Difference between revisions of "Safety"

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== User and Staff Safety Responsibilities ==
== '''SAFETY''' ==
 
  +
::'''Safe laboratory practices will be employed by all MEG staff and MEG Users to preclude any preventable accidents or occurrences. MEG staff will monitor MEG Users for compliance.'''
   
  +
::1. '''User Responsibilities - All MEG users:'''
=== <u>Laboratory Safety</u> ===
 
  +
::::a. Must attend [https://kurage.nimh.nih.gov/nih/staff/form.html '''''MEG Orientation and Training'''''] before being allowed to operate any MEG lab equipment. Each person will be responsible for familiarizing themselves with the safe operation of all MEG equipment used in their experiment.
'''Safe laboratory practices will be employed by all MEG staff and MEG Users to preclude any preventable accidents or occurrences. MEG staff will monitor MEG Users for compliance.'''
 
   
  +
::::b. Must adhere to '''''MEG Core Facility policies and procedures'''''. The Policy and Procedures Manual will be located at the Analysis Console for reference and also on the NIH MEG website.
   
  +
::::c. May '''NOT''' bring any '''“unapproved” or “special” equipment''' into the lab for use unless first approved by the Director and/or Staff Scientist. In addition, before any user’s equipment can be used in the lab it must be tested for electrical safety.
'''All MEG users:'''
 
::1. Must attend '''''MEG Orientation and Training''''' before being allowed to operate any MEG lab equipment. Each person will be responsible for familiarizing themselves with the safe operation of all MEG equipment used in their experiment.
 
   
  +
::::d. Must '''familiarize themselves with the properties of helium gas / liquid helium'''. Information on the safe handling of Helium is included in the Material Safety and Data Sheet (MSD) Manual located at the Analysis Console for reference.
::2. Must adhere to '''''MEG Core Facility policies and procedures'''''. The Policy and Procedures Manual will be located at the Analysis Console for reference and also on the NIH MEG website.
 
   
  +
::::e. Will be responsible for reporting any hazard or potential hazard.
::3. May '''''NOT''''' bring any '''''“unapproved” or “special” equipment''''' into the lab for use unless first approved by the Director and/or Staff Scientist. In addition, before any user’s equipment can be used in the lab it must be tested for electrical safety.
 
  +
:::::i. Immediately notify MEG Core staff of any defective equipment, malfunction or any improperly working equipment or medical devices used for patient / subject testing using the Problem Report Form (under construction)
  +
:::::ii. All events, occurrences or variances to normal operations, policies, procedures, and practices involving any users, subjects / patients and / or equipment must be documented via the Problem Report Form (under construction).
  +
:::::ii. Users are responsible for identifying and labeling any non-functional or hazardous equipment with an “Out of Service / Do Not Use” sticker, in addition to completing the Problem Report Form (under construction)
   
  +
::::f. Are encouraged to participate in the MEG Quality Assurance / Quality Improvement Program.
::4. Must '''''familiarize themselves with the properties of helium gas / liquid helium'''''. Information on the safe handling of Helium is included in the:
 
  +
::::: Users are encouraged to make suggestions and provide feedback to MEG staff, by directly contacting the lab manager (Anna Namyst), the staff scientist (Tom Holroyd), and director (Allison Nugent).
:::::a. P&P Manual (P&P 10.30, 10.31 and 10.32) and
 
:::::b. '''''Material Safety and Data Sheet (MSD) Manual''''' located at the Analysis Console for reference.
 
   
::5. Will be responsible for reporting any hazard or potential hazard.
+
::::g. Are responsible for subject / patient safety while conducting studies in the MEG Core Facility.
  +
:::::i. Full details of user and scanning requirements are found in the [User Guidelines] Section of this guide.
:::::a. Immediately notify MEG Core staff of any defective equipment, malfunction or any improperly working equipment or medical devices used for patient / subject testing.
 
  +
:::::ii. When scanning, subjects must be observed '''at all times'''. The subject must never be left alone in the MSR without a user in the control room for any reason.
:::::b. All events, occurrences or variances to normal operations, policies, procedures, and practices involving any users, subjects / patients and / or equipment must be documented via the Variance Report.
 
  +
:::::iii. Two (2) operators are required to be in the room when scanning, one of which is capable of operating the equipment.
:::::c. Users are responsible for identifying and labeling any hazardous equipment with an “Out of Service / Do Not Use” sticker.
 
  +
:::::iv. All personnel attending scans must complete a MEG orientation.
  +
:::::v. Clinical coverage is required for all invasive studies; other patient studies may require the presence of individuals with CC clinical credentials at the discretion of MEG Core Facility Staff.
   
  +
::::h. Must provide a safe environment for all patients and employees.
:::::6. Are encouraged to participate in the MEG Quality Assurance / Quality Improvement Program. Suggestions and recommendations for improvement (changes, upgrades, advancements) in equipment, processes or procedures may be submitted via the “QA/QI Variance Reporting System”.
 
  +
:::::i. All passageways, doorways and exits are clear at all times. Shoes are not to be left in front of the MSR door.
  +
:::::ii. All power cords should be in good condition.
  +
:::::iii. When in use, all electrical cords are unwrapped.
  +
:::::iv. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
   
::7. Are responsible for subject / patient safety while conducting studies in the MEG Core Facility.
+
::::i. Must maintain patient privacy and confidentiality, and not leave PII in the MEG laboratory.
:::::a. When scanning, subjects must be observed at all times.
 
:::::b. Two (2) operators are required when scanning, one of which is capable of operating the equipment.
 
:::::c. The subject must never be left alone in the MSR for any reason; two persons must be available for assistance if the subject were suddenly to take ill or if something unexpected were to happen.
 
   
  +
::::i. Must adhere to the Clinical Center’s policies and procedures regarding safe laboratory practices.
::8. Must provide a safe environment for all patients and employees.
 
:::::a. All passageways, doorways and exits are clear at all times / <u>no shoes in front of the MSR door</u>.
 
:::::b. All power cords are in good condition.
 
:::::c. When in use, all electrical cords are unwrapped.
 
:::::e. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
 
   
::9. Must adhere to the Clinical Center’s policies and procedures regarding safe laboratory practices.
 
   
  +
::2. '''Staff Responsibilities - The MEG Staff:'''
   
  +
::::a. The MEG Core Facility staff will provide a safe working environment for all patients, users and employees.
'''All MEG Staff:'''
 
::1. The MEG Core Facility staff will provide a safe working environment for all patients, users and employees.
 
   
::2. Will maintain a clean, neat, and safe work environment.
+
::::b. Will maintain a clean, neat, and safe work environment.
   
  +
::::c. Will maintain a respectful and professional work environment.
::3. All employees are constantly alert for unsafe conditions within the work area. If unsafe conditions are discovered, employees initiate immediate corrective action.
 
   
::4. Will report unsafe conditions beyond the capability of the employee to correct to the proper authorities for remedy.
+
::::c. All employees are constantly alert for unsafe conditions within the work area. If unsafe conditions are discovered, employees initiate immediate corrective action.
   
  +
::::d. Will report unsafe conditions beyond the capability of the employee to correct to the proper authorities for remedy.
::5. Some measures to be taken to eliminate hazards and prevent accidents are:
 
:::::a. All passageways, doorways and exits are clear at all times.
 
:::::b. All power cords are kept in good condition.
 
:::::c. When in use, all electrical cords are unwrapped.
 
:::::d. Power strips are kept at least 2 inches off the floor.
 
:::::e. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
 
:::::f. All file cabinet drawers are closed when not in use.
 
:::::g. Spills are cleaned immediately after they occur.
 
:::::h. All employees are informed about the location and use of the Material Safety Data Sheets (MSDS).
 
:::::i. All employees know the fire safety and evacuation plans.
 
   
  +
::::e. Some measures to be taken to eliminate hazards and prevent accidents are:
<br>
 
  +
:::::i. All passageways, doorways and exits are clear at all times.
<div align="center">______________________________________________</div>
 
  +
:::::ii. All power cords are kept in good condition.
  +
:::::iii. When in use, all electrical cords are unwrapped.
  +
:::::iv. Power strips are kept at least 2 inches off the floor.
  +
:::::v. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
  +
:::::vi. All file cabinet drawers are closed when not in use.
  +
:::::vii. Spills are cleaned immediately after they occur.
  +
:::::iix. All employees are informed about the location and use of the Material Safety Data Sheets (MSDS).
  +
:::::ix. All employees know the fire safety and evacuation plans.
   
=== <u>MEG Lab System Monitors</u> ===
+
==MEG Lab System Monitors==
'''MEG System Monitors evaluate the performance and integrity of MEG equipment. There are 3 monitors located in the MEG Lab.'''
+
::MEG System Monitors evaluate the performance and integrity of MEG equipment. There are 3 monitors located in the MEG Lab.
   
  +
==== PureAire Oxygen Monitor ====
<br>
 
===== AirPure Oxygen Monitor =====
 
   
::'''<u>The AirPure Oxygen Monitor</u> - gives an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipment. Measures the percentage of oxygen (O2) in the MEG lab. Located in the MEG Lab on the wall just outside the MSR (Magnetically Shielded Room).'''
+
::1. '''The PureAire Oxygen Monitor''' - gives an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipment. Measures the percentage of oxygen (O2) in the MEG lab. Remote display located in the MEG Lab on the wall just outside the MSR (Magnetically Shielded Room).
   
::::::::::{| class="wikitable"
+
::::::::{| class="wikitable"
 
|-
 
|-
|'''Normal Atmosphere''' || '''Oxygen Level 19.5-22%'''|| '''O2 level should be at about 20.9%'''
+
|'''Normal Atmosphere''' || '''Oxygen Level 19.6-22%'''|| '''O2 level should be at about 20.9%'''
 
|-
 
|-
 
|''' Enriched Atmosphere''' || '''Oxygen 22.0% or more''' || '''*can promote fires (burning)'''
 
|''' Enriched Atmosphere''' || '''Oxygen 22.0% or more''' || '''*can promote fires (burning)'''
Line 78: Line 77:
 
|}
 
|}
   
  +
::2. '''If the AirPure Oxygen Monitor Sounds due to low oxygen:'''
::::::::::'''''*WHAT TO DO IF - the alarm sounds because oxygen in the lab decreased below the set level; if that happens:'''
 
::::::::::::::::::::::• open the door to the MSR;
+
::::a. Open the door to the MSR;
::::::::::::::::::::::• both doors to the lab;
+
::::b. Open both doors to the lab;
::::::::::::::::::::::• evacuate lab if necessary;
+
::::c. Evacuate the lab if necessary;
::::::::::::::::::::::• notify MEG Lab staff immediately.
+
::::d. Notify MEG Lab staff immediately.
   
  +
==== Gilmont Gas Flow Meter ====
<br>
 
   
  +
1. ::'''The Gilmont Gas Flow Meter''' monitors the rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment. Located inside the MSR near the back-left wall.
<div align="center">______________________________________________</div>
 
   
  +
::::::::{| class="wikitable"
===== Gilmont Gas Flow Meter =====
 
  +
|+ Helium Boil-off Gas Flow Rate
::'''<u>The Gilmont Gas Flow Meter</u> - monitors the rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment. Located inside the MSR near the back-left wall.'''
 
 
 
::::::::::::::::::::'''Helium Boil-Off Gas Flow Rate'''
 
:::::::::::::::::{| class="wikitable"
 
 
|-
 
|-
 
| '''Normal Gas Flow Rate''' ||'''28'''
 
| '''Normal Gas Flow Rate''' ||'''28'''
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| '''High Gas Flow Rate''' || '''40 (*alarm will sound)'''
 
| '''High Gas Flow Rate''' || '''40 (*alarm will sound)'''
 
|}
 
|}
:::::::::::::''*Please note that the gas flow rate level normally fluctuates within a certain range.''
+
::''*Please note that the gas flow rate level normally fluctuates within a certain range.''
   
   
  +
2. :: Normal Conditions When The Alarm Might Go Off:
::::::::::::::'''''*NORMAL CONDITIONS WHEN THE ALARM MIGHT GO OFF:
 
::::::::::::::::::- if it is windy outside (until the wind subsides).
+
::::a. If it is windy outside (until the wind subsides).
::::::::::::::::::- after a fill the flow rate might get as high as 40 (should go back down to 28 within a reasonable period of time).'''
+
::::b. After a fill the flow rate might get as high as 40 (but should go back down to 28 within a reasonable period of time).
   
::::::::::::::'''''*WHAT TO DO IF - the Helium Boil-Off alarm goes off; if that happens:'''
+
3. :: What to do if the Helium Boil-Off alarm goes off
::::::::::::::::::• Re-set the alarm - if you know that it is windy outside re-set the alarm. Instructions are next to the alarm.
+
::::a. Re-set the alarm - if you know that it is windy outside re-set the alarm. Instructions are next to the alarm.
::::::::::::::::::• If you are unsure about resetting the alarm please seek MEG staff for assistance.
+
::::b. If you are unsure about resetting the alarm please seek MEG staff for assistance.
  +
::::c. Notify MEG Core Facility Staff.
   
  +
==== Optalarm Flowmeter ====
  +
::1. '''The Optalarm Flow Meter''' monitors the HE exhaust gas flow / measures the total flow rate of the MEG system and gives audible and visual alarm if flow rate is outside normal range which is an indication of the general performance and integrity of the MEG Dewar and related equipment. There is a high alarm and low alarm setting.
  +
::2. The meter is located outside the MSR on the back-left wall
  +
::3. During a liquid helium fill, after removing the Vent Port Safety Relief Cap the flow rate might get as high as 100 causing the alarm to go off. To prevent this, the alarm can be turned off during the fill. The level should go back down to 50 within a reasonable period of time after the fill.
  +
::4. The exhaust pipe is located on the roof of the building and the alarm may go off when it is windy outside. The solution is simply to re-set the alarm. Usually, if the problem is the wind the alarm can be re-set by pushing the Alarm Reset button (twice).
  +
::5/ However, if the alarm does not turn off after being re-set (stays on continuously) this might be an indication that there is a problem with the integrity of the system which is causing more boil-off (exhaust) than normal. In this case, notify MEG staff as soon as possible.
   
<br>
 
   
  +
::::::::{| class="wikitable"
<div align="center">______________________________________________</div>
 
  +
|+ Optalarm Helium Gas Flow Meter
 
===== Optalarm Flowmeter =====
 
::'''<u>The Optalarm Flow Meter</u> - this meter monitors the HE exhaust gas flow / measures the total flow rate of the MEG system and gives audible and visual alarm if flow rate is outside normal range which is an indication of the general performance and integrity of the MEG Dewar and related equipment. There is a high alarm and low alarm setting. '''The normal flow rate is around 50'''. Located outside the MSR on the back-left wall.'''
 
 
::During a fill, after removing the Vent Port Safety Relief Cap the flow rate might get as high as 100 causing the alarm to go off. To prevent this, the alarm can be turned off during the fill. The level should go back down to 50 within a reasonable period of time after the fill.
 
 
::The exhaust pipe is located on the roof of the building and the alarm may go off when it is windy outside. The solution is simply to re-set the alarm. Usually, if the problem is the wind the alarm can be re-set by pushing the Alarm Reset button (twice).
 
 
::However, if the alarm does not turn off after being re-set (stays on continuously) this might be an indication that there is a problem with the integrity of the system which is causing more boil-off (exhaust) than normal. In this case, notify MEG staff as soon as possible.
 
 
 
:::::::::::::::::::::::::'''Optalarm Helium Gas Flow Meter'''
 
::::::::::::::::::::{| class="wikitable"
 
 
|-
 
 
| '''If the alarm goes off Alarm Reset Procedure:'''
 
| '''If the alarm goes off Alarm Reset Procedure:'''
 
<br>
 
<br>
Line 134: Line 121:
   
 
:::b. If the alarm continues to go off or stays on continuously after re-setting notify the MEG lab staff immediately.
 
:::b. If the alarm continues to go off or stays on continuously after re-setting notify the MEG lab staff immediately.
  +
|}
   
  +
==== AMI Model 135 Liquid Helium Level Monitor ====
  +
::1. The '''AMI Model 135 Liquid Helium Level Monitor''' measures the amount of helium inside the MEG Dewar. It is located on the stand just outside the MSR. This monitor lets MEG staff know when it is time to perform a helium fill. This is used and attended to by MEG staff only; MEG Users should never need to check this monitor.
   
  +
::::::::{| class="wikitable"
<br>
 
  +
|+ Liquid Helium Level in the Dewar
:::References:
 
::::1. MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 
 
 
 
 
<br>
 
<div align="center">______________________________________________</div>
 
 
===== AMI Model 135 Liquid Helium Level Monitor =====
 
::'''<u>AMI Model 135 Liquid Helium Level Monitor</u>''' - '''measures the amount of helium inside the MEG Dewar. Located on the stand just outside the MSR. This monitor lets MEG staff know when it is time to perform a helium fill. This is used and attended to by MEG staff only; MEG Users should never need to check this monitor.'''
 
 
<br>
 
:::::::::::::::::'''LIQUID HELIUM LEVEL IN THE DEWAR'''
 
:::::::::::::::::::{| class="wikitable"
 
|-
 
 
| '''Normal Range''' || '''1 - 38'''
 
| '''Normal Range''' || '''1 - 38'''
 
|-
 
|-
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| '''Lower Limit''' || '''0'''
 
| '''Lower Limit''' || '''0'''
 
|}
 
|}
::::::::::::::::::''*Should never go below 0 (zero)''
+
::::::::''*Should never go below 0 (zero)''
   
::::'''<u>Checking the Helium Level in the Dewar:</u>'''
+
::2. '''Checking the Helium Level in the Dewar:'''
::::::1. Plug in the monitor cable. The plug is located inside the MSR near the back-left wall.
+
::::a. Plug in the monitor cable. The plug is located inside the MSR near the back-left wall.
  +
::::b. Check and record the reading on the QA / Maintenance Log.
 
  +
::::c. If the level is approaching 0 (zero) a liquid Helium Fill should be performed; notify appropriate lab personnel.
::::::2. Check and record the reading on the QA / Maintenance Log.
 
  +
::::d. When filled the Liquid Helium Level should not exceed 39.0.
 
  +
::::e. If an overfill occurs:
::::::3. If the level is approaching 0 (zero) a liquid Helium Fill should be performed; notify appropriate lab personnel.
 
  +
::::f. Keep the door to the MSR open;
 
::::::4. When filled the Liquid Helium Level should not exceed 39.0.
+
::::g. Leave the Dewar at 55 degrees for 12 to 24 hours.
 
::::::5. If an overfill occurs:
 
::::::::a. Keep the door to the MSR open;
 
::::::::b. Leave the Dewar at 55 degrees for 12 to 24 hours.
 
 
 
<br>
 
 
=== <u>Laboratory Gas Safety / Safe Handling of Laboratory Gases</u> ===
 
   
  +
== Laboratory Gas Safety / Safe Handling of Laboratory Gases ==
   
 
===== Liquid Helium =====
 
===== Liquid Helium =====
'''Users of Liquid Helium will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices.'''
+
::Users of Liquid Helium will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices.
 
 
   
'''All MEG staff and users must familiarize themselves with the properties of Liquid Helium.''' '''''* Refer to the Material Safety and Data Sheet (MSDS) Manual and the MEG Lab Policy & Procedures Manual.'''''
+
::1. All MEG staff and users must familiarize themselves with the properties of Liquid Helium. Refer to the Material Safety and Data Sheet (MSDS) Manual.
   
::1. The contents of '''''Liquid Helium Storage Dewars''''' must be identified with decals, stencils, or other markings on the outside of the Dewar.
+
::2. The contents of Liquid Helium Storage Dewars must be identified with decals, stencils, or other markings on the outside of the Dewar.
 
::::a. Color codes alone or tags hung on the outside of the Dewar are not acceptable.
 
::::a. Color codes alone or tags hung on the outside of the Dewar are not acceptable.
 
::::b. Dewars lacking proper identification must not be accepted from the vendors.
 
::::b. Dewars lacking proper identification must not be accepted from the vendors.
   
::2. Liquid Helium Storage Dewars are transported by using the handle to pull the Dewar; they must never be pushed. Always keep the Dewar in the upright position.
+
::3. Liquid Helium Storage Dewars are transported by using the handle to pull the Dewar; they must never be pushed. Always keep the Dewar in the upright position.
   
::3. Liquid Helium Storage Dewar will be transported with the '''Relief Isolation Valve''' OPEN so that pressure does not build up in the storage dewar.
+
::4. Liquid Helium Storage Dewar will be transported with the '''Relief Isolation Valve''' OPEN so that pressure does not build up in the storage dewar.
   
::4. The cylinder contents must be permanently attached to the outside of the Dewar. This identification shall not be removed, covered or defaced.
+
::5. The cylinder contents must be permanently attached to the outside of the Dewar. This identification shall not be removed, covered or defaced.
   
 
::6. Liquid Helium will not be used in environmental rooms unless there is adequate ventilation and/or an oxygen monitor with an audible alarm is present and permission has been granted by the Safety Officer.
 
::6. Liquid Helium will not be used in environmental rooms unless there is adequate ventilation and/or an oxygen monitor with an audible alarm is present and permission has been granted by the Safety Officer.
Line 204: Line 169:
   
 
::9. Empty cylinders will be marked “EMPTY”.
 
::9. Empty cylinders will be marked “EMPTY”.
 
 
<br>
 
   
 
{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
|<div align="center">'''Variance Event - What to do if there is a Helium Cylinder / Storage Dewar Leak'''</div>
+
|<div align="center">'''What to do if there is a Helium Cylinder / Storage Dewar Leak'''</div>
 
|-
 
|-
 
|'''Indication:'''
 
|'''Indication:'''
Line 217: Line 179:
 
| '''Course of Action:'''
 
| '''Course of Action:'''
 
::1. '''''Cylinder Leak – if this happens:'''''
 
::1. '''''Cylinder Leak – if this happens:'''''
  +
::::a. '''Notify MEG Core Staff immediately'''
::::a. If there are reasons to believe that a cylinder is leaking, test for the leak by painting soapy water over the valves and connections. This will indicate most gas leaks.
 
  +
::::b. If there are reasons to believe that a cylinder is leaking, test for the leak by painting soapy water over the valves and connections. This will indicate most gas leaks.
::::b. Do not attempt to repair leaks caused by loose valve stem packing.
 
  +
::::c. Do not attempt to repair leaks caused by loose valve stem packing.
::::c. Leaking storage Dewars of liquid helium will be moved to a well-ventilated area. There is no potential harm if helium does not critically displace the amount of oxygen.
 
  +
::::e. Leaking storage Dewars of liquid helium will be moved to a well-ventilated area. There is no potential harm if helium does not critically displace the amount of oxygen.
::::d. The Dewar must be labeled indicating the problem.
 
::::e. The vendor will be called for pickup.
+
::::f. The Dewar must be labeled indicating the problem.
  +
::::g. The vendor will be called for pickup.
::::f. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
 
  +
::::h. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
 
|-
 
|-
 
|<div align="center">''*Note: Leaks from cylinders of toxic or flammable gases require immediate attention.''</div>
 
|<div align="center">''*Note: Leaks from cylinders of toxic or flammable gases require immediate attention.''</div>
 
|}
 
|}
   
 
<br>
 
   
   
 
{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
|<div align="center">'''Variance Event - What to do if there is an MEG Dewar Leak / Spontaneous Warm Up'''</div>
+
|<div align="center">'''What to do if there is an MEG Dewar Leak / Spontaneous Warm Up'''</div>
 
|-
 
|-
 
|'''Indication:'''
 
|'''Indication:'''
Line 244: Line 205:
 
|-
 
|-
 
| '''Course of Action:'''
 
| '''Course of Action:'''
::1. MEG Dewar Leak - Notify MEG staff as soon as possible.
+
::1. MEG Dewar Leak '''Notify MEG Core Facility Staff immediately'''
   
 
::2. Spontaneous MEG Dewar Warm Up- if this happens:
 
::2. Spontaneous MEG Dewar Warm Up- if this happens:
Line 252: Line 213:
 
::::d. Turn off the Helium Alarm.
 
::::d. Turn off the Helium Alarm.
 
::::e. Turn off the Oxygen Alarm.
 
::::e. Turn off the Oxygen Alarm.
  +
::::g. '''Notify MEG Core Facility Staff immediately'''
::::f. Fill out an Incident Report. Place a “Do Not Operate / Do not Use” sign on the MSR door.
 
::::g. Notify the lab director or staff scientist as soon as possible.
 
 
|}
 
|}
 
   
 
<br>
 
<br>
   
 
===== Compressed Helium Gas =====
 
===== Compressed Helium Gas =====
'''Users of Compressed Helium Gas will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices. *Refer to the Material Safety and Data Sheets (MSDS) located in the MEG Lab.'''
+
::Users of Compressed Helium Gas will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices. Refer to the Material Safety and Data Sheets (MSDS) located in the MEG Lab.
   
   
::'''<u>Compressed Helium Gas Cylinders:</u>'''
+
::1. '''Compressed Helium Gas Cylinders:'''
::::1. The contents of Compressed Helium cylinders must be identified with decals, stencils, or other markings on the cylinders. Color codes alone or tags hung around the necks of the cylinders are not acceptable. Cylinders lacking proper identification must not be accepted from the vendors.
+
::::a. The contents of Compressed Helium cylinders must be identified with decals, stencils, or other markings on the cylinders. Color codes alone or tags hung around the necks of the cylinders are not acceptable. Cylinders lacking proper identification must not be accepted from the vendors.
   
::::2. Helium Cylinders will not be accepted from the vendors unless the valve safety covers are in place and properly tightened.
+
::::b. Helium Cylinders will not be accepted from the vendors unless the valve safety covers are in place and properly tightened.
   
::::3. Compressed Helium cylinders will be secured always so they cannot fall.
+
::::c. Compressed Helium cylinders will be secured always so they cannot fall.
   
::::4. Valve safety covers will be in place until pressure regulators are ready to be attached.
+
::::d. Valve safety covers will be in place until pressure regulators are ready to be attached.
   
::::5. The cylinder contents are permanently attached to the cylinders. This identification shall not be removed, covered or defaced.
+
::::e. The cylinder contents are permanently attached to the cylinders. This identification shall not be removed, covered or defaced.
   
::::6. Cylinders will be moved on chain equipped hand trucks or carts; they are never rolled or dragged.
+
::::f. Cylinders will be moved on chain equipped hand trucks or carts; they are never rolled or dragged.
   
::::7. Employees will not attempt to repair cylinders or cylinder valves, or to force stuck or frozen cylinder valves.
+
::::g. Employees will not attempt to repair cylinders or cylinder valves, or to force stuck or frozen cylinder valves.
   
::::8. The cylinder valve will not be opened or cracked without first attaching the proper pressure regulator.
+
::::h. The cylinder valve will not be opened or cracked without first attaching the proper pressure regulator.
 
<br>
 
   
::'''<u>Pressure Regulators and Needle Valves:</u>'''
+
::2. '''Pressure Regulators and Needle Valves:'''
::::1. The valve fittings of Liquid Helium cylinders must be valves attachments that are safe for use with Liquid Helium. Use of adapters to connect regulators to cylinder valves defeats this safeguard and is not authorized. Only pressure regulators and needle valves approved for the compressed Liquid Helium gases may be used.
+
::::a. The valve fittings of Liquid Helium cylinders must be valves attachments that are safe for use with Liquid Helium. Use of adapters to connect regulators to cylinder valves defeats this safeguard and is not authorized. Only pressure regulators and needle valves approved for the compressed Liquid Helium gases may be used.
 
 
::::2. Threads and points of unions must be clean. These surfaces must be inspected before they are connected.
+
::::b. Threads and points of unions must be clean. These surfaces must be inspected before they are connected.
   
::::3. When attaching regulators or needle valves, the connections must be tightened firmly. Wrenches of the proper size should be used. Pliers should not be used as they damage the soft brass nuts.
+
::::c. When attaching regulators or needle valves, the connections must be tightened firmly. Wrenches of the proper size should be used. Pliers should not be used as they damage the soft brass nuts.
   
::::4. Do not apply excessive force when attaching the regulator or valve. Need for excessive force often indicates that the regulators or needle valves do not fit the cylinders.
+
::::d. Do not apply excessive force when attaching the regulator or valve. Need for excessive force often indicates that the regulators or needle valves do not fit the cylinders.
   
::::5. Leaks at the unions between the regulators and the cylinder valves are usually due to damage to the faces of the connections. Attempts to force a tight fit may damage the previously undamaged half of the connection.
+
::::e. Leaks at the unions between the regulators and the cylinder valves are usually due to damage to the faces of the connections. Attempts to force a tight fit may damage the previously undamaged half of the connection.
   
::::6. If the cylinder valve faces are damaged, the cylinders will be returned to the vendors. Employees will not attempt to repair them.
+
::::f. If the cylinder valve faces are damaged, the cylinders will be returned to the vendors. Employees will not attempt to repair them.
   
::::7. Damaged regulators will not be used until repaired.
+
::::g. Damaged regulators will not be used until repaired.
   
   
::'''<u>Cylinder Leaks:</u>'''
+
::3. '''Cylinder Leaks:'''
::::1. Unless there are reasons to believe that cylinders are leaking, testing for leaks may be done after the pressure regulators are attached to the cylinder valves and the valves opened.
+
::::a. Unless there are reasons to believe that cylinders are leaking, testing for leaks may be done after the pressure regulators are attached to the cylinder valves and the valves opened.
   
::::2. Soapy water painted over the valves and connections will be performed if a leak is suspected.
+
::::b. Soapy water painted over the valves and connections will be performed if a leak is suspected.
   
::::3. Personnel will not attempt to repair leaks caused by loose valve stem packing.
+
::::c. Personnel will not attempt to repair leaks caused by loose valve stem packing.
   
::::4. Leaking cylinder of compressed Helium gas will be returned to the vendor.
+
::::d. Leaking cylinder of compressed Helium gas will be returned to the vendor.
   
::::5. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
+
::::e. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
   
   
::'''<u>Empty Cylinders:</u>'''
+
::4. '''Empty Cylinders:'''
::::1. A small amount of gas must be left in the cylinders and the cylinder valves must be closed to prevent contamination of the inside of the cylinders.
+
::::a. A small amount of gas must be left in the cylinders and the cylinder valves must be closed to prevent contamination of the inside of the cylinders.
   
::::2. Empty cylinders should be marked “EMPTY”.
+
::::b. Empty cylinders should be marked “EMPTY”.
   
::::3. Valve safety covers and the labels showing contents must be in place.
+
::::c. Valve safety covers and the labels showing contents must be in place.
   
::::4. Empty cylinders should be stored separately from full cylinders.
+
::::d. Empty cylinders should be stored separately from full cylinders.
   
::::5. Empty cylinders must be secured at all times so they can not fall.
+
::::e. Empty cylinders must be secured at all times so they can not fall.
   
  +
== Emergency Procedures ==
 
  +
::'''The MEG Lab has established emergency procedures, which are consistent with the Clinical Center's policies and procedures, to be followed in response to various potential emergency events.'''
::Reference:
 
::::1. Health & Safety Manual – General Safety and Laboratory Policies Compressed Gases (http://www.niehs.nih.gov/odhsb/manual/man4b.htm).
 
 
 
<br>
 
 
=== <u>Emergency Procedures</u> ===
 
'''The MEG Lab has established emergency procedures, which are consistent with the Clinical Center's policies and procedures, to be followed in response to various potential emergency events.'''
 
 
<br>
 
   
 
==== Emergency Evacuation Plan ====
 
==== Emergency Evacuation Plan ====
 
'''The Emergency Evacuation Plan has been created in order to facilitate the safe and orderly evacuation of staff, visitors and volunteers from the lab and/or building in case of an emergency. Refer to the <u>MEG Emergency Evacuation Floor Plan Map</u> which is posted inside the MEG Lab at each door and also outside the B1/D65B door.
 
'''The Emergency Evacuation Plan has been created in order to facilitate the safe and orderly evacuation of staff, visitors and volunteers from the lab and/or building in case of an emergency. Refer to the <u>MEG Emergency Evacuation Floor Plan Map</u> which is posted inside the MEG Lab at each door and also outside the B1/D65B door.
   
'''One person will be designated the primary Evacuation Team Leader (ETL) for the MEG Core Facility. The evacuation team leader will be responsible for''' '''''LEADING THE EVACUATION AND ACCOUNTING FOR ALL STAFF, SUBJECTS AND VISITORS.'''''
+
::1. One person will be designated the primary Evacuation Team Leader (ETL) for the MEG Core Facility. The evacuation team leader will be responsible for leading the evacuation and accounting for all staff, subjects, and visitors.
   
:::::::::::::::::::::::::{| class="wikitable"
+
::::{| class="wikitable"
 
|-
 
|-
 
!'''MEG Lab Emergency Evacuation Team Leaders (ETL) <br>Building 10 / Floor: B1; Corridor D; Room: 65B'''
 
!'''MEG Lab Emergency Evacuation Team Leaders (ETL) <br>Building 10 / Floor: B1; Corridor D; Room: 65B'''
 
|-
 
|-
|'''Primary ETL: Dr. Tom Holroyd <br>Phone: 301 / 402-2362 <br>Bldg/Rm: 10 / B1D65A'''
+
|'''Primary ETL''': Anna Namyst (lab manager) <br>Phone: 301.402.2445 <br>Bldg/Rm: 10 / B1D65B
 
|-
 
|-
|'''Secondary ETL: Judy Mitchell <br>Phone: 301 / 402-2445 <br>Bldg/Rm: 10 / B1D65B'''
+
|'''Secondary ETL''': Dr. Tom Holroyd <br>Phone: 301.402.2362 <br>Bldg/Rm: 10 / B1D65A
 
|}
 
|}
 
 
:'''Procedure:'''
 
::1. One person will be designated the Evacuation Team Leader (ETL) for the MEG Core Facility. The evacuation team leader will be responsible for directing the evacuation and accounting for staff, subjects and visitors.
 
   
 
::2. In the event that an evacuation is ordered, the ETL and/or other MEG Core Facility staff will evacuate the lab including all subjects / visitors.
 
::2. In the event that an evacuation is ordered, the ETL and/or other MEG Core Facility staff will evacuate the lab including all subjects / visitors.
Line 365: Line 309:
 
::8. Occupants may return to the building only when authorized by the Senior Fire Officer, Police Officer, or the Occupant Emergency Coordinator (OEC).
 
::8. Occupants may return to the building only when authorized by the Senior Fire Officer, Police Officer, or the Occupant Emergency Coordinator (OEC).
   
  +
::9. The nearest Fire Extinguisher is located just outside the MEG Core Facility.
   
  +
::10. Fire Alarm Pull Stations are located at each end of the NMR Center main corridor and at all Emergency Exits.
:::::::::::::::::'''IMPORTANT THINGS TO REMEMBER:'''
 
:::::::::::::::::{| class="wikitable"
 
|-
 
| '''• <u>Primary Evacuation Route</U>'''
 
If an evacuation is ordered, the MEG Core Facility staff will evacuate the lab <br>including all subjects / visitors via the primary evacuation route (the nearest exit) as directed by the ETL.
 
|-
 
|
 
'''• <u>Secondary &Alternate Exits</u>'''
 
The secondary exit should be used if the primary exit is inaccessible. <br>Refer to the MEG Emergency Evacuation Plan.
 
|-
 
| '''•<u> Evacuation Team Leader (ETL)</u>'''
 
All staff and subjects and visitors will report to ETL so that all persons may be accounted for.
 
|-
 
| '''•<u> Persons with Disabilities / Emergency Aides</u>'''
 
Individuals with disabilities will be assisted by one or more persons (aides) assigned by the ETL. <br>The aides will assist the individual(s) to the nearest elevator lobby to await evacuation by the fire department.
 
|-
 
| '''•<u> Elevators</u>'''
 
Must NEVER be used for emergency evacuation unless the elevators are under the direction of <br>the fire department, or are equipped with special systems and are pre-approved for evacuation.
 
|-
 
| '''•<u> Head Count</u>'''
 
Upon exiting the building, assemble 50 to 80 feet outside the exit door as directed by the ETL <br>for a head count. Occupants may return to the building only when authorized by the senior fire officer, <br>police officer, the Occupant Emergency Coordinator (OEC) or the ETL.
 
|}
 
   
  +
==== Emergency Evacuation Routes ====
<br>
 
   
  +
::1. If an evacuation is ordered, MEG Core Facility staff will evacuate the lab, including all subjects / visitors via the primary evacuation route (the nearest exit) as directed by the ETL. The secondary exit should be used if the primary exit is inaccessible. And the alternate route should only be used if both the primary and secondary exit are not an option.
==== '''Emergency Evacuation Routes''' ====
 
If an evacuation is ordered, MEG Core Facility staff will evacuate the lab, including all subjects / visitors via the primary evacuation route (the nearest exit) as directed by the ETL. The secondary exit should be used if the primary exit is inaccessible. And the alternate route should only be used if both the primary and secondary exit are not an option. '''''*Refer to the MEG Emergency Evacuation Plan and the Emergency Evacuation Floor Plan map.'''''
 
   
:::::::::::::::::{| class="wikitable"
+
:::::::{| class="wikitable"
 
|-
 
|-
! '''PRIMARY EVACUATION ROUTE – To Loading Dock:'''
+
! PRIMARY EVACUATION ROUTE – To Loading Dock:
  +
'''''*There are 4 or 5 stairs leading down to the sidewalk.'''''
 
|-
 
|-
  +
| • From the MEG Corridor, turn left down the main NMR Center corridor.
| <div align="center">'''''*There are 4 or 5 stairs at the loading dock exit.'''''<div>
 
 
|-
 
|-
| 1. From the MEG Corridor, turn left down the main NMR Center corridor.
+
| Turn RIGHT at the first corridor (MRI Corridor).
 
|-
 
|-
| 2. Turn right at the first corridor (MRI Corridor).
+
| At the end of the MRI Corridor, turn left down the <br>Animal Corridor; go through the double doors.
 
|-
 
|-
  +
| • Turn right at the exit sign to the loading dock.
|3. At the end of the MRI Corridor, turn left and proceed down the Animal Corridor; go through the double doors.
 
 
|-
 
|-
| 4. Make a right turn through at the second corridor on the right (at the second exit sign).
+
| Go through the EMERGENCY EXIT double doors to the back loading dock.
|-
 
| 5. Go through the EMERGENCY EXIT double doors to the back loading dock.
 
|-
 
| <div align="center">''**If for some reason the primary evacuation route is blocked by smoke or inaccessible the <br>WEST SIDE (SECONDARY) EMERGENCY EXIT may be used to evacuate the building.''<div>
 
 
|}
 
|}
   
   
  +
<div align="center">'''''If for some reason the primary evacuation route is blocked by smoke or inaccessible the WEST SIDE (SECONDARY) EMERGENCY EXIT may be used to evacuate the building.'''''</div>
<br>
 
  +
::::::::::::::::::{| class="wikitable"
 
  +
:::::::{| class="wikitable"
|-
 
! '''SECONDARY EVACUATION ROUTE – West Side Emergency Exit / outside Bld. 10:'''
 
 
|-
 
|-
  +
! SECONDARY EVACUATION ROUTE – West Side Emergency Exit / outside Bld. 10:
| <div align="center">'''*There are 6 or 7 stairs leading down to this exit.'''<div>
 
  +
*There are 6 or 7 stairs leading down to this exit.
 
|-
 
|-
| 1. From the MEG corridor, proceed left down the main NMR Center corridor towards room B1D67 <br>(past the signs for the Laboratory of Cardiac Energetics beyond the 7T).
+
| From the MEG corridor, proceed left down the main NMR Center corridor towards room B1D67 <br>(past the signs for the Laboratory of Cardiac Energetics).
 
|-
 
|-
| 2. Go through the EMERGENCY ONLY EXIT door down the stairs to the outside of the building.
+
| Go through the EMERGENCY ONLY EXIT door down the stairs to the outside of the building.
 
|-
 
|-
| 3. This exit leads to the west side of Building 10.
+
| This exit leads to the west side of Building 10.
 
|}
 
|}
 
   
  +
<br>
 
  +
<div align="center">'''''If during an emergency, the Primary Evacuation and the Secondary Evacuation Routes are blocked by smoke or other hazards use the Alternate Exit. The Alternate Exit should only be used if the Secondary Exit is inaccessible.'''''</div>
:::::::::::{| class="wikitable"
 
  +
  +
:::::::{| class="wikitable"
 
|-
 
|-
! '''ALTERNATE EVACUATION ROUTE– Towards Cafeteria/ Elevators / Front of Building 10:'''
+
! ALTERNATE EVACUATION ROUTE– Towards Cafeteria/ Elevators / Front of Building 10:
 
|-
 
|-
  +
| | • From the MEG corridor, turn right down the main NMR Center corridor towards the nearest exit.
|<div align="center">'''''If during an emergency, the Primary Evacuation and the Secondary Evacuation Routes are blocked by smoke or other hazards; use this exit. <br>The Alternate Exit should only be used if the Secondary Exit is inaccessible.'''''<div>
 
 
|-
 
|-
  +
| • Go through the EXIT door.
| 1. From the MEG corridor, turn right down the main NMR Center corridor towards the nearest exit.
 
 
|-
 
|-
| 2. Go through the EXIT door.
+
| Follow the sign to the cafeteria.
 
|-
 
|-
| 3. This exit leads to the main building towards the cafeteria and elevators, i.e., toward the front of Building 10.
+
| This exit leads to the main building towards the cafeteria and elevators,<br> i.e., toward the front of Building 10
 
|}
 
|}
  +
 
<br>
 
   
 
==== Fire Safety Plan ====
 
==== Fire Safety Plan ====
  +
'''The MEG Lab has established a Fire Safety Plan in order to define the scope and method for immediate, positive and orderly action to safeguard life and property during a fire emergency. The NIH utilizes a zoned evacuation system. When and if the fire alarm signal sounds and the flashing emergency strobe light has been activated in a particular area the occupants in that zone or area of the building must evacuate the building. This alarm is usually followed by recorded instructions to the occupants. Other areas may not be required to evacuate unless their zone fire alarm system has been activated as well.
 
  +
::The MEG Lab has established a Fire Safety Plan in order to define the scope and method for immediate, positive and orderly action to safeguard life and property during a fire emergency.
  +
  +
::1. The NIH utilizes a zoned evacuation system. When and if the fire alarm signal sounds and the flashing emergency strobe light has been activated in a particular area the occupants in that zone or area of the building must evacuate the building. This alarm is usually followed by recorded instructions to the occupants. Other areas may not be required to evacuate unless their zone fire alarm system has been activated as well.
   
 
<br>
 
<br>
The MEG Core Facility '''''Evacuation Team Leader(s) (ETL) ''''' may designate Assistant Team Leaders (ATL) to help with the evacuation.
+
::2. The MEG Core Facility '''Evacuation Team Leader(s) (ETL)''' may designate Assistant Team Leaders (ATL) to help with the evacuation.
   
::During a fire emergency:
+
::3. During a fire emergency:
::::* the ETL will be responsible for the orderly evacuation of and accounting for all staff, subjects and visitors;
+
::::a. The ETL will be responsible for the orderly evacuation of and accounting for all staff, subjects and visitors;
::::* the ATL will help to carry out the instructions of the ETL and assists all patients / visitors in the case of an evacuation.
+
::::b. The ATL will help to carry out the instructions of the ETL and assists all patients / visitors in the case of an evacuation.
   
::::::::::::::::::::::::::::'''Remember:'''
+
::::::::'''Remember:'''
::::::::::::::::::::::{| class="wikitable"
+
::::::::{| class="wikitable"
 
|-
 
|-
 
! R.A.C.E.
 
! R.A.C.E.
Line 469: Line 392:
 
|}
 
|}
   
  +
::4. If there is a small fire which may be contained using a fire extinguisher:
If there is a small fire which may be contained using a fire extinguisher, '''''the nearest fire extinguisher is located outside the MEG Lab.''''' Extinguish the fire only if it can be done without endangering anyone, after notifying the NIH Fire Department. When using a fire extinguisher, fight the fire from a position accessible to an exit to avoid entrapment; if in doubt, evacuate the area and wait for the NIH Fire Department to arrive. Remember:
 
  +
::::a. The nearest fire extinguisher is located outside the MEG Lab.
  +
::::b. Extinguish the fire only if it can be done without endangering anyone, after notifying the NIH Fire Department.
  +
::::c. When using a fire extinguisher, fight the fire from a position accessible to an exit to avoid entrapment; if in doubt, evacuate the area and wait for the NIH Fire Department to arrive.
   
  +
::::::::'''Remember:'''
 
:::::::::::::::::::::::::{| class="wikitable"
+
::::::::{| class="wikitable"
 
|-
 
|-
 
| '''P.A.S.S.'''
 
| '''P.A.S.S.'''
Line 485: Line 411:
 
|}
 
|}
   
::'''Fire Evacuation Procedures:'''
+
::5. '''Fire Evacuation Procedures:'''
::::1. Close all doors as you leave (close the MSR door if safe to do so).
+
::::a. Close all doors as you leave (close the MSR door if safe to do so).
::::2. Walk to the nearest FIRE ALARM PULL STATION which is located in the NMR Center main corridor on <br>the wall between the Waiting Area and the door leading to the main building; activate the alarm.
+
::::b. Walk to the nearest FIRE ALARM PULL STATION which is located in the NMR Center main corridor on the wall between the Waiting Area and the door leading to the main building; activate the alarm.
::::3. Dial 911 from the nearest phone.
+
::::c. Dial 111 from the nearest phone.
::::4. All staff, subjects, users and visitors must evacuate the zone or the building using the Primary Evacuation Route.
+
::::d. All staff, subjects, users and visitors must evacuate the zone or the building using the Primary Evacuation Route.
::::5. If the Primary Evacuation Route is blocked or inaccessible use the Secondary Route.
+
::::e. If the Primary Evacuation Route is blocked or inaccessible use the Secondary Route.
::::6. The ETL will designate a place away from the building for everyone to meet.
+
::::f. The ETL will designate a place away from the building for everyone to meet.
::::7. Everyone (all staff, subjects, users and visitors) will report to the ETL and remain <br>outside at the designated area until all persons have been accounted for or until otherwise instructed by the ETL.
+
::::g. Everyone (all staff, subjects, users and visitors) will report to the ETL and remain <br>outside at the designated area until all persons have been accounted for or until otherwise instructed by the ETL.
  +
::::h. Refer to the MEG Emergency Evacuation Floor Plan Map which is posted inside the MEG Lab at each door and also outside the B1/D65B door.''
 
::::::''*Refer to the MEG Emergency Evacuation Floor Plan Map which is posted inside the MEG Lab at each door and also outside the B1/D65B door.''
 
 
   
 
<br>
 
<br>
   
 
==== Power Failure ====
 
==== Power Failure ====
'''In the event of a power failure, the appropriate action will be determined by the MEG Evacuation Team Leader (ETL). If the power fails, the emergency backup lights in the lab and the MSR will automatically activate. The ETL will determine whether to evacuate the MEG Lab; if evacuation is necessary the Lab will be evacuated in a safe and orderly manner.'''
+
::In the event of a power failure, the appropriate action will be determined by the MEG Evacuation Team Leader (ETL). If the power fails, the emergency backup lights in the lab and the MSR will automatically activate. The ETL will determine whether to evacuate the MEG Lab; if evacuation is necessary the Lab will be evacuated in a safe and orderly manner.
 
   
  +
::1. Discontinue testing and evacuate all staff and subjects / patients.
::'''Procedure:'''
 
::::1. Discontinue testing and evacuate all staff and subjects / patients.
 
   
::::2. Turn off all computers and other electrical equipment, if safe to do so.
+
::2. Turn off all computers and other electrical equipment, if safe to do so.
   
::::3. Call / contact Maintenance at 496-5862 to report the power outage.
+
::3. Call / contact Maintenance at 496-5862 to report the power outage.
   
::::4. Notify MEG Core staff.
+
::4. Notify MEG Core staff.
   
::::5. If determined appropriate, evacuate to the nearest area which does have power; listen for emergency communications/ announcements over the PA system.
+
::5. If determined appropriate, evacuate to the nearest area which does have power; listen for emergency communications/ announcements over the PA system.
   
::::6. Return to the facility when power has been restored and / or when it has been determined that it is safe to do so.
+
::6. Return to the facility when power has been restored and / or when it has been determined that it is safe to do so.
   
::::7. All emergency backup lights and flashlights will be tested once a year to assure that they are operable.
+
::7. All emergency backup lights and flashlights will be tested once a year to assure that they are operable.
   
   
 
:::::{| class="wikitable"
 
:::::{| class="wikitable"
 
|-
 
|-
| '''''*Flashlights are located on the top shelf of the "Supply Cabinet' nearest the B1D65B door. Batteries are located in the "Equipment Cabinet".'''''
+
| Flashlights are located on the top shelf of the "Supply Cabinet' nearest the B1D65B door. Batteries are located in the "Equipment Cabinet".
 
|}
 
|}
   
  +
==== Chemical / Biological Incident ====
   
  +
::1. If a biological incident were to occur, it is important to take immediate and appropriate action in order to:
::Reference:
 
  +
::::a. limit exposure to the potentially harmful chemical or biological substances
::::1. NIH Occupant Evacuation Plan – 1430, NIH Policy Manual (ttp://www1.od.nih.gov/oma/manualchapters/management/1430/main.html).
 
  +
::::b. to evacuate the immediate area of the contamination and
  +
::::c. to contain or close-off the contaminated area.'''
   
  +
::2. '''Procedure:'''
<br>
 
  +
::::a. Evacuate the room and close doors.
   
  +
::::b. Call the Fire Department by dialing 111 (on campus).
==== Chemical / Biological Incident ====
 
'''If a biological incident were to occur, it is important to take immediate and appropriate action in order to: 1) limit exposure to the potentially harmful chemical or biological substances, 2) to evacuate the immediate area of the contamination and 3) to contain or close-off the contaminated area.'''
 
   
  +
::::c. Notify MEG Core Facility staff immediately.
::'''Procedure:'''
 
::::1. Leave the room and close doors.
 
   
  +
::::d. Remove contaminated clothing and wash any parts of the body which may have come in contact with the hazardous material.
::::2. Call the Fire Department by dialing 911 (on campus) or 9-911 at leased (off-campus) facilities.
 
   
  +
::::e. Do not permit anyone to enter the room/area until the appropriate authorities determine that the area is safe.
::::3. Remove contaminated clothing and wash any parts of the body which may have come in contact with the hazardous material.
 
   
  +
::::f. After safely evacuating, any person(s) who may have become contaminated should be restricted to a single staging area and not permitted to move freely to other locations. Moving to other locations may create a contamination concern to other occupants and/or other areas of the building.
::::4. Do not permit anyone to enter the room/area until the appropriate authorities determine that the area is safe.
 
   
  +
::::g. If a patient or subject is involved, notify the physician in charge and the Chief of Nursing Service or the Nursing Supervisor, along with the institute clinical director
::::5. After safely evacuating, any person(s) who may have become contaminated should be restricted to a single staging area and not permitted to move freely to other locations. Moving to other locations may create a contamination concern to other occupants and/or other areas of the building.
 
   
  +
::{| class="wikitable"
::::6. If a patient or subject is involved, notify the physician in charge and the Chief of Nursing Service or the Nursing Supervisor.
 
 
 
::::::::{| class="wikitable"
 
 
|-
 
|-
| '''''*The nearest Emergency Eye Wash Stations in the NMR Center are located in the Patient Prep Rooms (B1D 302 and B1D 304). <br><div align="center">**The nearest showers are located on the 1st floor directly above the MEG Lab - Rm 1D 070.'''''
+
|The nearest Emergency Eye Wash Stations in the NMR Center are located in the Patient Prep Rooms (B1D 302 and B1D 304).
  +
|-
  +
|The nearest showers are located on the 1st floor directly above the MEG Lab (Rm 1D 070).
 
|}
 
|}
   
  +
==== Medical Emergency - Possible Seizure Event ====
   
  +
::In the event a possible seizure / medical emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. A seizure is a medical condition where a person may or may not lose consciousness. There might be jerking of a body part, incontinence, tongue biting, a lack of responsiveness / blank stare or other neurological symptoms. It is important that any person observing the event assures that the victim does not injure him/herself and that they get immediate assistance / medical care, if at all indicated.
 
<br>
 
<br>
  +
1. In the event of a suspected seizure without loss of consciousness:
   
  +
::::a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition.
==== Radiation Incident ====
 
   
  +
::::b. If seated, slide the subject/person out of the chair; If necessary, help the person lie down on the floor. Do not attempt to operate the controls for the chair.
'''If a radiation incident were to occur, it is important to take immediate and appropriate action in order to: 1) limit exposure to the potentially harmful substances, 2) to evacuate the immediate area of the contamination and 3) to contain or close-off the contaminated area.'''
 
   
  +
::::c. Assure that the person does not injure himself. Try to remove harmful objects from the person's pathway or coax the person away from those objects.
::'''Procedure:'''
 
:::::1. Confine the contamination, using absorbent material to keep it from spreading (i.e., using an Emergency Contaminate Kit if available, towels, or paper towels).
 
   
  +
::::d. Do not try to restrain the person; you cannot stop the seizure. Do not agitate the person.
:::::2. Close the doors and leave the room.
 
   
  +
::::e. If the person appears to be angry or aggressive, do not approach the person if you are alone.
:::::3. Remove contaminated clothing and shoes before entering a clean area.
 
   
  +
::::f. Observe and document details of the event:
:::::4. Wash any parts of the body which may have come in contact with the radioactive material.
 
  +
:::::i. Record the sequence of events.
  +
:::::ii. Note body parts involved.
  +
:::::iii. Record length of event.
   
  +
::::g. Assess the subject’s level of consciousness.
:::::5. Call the Fire Department by dialing 911 (on campus) or 9-911 at leased (off-campus) facilities.
 
   
  +
::::h. Stay with the individual.
:::::6. Contact the Occupational Medical Service at 301 / 496-4411 (7:30-5:00), Building 10 / 6C306.
 
   
  +
::::i. After the event escort victim (or transport via wheelchair) to the Clinical Center office of Occupational Medical Services (OMS) 10/6C306 7:30 am-4:00pm and / or recommend that the subject seek immediate medical care from their physician.
:::::7. Do not permit anyone to enter the room/area until the appropriate authorities determine that the area is safe.
 
   
  +
::::j. Ask subject if they have a history of seizures; ask subject if he has any memory of the event. Document information.
:::::8. After safely evacuating, any person(s) who may have become contaminated should be restricted to a single staging area and not be permitted to move freely to other locations. Moving to other locations may create a contamination concern to other occupants and/or other areas of the building.
 
   
  +
::::k. If the subject subsequently loses consciousness and/or the seizure does not terminate after about 5-10 minutes call a Code Blue (111).
:::::9.If a Clinical Center patient is involved, call the physician in charge and the Nursing Service Chief or Nursing Supervisor.
 
   
  +
::::l. Notify MEG Core Facility Staff
   
  +
::2 In the event of a suspected seizure WITH loss of consciousness:
<br>
 
   
  +
::::a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition.
==== Bomb Threat ====
 
'''Most bomb threats are received by phone and they are to be taken seriously until proven otherwise. These procedures will assist employees to: 1) understand the appropriate actions to take, 2) know the appropriate administrative and security personnel to contact and 3) understand the most important information to obtain to assure the best possible outcome.'''
 
   
  +
::::b. Slide the subject out of the chair down to the floor; do not attempt to operate the controls for the chair.
   
  +
::::c. Assure that the subject does not injure himself.
:'''Procedure:'''
 
  +
:::::i. Put something soft under the head.
::'''I. <u>Threat Received by Phone Call'''</u>
 
  +
:::::ii. Remove any eyeglasses.
::::1. Engage caller in conversation; keep the caller on the line as long as possible to learn information while also discretely attempting to notify a co-worker or others of the threat (i.e., write a note and pass it to a co-worker) so that they can immediately contact NIH Police.
 
  +
:::::iii. Loosen any tight clothes.
  +
:::::iv. Clear the area of sharp or hard objects.
   
  +
::::d. DO NOT force anything into the subject’s mouth.
::::2. Remain calm, listen carefully and take notes of the conversation. Be polite and show interest.
 
   
  +
::::e. Do not try to restrain the person; you cannot stop the seizure.
::::3. While on the phone – fill out the Bomb Threat Checklist to record all details and the caller’s characteristics. *Refer to the Bomb ::::::::::Threat Checklist - https://www.dhs.gov/what-to-do-bomb-threat.
 
   
::::4. If possible, record every word spoken by the person making the call.
+
::::f. Observe and document details of the event.
  +
:::::i. Record the sequence of events.
  +
:::::ii. Note body parts involved.
  +
:::::iii. Record length of event.
   
  +
::::g. Assess the subject’s level of consciousness.
::::5. Try to determine:
 
::::::• The exact location of the bomb
 
::::::• The source of the threat
 
::::::• Time of the threatened explosion
 
::::::• Background noises on the phone
 
::::::• Qualities of the caller’s voice
 
::::::• Gender and approximate age of the caller
 
   
::::6. Questions to Ask:
+
::::h. Stay with the individual.
::::::• Ask the caller to repeat the message.
 
::::::• What is your name?
 
::::::• What is your address?
 
::::::• Where is the bomb located?
 
::::::• When is the bomb going to explode?
 
::::::• Where is the bomb?
 
::::::• What does the bomb look like?
 
::::::• What kind of bomb is it?
 
::::::• What will make the bomb to explode?
 
::::::• Did you place the bomb? Why?
 
::::::• Where are you calling from?
 
   
  +
::::i. Call 111 to report a Medical Emergency.
::::7. Inform the caller that the building is occupied and the detonation of a bomb could result in death or serious injury to many innocent people.
 
   
  +
::::j. If the subject recovers before emergency personnel arrive, turn the person to one side (rescue position) to allow saliva to drain from the mouth.
::::8. Record the time the call was received and terminated.
 
   
::::9. If possible, have someone listen in on the call.
+
::::k. Do not offer the person any fluid or drink.
   
  +
::::l. Access/monitor for respiratory or cardiac compromise. If necessary, begin rescue breathing or CPR until emergency medical personnel arrives.
::::10. Check "CALLER ID", or immediately after the caller hangs up dial *69 to determine where the call originated.
 
   
  +
::::m. Notify MEG Core Facility Staff
::::11. Call the NIH Police at 911 (on campus) or 9-911 (off campus).
 
 
::::12. Never touch a suspected bomb.
 
 
::::13. If possible, turn off all radios and transceiver equipment near the suspected area.
 
 
::::14. Evacuate all staff, subjects and visitors from the building in an orderly manner. *Refer to the MEG Core Facility Evacuation Floor Plan.
 
 
::::15. Cooperate with emergency personnel during evacuation to resolve the incident.
 
 
::::16. Notify all appropriate staff.
 
 
 
::'''I. <u>Threat Received by Handwritten Note</u>'''
 
::::1. Call the NIH Police at 911 (on campus) or 9-911 (off campus).
 
::::2. Handle bomb threat note as minimally as possible.
 
 
 
::'''II. <u>Threat Received by Email</u>'''
 
::::1. Call the NIH Police at 911 (on campus) or 9-911 (off campus).
 
::::2. Do not delete the message.
 
 
 
'''''DO NOT:'''''
 
::''• Use two-way radios or cellular phone. Radio signals have the potential to detonate a bomb.''
 
::''• Touch or move a suspicious package.''
 
 
 
<br>
 
 
==== Medical Emergency - Possible Seizure Event ====
 
'''In the event a possible seizure / medical emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. A seizure is a medical condition where a person may or may not lose consciousness. There might be jerking of a body part, incontinence, tongue biting, a lack of responsiveness / blank stare or other neurological symptoms. It is important that any person observing the event assures that the victim does not injury him/herself and that they get immediate assistance / medical care, if all at indicated. * Refer to the chart for a description of the various seizure types.'''
 
 
<br>
 
'''Procedure:'''
 
::'''I. In the event of a suspected seizure without loss of consciousness:'''
 
::::1. If recording, suspend immediately (it is not necessary to stop the acquisition).
 
 
::::2. Open the door to the MSR.
 
 
::::3. If seated, slide the subject/person out of the chair; If necessary, help the person lie down on the floor. Do not attempt to operate the controls for the chair.
 
 
::::4. Assure that the person does not injure himself. Try to remove harmful objects from the person's pathway or coax the person away from those objects.
 
 
::::5. Do not try to restrain the person; you cannot stop the seizure. Do not agitate the person.
 
 
::::6. If the person appears to be angry or aggressive, do not approach the person if you are alone.
 
 
::::7. Observe and document details of the event:
 
::::::a. Record the sequence of events.
 
::::::b. Note body parts involved.
 
::::::c. Record length of event.
 
 
::::8. Assess the subject’s level of consciousness.
 
 
::::9. Stay with the individual.
 
 
::::10. After the event escort victim (or transport via wheelchair) to the Clinical Center office of Occupational Medical Services (OMS) 10/6C306 7:30 am-4:00pm and / or recommend that the subject seek immediate medical care from their physician.
 
 
::::11. Ask subject if they have a history of seizures; ask subject if he has any memory of the event. Document information.
 
 
::::12. If the subject subsequently loses consciousness and/or the seizure does not terminate after about 5-10 minutes call a Code Blue (111).
 
 
::::13. Fill out Variance Report.
 
 
 
::'''II. In the event of a suspected seizure WITH loss of consciousness:'''
 
::::1. If recording, suspend immediately (it is not necessary to stop the acquisition).
 
 
::::2. Open the door to the MSR.
 
 
::::3. Slide the subject out of the chair down to the floor; do not attempt to operate the controls for the chair.
 
 
::::4. Assure that the subject does not injure himself.
 
::::::a. Put something soft under the head.
 
::::::b. Remove any eyeglasses.
 
::::::c. Loosen any tight clothes.
 
::::::d. Clear the area of sharp or hard objects.
 
 
::::5. DO NOT force anything into the subject’s mouth.
 
 
::::6. Do not try to restrain the person; you cannot stop the seizure.
 
 
::::7. Observe and document details of the event.
 
::::::a. Record the sequence of events.
 
::::::b. Note body parts involved.
 
::::::c. Record length of event.
 
 
::::8. Assess the subject’s level of consciousness.
 
 
::::9. Stay with the individual.
 
 
::::10. Call 111 to report a Medical Emergency.
 
 
::::11. If the subject recovers before emergency personnel arrive, turn the person to one side (rescue position) to allow saliva to drain from the mouth.
 
 
::::12. Do not offer the person any fluid or drink.
 
 
::::13. Access/monitor for respiratory or cardiac compromise. If necessary, begin rescue breathing or CPR until emergency medical personnel arrives.
 
 
::::14. Fill out Variance Report.
 
 
 
<br>
 
   
 
==== Medical Emergency - Suspected Cardiac or Respiratory Event ====
 
==== Medical Emergency - Suspected Cardiac or Respiratory Event ====
'''In the event a possible cardiac or respiratory emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. It is important that any person at the scene provide immediate aide and call for medical assistance as soon as possible.'''
+
::In the event a possible cardiac or respiratory emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. It is important that any person at the scene provide immediate aide and call for medical assistance as soon as possible.
 
 
   
'''Adult Victim:''' The most common medical emergency in an adult victim is usually a heart attack. Symptoms of a heart attack might include: pressure / achy pain in the chest, back (between the shoulder blades), jaw, perhaps radiating to the arm, nausea, dizziness, sweating, agitation, indigestion, denial on the part of the subject.
+
::1.'''Adult Victim:''' The most common medical emergency in an adult victim is usually a heart attack. Symptoms of a heart attack might include: pressure / achy pain in the chest, back (between the shoulder blades), jaw, perhaps radiating to the arm, nausea, dizziness, sweating, agitation, indigestion, denial on the part of the subject.
   
 
<br>
 
<br>
::::::{| class="wikitable"
+
::::{| class="wikitable"
 
|-
 
|-
| '''''The greatest impact on improving the survival from adult sudden cardiac arrest is immediate bystander CPR and defibrillation within 5 minutes. <br><div align="center">The key to survival is <u>early defibrillation</u>. For an adult victim call first.</div>'''''
+
| '''<div align="center">The greatest impact on improving the survival from adult sudden cardiac arrest is immediate bystander CPR and defibrillation within 5 minutes.'''</div> <br><div align="center"> The key to survival is <u>early defibrillation</u>. For an adult victim call first.</div>'''''
 
|}
 
|}
   
   
  +
::2. '''Child/Pediatric Victim:''' The most common cause of sudden cardiac arrest in kids (infants and children) is a lack of oxygen to the heart muscle and brain caused by severe breathing emergencies, respiratory arrest, or shock. Symptoms of a choking victim might include: gasping for air, hand around the neck, cyanosis or pallor and eventually loss of consciousness.
<br>
 
'''Child/Pediatric Victim:''' The most common cause of sudden cardiac arrest in kids (infants and children) is a lack of oxygen to the heart muscle and brain caused by severe breathing emergencies, respiratory arrest, or shock. Symptoms of a choking victim might include: gasping for air, hand around the neck, cyanosis or pallor and eventually loss of consciousness.
 
   
 
<br>
 
<br>
::::::::::{| class="wikitable"
+
::::{| class="wikitable"
 
|-
 
|-
| '''''The greatest impact on improving the survival chances of a pediatric victim and the key survival to is <u>early ventilation. <br><div align="center">For a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.</div>'''''
+
| '''<div align="center">The greatest impact on improving the survival chances of a pediatric victim and the key survival to is <u>early ventilation.</div>''' <br><div align="center">For a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.</div>'''''
 
|}
 
|}
   
   
  +
::'''3. Procedure:'''
<br>
 
  +
::::a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition
::'''Procedure:'''
 
::::1. If subject is in the MSR, immediately open the door to the MSR. It is not necessary to stop the acquisition.
 
 
 
::::2. Do not attempt to operate the controls for the chair; simply slide the subject out of the chair down to the floor.
+
::::b. Do not attempt to operate the controls for the chair; simply slide the subject out of the chair down to the floor.
   
::::3. Check for victim's responsiveness.
+
::::c. Check for victim's responsiveness.
   
::::4. Shout out for "HELP!" / have the other (second) MEG operator/observer go get /call help.
+
::::d. Shout out for "HELP!" / have the other (second) MEG operator/observer go get /call help.
   
::::5. Call X111 for the emergency medical team.
+
::::e. Call X111 for the emergency medical team.
   
  +
::::{| class="wikitable"
 
::::::::::::{| class="wikitable"
 
 
|-
 
|-
| '''''Remember: For an adult victim call first; for a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.'''''
+
| '''Remember: For an adult victim call first; for a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.'''
 
|}
 
|}
 
 
 
::::6. Assess the victim / Initiate CPR:
+
::::f. Assess the victim / Initiate CPR:
:::::::a. Open airway;
+
:::::i. Open airway;
   
:::::::b. Look, listen, feel for breathing;
+
:::::ii. Look, listen, feel for breathing;
   
:::::::::i. Attempt 2 breaths;
+
:::::iii. Attempt 2 breaths;
   
::::::::::::• If breathes do NOT go in / unable to ventilate there is possibly an obstruction:
+
:::::iv. If breathes do NOT go in / unable to ventilate there is possibly an obstruction:
   
::::::::::::• Re-position the head and attempt ventilation again; if still unable to ventilate;
+
::::::• Re-position the head and attempt ventilation again; if still unable to ventilate;
   
::::::::::::• Give 5 abdominal thrusts (if pregnant or obese - chest thrusts);
+
::::::• Give 5 abdominal thrusts (if pregnant or obese - chest thrusts);
   
::::::::::::• Open then check mouth, sweep to remove seen objects;
+
::::::• Open then check mouth, sweep to remove seen objects;
   
::::::::::::• Attempt to ventilate, if no air goes in, re-position and try again, etc. <br>Continue to try to ventilate along with abdominal thrusts until successful in <br>dislodging obstruction or victim begins breathing on his own.
+
::::::• Attempt to ventilate, if no air goes in, re-position and try again, etc. Continue to try to ventilate along with abdominal thrusts until successful in dislodging obstruction or victim begins breathing on his own.
   
::::::::::::• Check for pulse and respiration after 2 minutes (5 cycles).
+
:::::v. Check for pulse and respiration after 2 minutes (5 cycles).
   
  +
:::::vi. Check for signs of circulation (or lack thereof) – respiration & heart beat / pulse.
:::::::::ii. Once breaths goes in, check for:
 
::::::::::::• Signs of circulation (or lack thereof) – respiration & heart beat / pulse.
 
   
:::::::d. If NO pulse (no circulation) and NO respiration, begin chest compressions and continue to ventilate;
+
::::::. If NO pulse (no circulation) and NO respiration, begin chest compressions and continue to ventilate;
   
:::::::e. If NO pulse (no circulation) but there is respiration, perform chest compressions only,
+
:::::: If NO pulse (no circulation) but there is respiration, perform chest compressions only,
   
:::::::f. If pulse is present, but NO respiration continue to ventilate by giving rescue breaths,
+
:::::: If pulse is present, but NO respiration continue to ventilate by giving rescue breaths,
   
:::::::g. If heartbeat and breathing present, turn victim onto the side (in the Rescue or Recovery position to maintain the airway.
+
:::::vii. If heartbeat and breathing present, turn victim onto the side (in the Rescue or Recovery position to maintain the airway.
   
  +
::::{| class="wikitable"
<br>
 
  +
|-
<div align="center">'''''*An Emergency Cardiac Defibrillator is located in the NMR Center main corridor on the wall'''''</div>
 
<div align="center">'''''next to Room B1D69 (the NMR Center Office) opposite the entrance to the Signa Corridor.'''''</div>
+
| '''<div align="center">An Emergency Cardiac Defibrillator is located in the NMR Center main corridor on the wall next to Room B1D69 (the NMR Center Office) opposite the entrance to the Signa Corridor.</div>'''
  +
|}
   
  +
<div align="center">*Guidelines and instructions for performing CPR: <br> https://www.ors.od.nih.gov/sr/dohs/Documents/CPR%20Study%20Guide%20041106_revised_1.pdf</div>
 
 
<div align="center">*Guidelines and instructions for performing CPR: https://www.ors.od.nih.gov/sr/dohs/Documents/CPR%20Study%20Guide%20041106_revised_1.pdf</div>
 
 
<br>
 
   
 
=== Emergency Contact Information / Numbers ===
 
=== Emergency Contact Information / Numbers ===
 
 
::::::::::::::::::::::'''In case of an emergency contact:'''
+
::::::::'''In case of an emergency contact:'''
   
::::::::::::::::::::{| class="wikitable"
+
::::::::{| class="wikitable"
 
|-
 
|-
 
|''' MEG Director: Dr. Allison Nugent, 301/451-8863'''
 
|''' MEG Director: Dr. Allison Nugent, 301/451-8863'''
 
|-
 
|-
  +
|''' MEG Lab Manager: Anna Namyst, 301/405-2445'''
|
 
 
|-
 
|-
 
| '''MEG Staff Scientist: Dr. Tom Holroyd, 301/402-2362'''
 
| '''MEG Staff Scientist: Dr. Tom Holroyd, 301/402-2362'''
 
|}
 
|}
   
  +
::::::::'''FOR LIFE-THREATENING EMERGENCIES'''
 
  +
::::::::(e.g., Fire, Explosion, Chemical Spill, Radiation Release, Natural Gas Odor, Suspicious/Dangerous Activity)
 
  +
::::::::{| class="wikitable"
:::::::::::::::::::::'''FOR LIFE-THREATENING EMERGENCIES'''
 
:::::::::::::(e.g., Fire, Explosion, Chemical Spill, Radiation Release, Natural Gas Odor, Suspicious/Dangerous Activity)
 
:::::::::::::::{| class="wikitable"
 
 
|-
 
|-
 
| '''Fire''' / '''Ambulance''' ||style="padding-left: 0.5cm;" |'''call 911 or''' <br>'''301 / 496-9911 from cell phone'''
 
| '''Fire''' / '''Ambulance''' ||style="padding-left: 0.5cm;" |'''call 911 or''' <br>'''301 / 496-9911 from cell phone'''
Line 844: Line 648:
   
   
:::::::::::::::::::::'''FOR NON-LIFE-THREATENING EMERGENCIES'''
+
::::::::'''FOR NON-LIFE-THREATENING EMERGENCIES'''
::::::::::::::::::::::(e.g., Damaging Leaks / Flood, Power Outage)
+
::::::::(e.g., Damaging Leaks / Flood, Power Outage)
:::::::::::::::::{| class="wikitable"
+
::::::::{| class="wikitable"
 
|-
 
|-
 
| '''Fire Department''' || '''301 / 496-2372'''
 
| '''Fire Department''' || '''301 / 496-2372'''
Line 857: Line 661:
 
|}
 
|}
   
  +
::::::::{| class="wikitable"
 
 
::::::::::::::::{| class="wikitable"
 
 
|-
 
|-
 
| <br> <div align="center">'''Emergency Communications Center'''</div>
 
| <br> <div align="center">'''Emergency Communications Center'''</div>
Line 882: Line 684:
 
|}
 
|}
   
  +
== Infection Control ==
  +
::In order to interrupt the spread of infection at the point of transmission between the source and host, the following policies and procedures have been established. All staff, MEG Lab users and subjects are required to comply with NIH Clinical Centers infection prevention / infection control policies and procedures, in addition to MEG Lab practices.
   
  +
==== Hand Hygiene ====
<br>
 
  +
::Hand Hygiene is one of the most important steps in infection control in order to prevent the spread of germs. Cleaning your hands often using either soap and water or alcohol hand gel is required by the NIH Clinical Center and the MEG Lab.
   
  +
::1. In general, it is important to wash / clean your hands in each of these situations:
== INFECTION CONTROL ==
 
  +
::::a. After reporting to work (at the beginning of your shift).
'''In order to interrupt the spread of infection at the point of transmission between the source and host, the following policies and procedures have been established. All staff, MEG Lab users and subjects are required to comply with NIH Clinical Centers infection prevention / infection control policies and procedures, in addition to MEG Lab practices.'''
 
  +
::::b. Before and after subject / patient contact.
  +
::::c. Before donning gloves.
  +
::::d. After removing gloves and other personal protective equipment.
  +
::::e. After touching objects that are likely to be contaminated with microorganisms (e.g., equipment or other items, keyboards, telephones / cell phones, doorknobs, stair banister, elevator buttons, etc.
  +
::::f. Whenever hand are visibly soiled.
  +
::::g. After sneezing, coughing or blowing your nose.
  +
::::h. After contact with blood, or other potentially infectious material and equipment or articles.
  +
::::i. When hands are likely to be contaminated with blood, body fluids, secretions or excretions.
  +
::::j. After handling any equipment that comes in contact with subjects with a known infection.
   
  +
::2. In addition when in the MEG Lab, it is important to wash / clean your hands in each of these situations:
===== Hand Hygiene =====
 
  +
::::a. At the beginning and end of each MEG scan.
'''Hand Hygiene is one of the most important steps in infection control in order to prevent the spread of germs. Cleaning your hands often using either soap and water or alcohol hand gel is required by the NIH Clinical Center and the MEG Lab.'''
 
  +
::::b. Before setting up a subject.
  +
::::c. After setting up an EEG / EMG subject.
  +
::::d. After abrading the skin.
  +
::::e. After applying, handling and processing electrodes.
  +
::::f. After Brainsight coregistration.
   
  +
::3. '''If you use Alcohol Hand Gel to clean your hands''', you must wash your hands with soap and water if they are visibly soil and/or after every 10 uses of gel.
   
  +
The [https://www.cdc.gov/ Centers for Disease Control] also have useful information on the use of hand sanitizer: [https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html Handwashing: Show Me the Science]
'''''In general, it is important to wash / clean your hands in each of these situations:'''''
 
:::•After reporting to work (at the beginning of your shift).
 
:::•Before and after subject / patient contact.
 
:::•Before donning gloves.
 
:::•After removing gloves and other personal protective equipment.
 
:::•After touching objects that are likely to be contaminated with microorganisms (e.g., equipment or other items, keyboards, telephones / cell phones, doorknobs, stair banister, elevator buttons, etc.
 
:::•Whenever hand are visibly soiled.
 
:::•After sneezing, coughing or blowing your nose.
 
:::•After contact with blood, or other potentially infectious material and equipment or articles.
 
:::•When hands are likely to be contaminated with blood, body fluids, secretions or excretions.
 
:::•After handling any equipment that comes in contact with subjects with a known infection.
 
   
  +
==== Use of Personal Protective Equipment (PPE) / Protective Barriers ====
<br>
 
'''''In addition when in the MEG Lab, it is important to wash / clean your hands in each of these situations:'''''
 
:::•At the beginning and end of each MEG scan.
 
:::•Before setting up a subject.
 
:::•After setting up an EEG / EMG subject.
 
:::•After abrading the skin.
 
:::•After applying, handling and processing electrodes.
 
   
  +
::Personal Protective Equipment (PPE) - gloves, gown, plastic apron, masks, protective goggles and impervious barrier will be used, if transfer, aerosolization or splattering of particulate matter is likely to occur. If item(s) are visibly soiled dispose of in a Medical Pathological Waste (MPW) Box otherwise disposed in the trash.
 
:::'''''*If you use Alcohol Hand Gel to clean your hands, you must wash your hands with soap and water IF THEY ARE VISIBLY SOILED AND/OR AFTER EVERY 10 USES OF HAND GEL.'''''
 
   
  +
::'''1. Gloves will be used when:'''
<br>
 
  +
::::a. Abrading skin,
  +
::::b. Cleaning, disinfecting or handling equipment used on abraded skin,
  +
::::c. Handling all soiled instruments and equipment,
  +
::::d. In contact with a patient/subject with a known infectious disease,
  +
::::e. During Brainsight localization,
  +
::::f. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
   
===== Use of Personal Protective Equipment (PPE) / Protective Barriers =====
+
:::'''2. Workspace Protective Impervious Barrier are used:''' -
  +
::::a. To cover the work area when abrading the skin to place “contaminated/used” equipment or supplies.
  +
::::b. When temporarily maintaining any item considered contaminated if needed for additional use,
  +
::::c. To place all soiled instruments and equipment,
  +
::::d. To place items that have come in contact with a patient/subject with a known infectious disease,
  +
::::e. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
  +
::::f. Any items placed on this barrier will be considered contaminated and must be disposed of or cleaned using Dispatch or Asepti-Wipe II.
  +
::::g. The barrier will be discarded after each use and the physical work surface will be disinfected using Hydrogen Peroxide Disinfectant, Dispatch or Asepti-Wipe II.
   
  +
==== Studies Requiring A Blood Draw or Infusion/Injection during a MEG Scan ====
'''Personal Protective Equipment (PPE) - gloves, gown, plastic apron, masks, protective goggles and impervious barrier will be used, if transfer, aerosolization or splattering of particulate matter is likely to occur. If item(s) are visibly soiled dispose of in a Medical Pathological Waste (MPW) Box otherwise disposed in the trash.'''
 
  +
::'''During an MEG scan that involves drawing blood or Infusion/Injection MEG infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab Infection Prevention / Infection Control Policies and Procedures and must comply with all Clinical Center Infection Control Policies and Procedures.'''
   
  +
::1. All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.
   
  +
::2. Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.
::•'''''Gloves will be used when:'''''
 
::::-abrading skin.
 
::::-handling, cleaning or disinfecting equipment used on abraded skin.
 
::::-handling all soiled instruments and equipment.
 
::::-in contact with a patient/subject with a known infectious disease.
 
::::-in accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
 
   
  +
::3. “Contaminated” gloves will be discarded before touching any other items in the MEG lab.
   
  +
::4. After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.
::•'''''Protective Impervious Barrier will be used when:'''''
 
::::-items used on abraded skin, i.e., electrodes, electrolyte, Q-tips, gauze, etc.; the items will be immediately disposed of or placed on a impervious barrier for further use.
 
::::-items used on a subject/patient with a known infectious disease, the physical work area surface will be covered with a barrier which will be used to place “contaminated/used” equipment or supplies.
 
   
  +
::5. All surfaces (prep table, cabinets) will be wiped with Dispatch after use.
<br>
 
<div align="center">'''''*Any items placed on this barrier will be considered contaminated and must be disposed of or cleaned using Dispatch or Asepti-Wipe II.'''''</div>
 
<div align="center">'''''**The barrier will be discarded after each use and the physical work surface will be disinfected using Hydrogen Peroxide Disinfectant, Dispatch or Asepti-Wipe II.'''''</div>
 
   
  +
::6. All MEG Lab staff will monitor participants for compliance.
<br>
 
   
===== Studies Requiring A Blood Draw during a MEG Scan =====
 
'''During an MEG scan that involves drawing blood MEG infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab Infection Prevention / Infection Control Policies and Procedures (9.00, 9.20, 9.30, 9.40) which are posted in the Policy & Procedures Manual located in the MEG lab and also on the MEG lab website (http://kurage.nimh.nih.gov/meglab). In addition, nurses and staff must comply with all Clinical Center Infection Control Policies and Procedures.'''
 
 
 
::'''Policy:'''
 
::::• All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.
 
 
::::• Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.
 
 
::::• “Contaminated” gloves will be discarded before touching any other items in the MEG lab.
 
 
::::• After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.
 
 
::::• All surfaces (prep table, cabinets) will be wiped with Dispatch after use.
 
 
::::• All MEG Lab staff will monitor participants for compliance.
 
 
 
<div align="center">'''''*Anyone who has not received MEG lab Infection Control training should contact the MEG Lab Manager as soon as possible.'''''</div>
 
<div align="center">'''''Please refer to MEG P&P on Infection Control posted on the MEG Lab website: http://kurage.nimh.nih.gov/meglab/ under “User Information”.'''''</div>
 
 
<br>
 
   
===== Non-Disposable Electrodes / EEG Caps / Other Non-Disposable Equipment =====
+
==== Non-Disposable Equipment in Contact with Abraded Skin ====
'''All non-disposable electrodes, EEG caps and other equipment that comes in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization. It is the responsibility of the MEG User to place any used / "contaminated" equipment in a hospital approved transport container, fill out the appropriate SPS form and then place the container on the SPS cart in the MEG lab. MEG staff will then transport and pickup all MEG equipment.'''
+
::All non-disposable electrodes, EEG caps and other equipment that comes in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization. It is the responsibility of the MEG User to place any used / "contaminated" equipment in a hospital approved transport container, fill out the appropriate SPS form and then place the container on the SPS cart in the MEG lab. SPS staff will collect and transport all MEG equipment that requires disinfection/sterilization.
   
 
:::::{| class="wikitable"
 
:::::{| class="wikitable"
 
|-
 
|-
| '''Each User/Research Assistant''' || - will be responsible for preparing the “used / contaminated” item(s) for disinfection/sterilization by SPS after each use.
+
| '''Each User''' || - will be responsible for preparing the “used / contaminated” item(s) for disinfection/sterilization by SPS after each use.
 
|-
 
|-
 
| ''' Sterile Processing Services (SPS)''' ||- will provide disinfection and sterilization services in compliance with standard operating procedures.
 
| ''' Sterile Processing Services (SPS)''' ||- will provide disinfection and sterilization services in compliance with standard operating procedures.
  +
- will be responsible for transporting the equipment to SPS for disinfection/sterilization.
 
|-
 
|-
 
| '''MEG Core Staff''' || - will provide each user instructions regarding preparing “used”/contaminated MEG equipment for disinfection/sterilization.
 
| '''MEG Core Staff''' || - will provide each user instructions regarding preparing “used”/contaminated MEG equipment for disinfection/sterilization.
  +
-will be responsible for transporting the equipment to SPS for disinfection/sterilization.
 
 
|}
 
|}
   
  +
::'''1. Non-Disposable Electrodes'''
 
  +
::{| class="wikitable"
<br>
 
  +
|-
 
  +
|<div align="center">'''REMEMBER!'''</div>
::'''I. Non-Disposable Electrodes'''
 
::::::{| class="wikitable"
 
 
|-
 
|-
|<div align="center">'''REMEMBER!'''</div> <br>'''Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes and all non-disposable electrodes <br><div align="center">that come in contact with skin that has been abraded will be considered “contaminated” and <br><div align="center">MUST BE sent to Sterile Processing Services (SPS) for disinfection / sterilization.</div>'''
+
|<div align="center">Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes and all non-disposable electrodes that come in contact with skin that has been abraded will be considered “contaminated” and <b>must be </b> sent to Sterile Processing Services (SPS) for disinfection / sterilization.</div>'''
 
|}
 
|}
 
 
   
  +
::::a. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
   
  +
::::b. Place the disk end of the electrode in the zippered section of the 2 pocket zip lock plastic bag.
:::'''Procedure:'''
 
::::1. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
 
   
::::2. Place the disk end of the electrode in the zippered section of the 2 pocket zip lock plastic bag.
+
::::c. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
   
::::3. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
+
::::d. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
   
::::4. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
+
::::e. Place the lid on the Biohazard Container.
   
::::5. Place the lid on the Biohazard Container.
+
::::f. Place the Biohazard Container on the top shelf of the CHS Processing Cart.
   
  +
::::g. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
::::6. Place the Biohazard Container on the top shelf of the CHS Processing Cart.
 
   
  +
::::h. SPS staff will collect the Biohazard Container and take to their facilities for disinfection/sterilization.
::::7. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
 
   
  +
::::i. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.
::::8. MEG staff will transport the Biohazard Container to CHS for disinfection/sterilization.
 
   
::::9. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.
 
   
  +
::2. '''Non-Disposable EEG Cap – i.e., Easy Cap'''
   
<br>
 
 
::'''II. Non-Disposable EEG Cap – i.e., Easy Cap'''
 
 
::{| class="wikitable"
 
::{| class="wikitable"
 
 
|-
 
|-
| '''All EEG caps, including the EasyCap, that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization.'''
+
| <div align="center">All EEG caps, including the EasyCap, that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization. </div>
 
|}
 
|}
   
  +
::::a. Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
   
  +
::::b. All electrodes will be removed from the cap and processed separately from the electrodes.
:::'''Procedure:'''
 
::::1. Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
 
   
::::2. All electrodes will be removed from the cap and processed separately from the electrodes.
+
::::c. The cap will be placed in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
  +
::::d. The Biohazard Container will then be placed on the top shelf of the SPS processing cart.
   
::::3. The cap will be placed in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
+
::::e. Place the lid on the Biohazard Container.
   
::::4. The Biohazard Container will then be placed on the top shelf of the CHS processing cart.
+
::::f. The Sterilization Request Form will be filled out for each container and placed on top of the appropriate closed container.
   
::::5. Place the lid on the Biohazard Container.
+
::::g. MEG staff will transport the Biohazard Container to SPS for disinfection / sterilization.
   
  +
<br>
::::6. The Sterilization Request Form will be filled out for each container and placed on top of the appropriate closed container.
 
   
  +
::'''3. The VSM EasyCap and Electrodes'''
::::7. MEG staff will transport the Biohazard Container to SPS for disinfection / sterilization.
 
  +
::Currently, VSM EasyCap and electrodes are used exclusively by the NINDS EEG Department. VSM EasyCap and electrodes will be cleaned and disinfected per manufacturers’ instructions in the NINDS EEG Department. Cleaning / disinfection will be performed using NIH approved chemical disinfectants according to Hospital Epidemiology Service requirements in hospital approved designated area(s) only. Additional laboratories wishing to use the VSM EasyCap should work with the MEG Core Facility and Hospital Epidemiology Service to deploy appropriate cleaning / disinfection procedures.
   
  +
::'''4. Other Non-Disposable Equipment'''
<br>
 
   
::'''III. Other Non-Disposable Equipment'''
 
 
::{| class="wikitable"
 
::{| class="wikitable"
   
 
|-
 
|-
|'''All Electrode Bars / Stimulating Bars / Twisted Pair / Ground Electrodes that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization.'''
+
|<div align="center"> All Electrode Bars / Stimulating Bars / Twisted Pair / Ground Electrodes that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization.</div>
 
|}
 
|}
   
  +
::::a. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
   
  +
::::b. Place the disk / bar / electrode end in the zippered section of the 2 pocket zip lock plastic bag.
:::'''Procedure:'''
 
::::1. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
 
   
::::2. Place the disk / bar / electrode end in the zippered section of the 2 pocket zip lock plastic bag.
+
::::c. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
   
::::3. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
+
::::d. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
   
::::4. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
+
::::e. Place the lid on the Biohazard Container.
   
::::5. Place the lid on the Biohazard Container.
+
::::f. Place the Biohazard Container on the top shelf of the SPS Processing Cart.
   
  +
::::g. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
::::6. Place the Biohazard Container on the top shelf of the SPS Processing Cart.
 
   
  +
::::h. SPS staff will collect the Biohazard Container and take to their facilities for disinfection/sterilization.
::::7. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
 
   
  +
::::i. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.
::::8. MEG staff will transport the Biohazard Container to SPS for disinfection/sterilization.
 
   
  +
==== Non-Disposable Equipment in Contact with Non-abraded Skin ====
::::9. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.
 
   
  +
::'''1. All Portable Non-Disposable equipment''', i.e., head localization coils and Brainsight stylus, that comes in contact with un-abraded and otherwise intact skin (including sweat) will be cleaned using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol.
<br>
 
  +
::::a. Wash hands.
  +
::::b. Wipe the Head Localization Coils with alcohol.
  +
::::c. Adhesive Remover may be used occasionally to remove any adhesive buildup or sticky residue.
  +
::::d. Wash hands.
  +
  +
::'''2. Known Infectious Disease (Abraded or Un-Abraded Skin)'''
  +
::::a. All Portable Non-Disposable / Reusable Equipment used by a patient with a known infectious disease will treated as equipment used on abraded skin ([[Safety#Non-Disposable Equipment in Contact with Abraded Skin | See Non-Disposable Equipment in Contact with Abraded Skin]]) and be sent to Sterile Processing Services for disinfection /sterilization.
  +
  +
====Disposable / single use equipment====
  +
  +
::'''1. Routine Procedure for Single Use Equipment used on Abraded or Un-abraded Skin'''
  +
::::a. All Disposable / Single Use Equipment used abraded skin will be disposed of in the trash. Gloves will be used when abrading the skin.
  +
  +
::'''2. Known Infectious Disease (Single Use Equipment)'''
  +
::::b. All Disposable / Single Use Equipment used by a patient with a known infectious disease must be disposed of in a '''Medical Pathological Waste (MPW) Box'''.
  +
  +
====Non-portable non-disposable / reusable equipment====
  +
  +
::1. All Non-Disposable Immobile or Non-Immersable equipment that comes in contact with a subject/patient will be routinely cleaned by the person(s) conducting the MEG scan using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol after each subject/patient use.

Latest revision as of 22:13, 20 January 2022

User and Staff Safety Responsibilities

Safe laboratory practices will be employed by all MEG staff and MEG Users to preclude any preventable accidents or occurrences. MEG staff will monitor MEG Users for compliance.
1. User Responsibilities - All MEG users:
a. Must attend MEG Orientation and Training before being allowed to operate any MEG lab equipment. Each person will be responsible for familiarizing themselves with the safe operation of all MEG equipment used in their experiment.
b. Must adhere to MEG Core Facility policies and procedures. The Policy and Procedures Manual will be located at the Analysis Console for reference and also on the NIH MEG website.
c. May NOT bring any “unapproved” or “special” equipment into the lab for use unless first approved by the Director and/or Staff Scientist. In addition, before any user’s equipment can be used in the lab it must be tested for electrical safety.
d. Must familiarize themselves with the properties of helium gas / liquid helium. Information on the safe handling of Helium is included in the Material Safety and Data Sheet (MSD) Manual located at the Analysis Console for reference.
e. Will be responsible for reporting any hazard or potential hazard.
i. Immediately notify MEG Core staff of any defective equipment, malfunction or any improperly working equipment or medical devices used for patient / subject testing using the Problem Report Form (under construction)
ii. All events, occurrences or variances to normal operations, policies, procedures, and practices involving any users, subjects / patients and / or equipment must be documented via the Problem Report Form (under construction).
ii. Users are responsible for identifying and labeling any non-functional or hazardous equipment with an “Out of Service / Do Not Use” sticker, in addition to completing the Problem Report Form (under construction)
f. Are encouraged to participate in the MEG Quality Assurance / Quality Improvement Program.
Users are encouraged to make suggestions and provide feedback to MEG staff, by directly contacting the lab manager (Anna Namyst), the staff scientist (Tom Holroyd), and director (Allison Nugent).
g. Are responsible for subject / patient safety while conducting studies in the MEG Core Facility.
i. Full details of user and scanning requirements are found in the [User Guidelines] Section of this guide.
ii. When scanning, subjects must be observed at all times. The subject must never be left alone in the MSR without a user in the control room for any reason.
iii. Two (2) operators are required to be in the room when scanning, one of which is capable of operating the equipment.
iv. All personnel attending scans must complete a MEG orientation.
v. Clinical coverage is required for all invasive studies; other patient studies may require the presence of individuals with CC clinical credentials at the discretion of MEG Core Facility Staff.
h. Must provide a safe environment for all patients and employees.
i. All passageways, doorways and exits are clear at all times. Shoes are not to be left in front of the MSR door.
ii. All power cords should be in good condition.
iii. When in use, all electrical cords are unwrapped.
iv. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
i. Must maintain patient privacy and confidentiality, and not leave PII in the MEG laboratory.
i. Must adhere to the Clinical Center’s policies and procedures regarding safe laboratory practices.


2. Staff Responsibilities - The MEG Staff:
a. The MEG Core Facility staff will provide a safe working environment for all patients, users and employees.
b. Will maintain a clean, neat, and safe work environment.
c. Will maintain a respectful and professional work environment.
c. All employees are constantly alert for unsafe conditions within the work area. If unsafe conditions are discovered, employees initiate immediate corrective action.
d. Will report unsafe conditions beyond the capability of the employee to correct to the proper authorities for remedy.
e. