium Services (877-709-2667) and the Campus Administrator (Thadd Bridges, Workers′ Compensation Administrator at 323-2392) should be contacted as soon as the situation allows.
  
  
• When an injured employee is transported to an emergency treatment facility for care, the supervisor or a designated University representative should accompany them to the facility and remain until the employee has been admitted or released.
  
  
• The supervisor or designated representative should notify the treating facility that workers′ compensation may be filed for the injured employee and provide the following insurance information, if needed:
  
  

For case management and treatment authorization: 

Compendium Services, Inc.

877-709-2667

3. Procedures for Student Incidents Requiring Medical Attention

• For all student incidents requiring medical attention, the employee in charge of the lab at the time of the incident must

o Call 911 or 323-3333 immediately in the event of a serious or life-threatening injury.

o Notify the chair of the department immediately. If the chair is unavailable, the incident must be reported to the department's secretary or the department′s safety coordinator.

o Incidents during evening classes must be reported to public safety at 323-3333.

o An incident report form must be completed by the employee and the student. The completed form must be submitted to the chair.

o For minor incidents, the student must go to Crawford Health Services. The student′s supervisor (or a designated University representative) should accompany them to ensure the student makes it safety.

• Accident report forms are available on line from the chemical hygiene plan. The completed form must be submitted to the chair.

4.  Summary Emergency Procedures and Contact Numbers

University Employees¹

Very Serious^3	Cell phone call -911 or (803) 323-3333 Campus phone dial 9-911 or -3333
Serious^4	Notify supervisor and contact Compendium Services at 877-709-2667
Minor^5	Minor first aid treatment

Students²

Very Serious^3	Cell phone call -911 or (803) 323-3333 Campus phone dial 9-911 or -3333
Serious^4	Call Public Safety Cell phone (803) 323-3333 Campus phone dial -3333
Minor^5	Report to Crawford Health Services - Cell phone (803) 323-2206 Campus phone dial -2206

¹University employees include all faculty and staff employees, and also include student assistants who are performing their work duties at the time of the incident.
²Students include all students not receiving any University pay for services rendered and all students who were not performing their work duties at the time of the accident.
³Very serious injury would involve an injury requiring immediate medical attention.
⁴Serious injury would involve an injury where the person is in need of medical attention, but the incident is not life-threatening or the injured is not in need of immediate emergency medical attention.
⁵Minor injury would involve a minor cut, burn, etc.

Report Forms

Appendix J: Possible Chemical Overexposure Report
Appendix K: Incident Report Form Involving Injury
Appendix L: Near Miss Incident
Appendix M: Hazard Report Form

5.  Guidelines for Dealing with Various Hazards in the Laboratory

If you are attempting to assist someone else who is injured, do not become injured yourself or you will no longer be of much help.

If you are attempting to assist someone covered in chemicals, wear safety goggles and gloves so that you too do not become injured.

Chemical Burns

Chemicals on the Skin in Confined Areas

• Immediately flush the area with cool water for at least 15 minutes. Remove all jewelry to facilitate removal of any residual material.
• If medical attention is required, follow the above procedures. Be sure to inform medical personnel as to what chemical was involved.
• Check the MSDS to see if any delayed effects should be expected.

Chemicals Spilled over a Large Area of the Body

• The person should immediately head to the nearest safety shower.
• Notify an instructor- Treat as a life threatening emergency. Call -911 or 323-3333.
• Once in the shower, rinse first, and then remove clothes taking care not to spread chemicals especially into the eyes.
• Wash head and remove clothing before removing goggles.
• Flush skin for 15 minutes, and seek immediate medical attention.
• If a fire blanket is available it can be used as a shower curtain for someone using the safety shower and then used to keep someone warm while waiting for emergency help to arrive.
• Avoid putting anything on the affected area; it may worsen the condition and cause irritation.
• Send MSDS with the injured person

Chemicals in the Eyes

• Get the victim to an eyewash station immediately, and rinse the eyes for at least 15 minutes.
• Eyelids have to forcibly opened to ensure effective washing behind the eyelid.
• Remove contact lenses as soon as possible so that the eyes can be thoroughly rinsed.
• All eye injuries must be treated by a doctor. Follow the above procedures.

