Danger in the Clinical Lab

Danger in the Clinical Lab

What to do when an emergency strikes in your clinical lab

Clinical laboratories are dangerous places to work. Sometimes, as lab managers, we become complacent to the hazards that surround us every day at work. Even in the best prepared laboratories, accidents still occur. When it comes to lab safety, prevention is key, but if staff don’t know what to do when an accident actually occurs, then we have missed the mark in terms of training our staff in laboratory safety. In this article, I review potential emergency scenarios that could happen in your laboratory. If they were to occur, would you know what to do?

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1. Walking centrifuge 

You load some samples into a centrifuge, turn it on, and continue your work. Soon after, you hear a knocking noise coming from the centrifuge that you’ve never heard before. You notice that it has started to move slowly across the bench. What should you do?

If improperly balanced, centrifuges can walk off the counter. If you notice anything unusual such as smells or sounds, stop the centrifuge immediately. Check for error codes and make note of any that are present, then turn the centrifuge off. Let the centrifuge rest for 30 minutes before opening the lid in case anything has spilled inside. Resting the centrifuge allows everything inside to settle so you can avoid being sprayed in the face when you open it. If you fi nd a spill inside the centrifuge, make sure you have appropriate PPE on, then:

  • Use tongs to handle and disposed of any sharps in a sharps container.
  • Remove sealed buckets and disassemble other affected parts, placing items into disinfectant inside a biosafety cabinet.
  • Open sealed buckets inside a biosafety cabinet and recover your samples, if possible. 
  • Follow your institutional policies for disposal of disinfectant and PPE.

Once everything is disinfected, thoroughly dry all parts before reassembling and placing them back into your centrifuge. Always keep your centrifuge’s operating manual nearby and ensure all lab staff know where to find it, as well as any tools used to take the unit apart in case of emergency.

2. Bottle explodes in autoclave

You just ran a liquid autoclave cycle. When you open the autoclave, you see that your bottles have exploded, there is broken glass inside, and the liquid from inside the bottles has spilled out. What should you do?

  • Allow the autoclave to cool completely before attempting to clean up the broken bottles. 
  • Collect the glass using tongs or forceps and place it into a sharps container. 
  • Remove the secondary container containing the spilled liquid and dispose of the liquid following lab safety rules for liquid disposal, according to what type of liquid it is. 
  • Clean out the secondary container and place it back inside the autoclave. If you have any concerns about cleaning up the spilled liquid, contact Environmental Health and Safety immediately.

To avoid such an accident in the future, always allow the autoclave pressure to drop to zero before opening the door. If the pressure is too high when the door is opened, the rapid change in pressure can cause glass to shatter. In addition, never place sealed bottles into autoclaves. Always loosen any caps before loading liquids into an autoclave. This will prevent the bottles from exploding. Finally, to prevent spills from running into the drain at the bottom of the autoclave, always use secondary containment, designed for use in autoclaves.

3. Employee on fire

The power cord to one of your lab’s stirring hot plates has become brittle and frayed. One afternoon, the power cord begins to smoke and catches on fire, also setting the sleeve of your lab mate’s lab coat on fire. What should you do?

There are two issues to contend with here: First, your lab mate is on fire and second, the power cord is also on fire. This scenario involves huge risk, as any laboratory fire is very dangerous due to the presence of flammable chemicals and gasses in the lab, but you also need to aid your lab mate to prevent serious injury. 

First help your lab mate. Immediately instruct your lab mate to drop to the ground and roll in order to extinguish the flames. If available, grab the lab’s fire blanket and use it to smother your lab mate’s burning clothing. Call for help! When help arrives, one of you should tend to your lab mate while the other extinguishes the burning power cord. 

Once your lab mate’s clothing is extinguished, run cold water over the burnt skin. Burning skin needs to be run under cold water to reduce the burning, even if the flames are out. Human skin begins to feel pain at a temperature of 111 degrees Fahrenheit, it can sustain first-degree burns at 118 degrees Fahrenheit, and a second-degree burn can occur at 131 degrees Fahrenheit. Run the skin under cold water for at least 10 minutes, then seek medical care.

Next, extinguish the power cord. If you are able to safely reach the power outlet where the cord is plugged in, pull the plug out of the wall outlet to stop the flow of electricity to extinguish the flames. If you are unable to safely reach the outlet, you can smother the fire either with your lab’s fire blanket, if available, or with sodium bicarbonate, which is commonly found in labs. 

If neither of those items are available, it’s time to check your lab’s fire extinguisher. Electrical fires are Class C fires, so before using a fire extinguisher on an electrical fire, verify that you have the proper type of fire extinguisher for an electrical fire. Your fire extinguisher will be labelled according to the types of fires it can extinguish. If it is labelled for Class C fires, then use it to extinguish the flames. 

Whatever you do, do not pour water onto an electrical fire! Water conducts electricity, so pouring water onto an electrical fire not only risks that you will be shocked or electrocuted, but you also risk spreading the fire through the water, which can conduct electricity as it spreads.

If all of the above is unavailable to you, then leave the lab and call 911 once you are a safe distance away. Warn your lab mates to leave as well, and in an effort to contain the fire, close the door to the lab as you leave. 

To prevent fires in your lab, inspect power cords regularly to ensure they are in good condition. If cords show signs of fraying, unplug the equipment immediately and do not use it. Avoid the use of extension cords, as they increase the risk of fires. Also, it’s a good idea to look at your lab’s fire extinguisher today to learn what type of fires it can be used to extinguish, because hunting around for that information when a fire is already burning could cost you valuable time.

4. Rolling acid bottle

You are moving concentrated sulfuric acid from its source container into a tube when you bump the source container. It falls over and rolls off the bench onto the floor, and the contents (500 ml) spill onto the bench and floor. None has spilled on you. What should you do? 

Every lab should have a spill kit that you can use to clean up acid and base spills. Open your lab’s spill cleanup kit, then neutralize and contain the spill using the components of the kit. Once the acid is neutralized, you can dispose of the spill cleanup materials using the waste bags included in your kit. Then, dispose of the bag and its contents according to your institution’s policies and call your Environmental Health and Safety for further instructions.

Finally, it is a good idea to conduct regular spill cleanup drills in your lab. It is not necessary to actually waste the kit contents on a fake water spill during a drill, but lab members should know what the components of the kit are and how to use them.

DID YOU KNOW THAT SPILL KITS EXPIRE?

They also have a maximum volume of fluid they can neutralize and clean up. Make sure to check your spill cleanup kits regularly for expiration dates and reorder them as necessary. Also, be sure you know what volume of spill your kit can handle and whether it’s enough for the volumes of acids and bases used in your laboratory.

5. Human blood in eye

You just splashed a human blood sample in your eye. What should you do?

Move immediately to the nearest eye wash station. Flush your eye for 15 minutes, holding the eyelid open as much as you can, then seek medical care to ensure your eye has not sustained any long-term damage. After flushing it, do not rub your eye until you seek medical treatment. If wearing contact lenses, do not attempt to remove them before flushing your eye. 

To avoid eye injuries in the future, follow standard laboratory safety practices, including wearing eye protection and not wearing contact lenses in the lab.