Ingestion of Chemicals

• Identify the chemical ingested and call 323-3333 immediately.
• Wrap the injured person in a blanket to prevent shock.

Inhalation of Chemicals

• Evacuate the area and move the victim into fresh air.
• Call 323-3333

Wounds

Small cuts and scratches

• Cleanse area with soap and water preferably in a restroom and not in lab.
• Place a clean dressing over the wound.
• If you are assisting someone with a minor wound, wear safety glasses and disposable latex gloves, which are located in all first aid kits.

Significant bleeding

• Call 323-3333 immediately

Fires

• A fire contained in a small vessel often can be suffocated, for example by placing a watch glass over its opening or using a fire blanket.
• If the fire is too large to be suffocated quickly, activate the fire alarm and notify everyone around you. Use the stairs when evacuating the building. Do not use the elevator during the evacuation.
• It is easy to underestimate a fire. Fires spend quickly. Never attempt to use a fire extinguisher unless you have been trained in its use. Locate yourself between the fire and the exit. Always be sure you can escape.
• If a person′s clothes are on fire, get them to stop, drop, and roll or lead them to a safety shower and douse them with water.
• Cover the victim with whatever is available (most labs have fire blankets), but leave the head uncovered. Do not cover a person with a fire blanket until the flames have been extinguished
• Get medical attention immediately (public safety 323-3333 or -911).

FIRST AID KITS

• There is a first aid kit located on each floor of the chemistry building. All accidents must be reported to the chair or the safety coordinator. The faculty or stuff member must inform the safety coordinator of all accidents so that a record of all accidents can be maintained and first aid kits can be restocked.
• No oral medication can be stocked in the first aid kits.

6.  Cleaning up Chemical Spill

General Rules for Identifying and Cleaning up Chemical Spills

• Any student generating or finding a spill must inform a faculty member, the chemical hygiene coordinator, or lab personnel.
• Identify the chemical if possible.
• It is the responsibility of the faculty member, the chemical hygiene coordinator, the laboratory chemist, or the lab instructor to determine whether the spill is a simple spill or a complex spill.

Complex spills are defined as:

• Causes personal injury or chemical exposure that requires medical attention
• Presents a fire hazard
• Requires the need for a breathing apparatus to handle the material involved

Simple Spills

Simple spills are non-emergency situations. A spill can be identified as a simple spill if it meets the following criteria

1. Does not spread rapidly	The spilled chemical or toxic vapors are not spreading beyond the immediate area
2. Does not endanger people or property except by direct contact	A person has not been injured
	A fire is not present or an explosion has not occurred
	Flammable vapors and ignition sources are not present
	Toxic vapors or dust are not present
	The spilled chemical is not a strong oxidizer
	The spilled chemical is not air, water, or otherwise highly reactive
	The identity of the chemical is known
3. Does not endanger the environment	No risk of spilled chemical entering a sewer or contaminating soil

If a spill has been identified as a simple spill, it can safely be cleaned up if:

• A knowledgeable person can make an informed decision as to the safety and health hazards associated with the chemical and is comfortable doing it.
• The spill can be cleaned up with the material contained in the spill control kits.
• Personal protective equipment is available.
• The cleanup can be completed in a normal work day
  
  

If a spill does not meet the above criteria, treat it as a complex spill and an emergency situation--Evacuate the area and call public safety 323-3333.

Procedures for Cleaning Up Simple Spills

• Shut off all possible ignition sources
• Notify your lab instructor
• Wear appropriate personal protective equipment
• Identify the spill
• Isolate the spill area. Evacuate the immediate area
• Locate the appropriate spill cleanup kit. Each laboratory should be equipped with spill cleanup kits. If not, get the appropriate kit from the chemistry storage room (SIMS 106)
• After the spilled chemical has been identified, obtain the proper absorbent material from the spill control kit. When using the Spill-X Chemical Spill Treatment Kits, you must make sure that the adsorbent is approved for the chemical that is being cleaned up. See Appendix N for a list of chemicals that can safely be cleaned up using the Spill-X Chemical Spill Treatment Kits
• For acid spills, Spill-X-A
• For caustic spills, Spill-X-C
• For solvent spills, Spill-X-S
• Pour the spill agent around the perimeter of the spill first, and then continue to cover the spill with spill agent evenly working your way around to the center of the spill.
• Using the scraper provided carefully mix agent into the spill for the most complete reaction.
• If SPILL-X-A or SPILL-X-C was used, the spill residue must be tested for pH. See below for direction on testing the pH*.
• If SPILL-X-S agent was used, solvent is adsorbed onto the agent and the final spill residue should be dry and powdery.
• After spill residue cools, use scraper and pan to put the spill residue into a waste disposal bag and label with a yellow University hazardous waste label. The label must be completely filled out with the name of the spilled chemical along with the pH if appropriate.
• Wash utensils including gloves, if not disposable, with soap and water and put back in the spill control kit if still in good condition. If not, inform the chemical hygiene coordinator that those items need to be replaced.
• Decontaminate the spill area by mopping the area with a conventional cleaning agent
• Ventilating the spill area may be necessary.
• If the chemical that was spilled was a highly toxic substance, then the scraper and scoop that was used to pick up the spilled material should be discarded as hazardous waste.

*If SPILL-X-A or SPILL-X-C was used, the spill residue must be tested for pH.

• Place about 10 mL of the spill residue in a 150-mL beaker.
• Slowly add distilled water until the mixture volume reaches 100 mL. Note: Severe foaming and high heat generation is a sign of incomplete neutralization. Stir contents for about 3 minutes.
• Using a pH meter or the pH test strips provided in the kit, test the solution′s pH. The pH should be between 2.0 to 12.0. If the pH is unacceptable, mix more of the neutralizer into the spill and retest the pH. Repeat the procedure until an acceptable pH is reached.
• Record the final pH on the waste disposal bag.

Reference:  The ACS Guide for Chemical Spill Response Planning in Laboratories, the American Chemical Society, 1995.

7.  Mercury Spills

• Caution: Mercury is toxic, easily vaporizes, is absorbed directly through the skin and by inhalation, and threshold values of mercury and mercury vapors are very low. If possible, do not use mercury thermometers. Ethanol thermometers are available in Sims 106.

• A mercury spill kit (containing amalgamation powder, indicator powder, aspirator bottle, waste collection bottle) is available in Sims 106 and most of chemistry elective labs and research labs have a mercury collector in their spill kits.
• A mercury spill due to a broken thermometer can be safely cleaned up by a knowable person.

• Inform others around you that there is mercury spill to prevent personal injury and further contamination of the area, i.e. you do not want to step in it and track the mercury all over the room.
• Personal protective equipment must be worn, i.e. safety goggles, gloves, and preferably a lab coat.
• Ventilate the contaminated area.
• Collect all visible mercury using either an aspirator bottle or a mercury collector, which is a jar with a screw type lid, which contains a foam pad for picking up the mercury. If using the mercury collector, press the foam pad firmly onto the spill to collect the mercury. Then screw the lid back onto the jar, which compresses the pad against a perforated plate inside the jar and releases the mercury into the bottom of the jar. The mercury in the jar must now be disposed of as waste. Do not leave the collected mercury in the jar.
• The broken thermometer must also be disposed of as hazardous waste.

• If the mercury spill occurred on a non-smooth surface, the following steps should be taken to ensure that all of the mercury gets cleaned up. You must obtain the mercury spill kit from Sims 106.

• Use a mercury absorber (the name will vary depending on the manufacturer such as MERCSORB powder, Hg Absorb powder, etc.) located in the mercury spill kit located in Sims 106.
• The different brands require different clean up instructions. Be sure to following the directions precisely.
• This procedure will convert elemental mercury to an amalgam, which stops dangerous mercury vapors from being emitted.
• Next, use the mercury indicator to ensure that all the mercury was cleaned up.
• Clean up all waste and dispose of in a waste container, which is clearly labeled as to its contents. Such as "Hazardous waste. Mercury".
• The broken thermometer must be disposed of as hazardous waste.

8. Reporting Unsafe Conditions

Any employee or student can and should report any condition or situation that may be a potential hazard. See Appendix M, Reporting Unsafe Conditions.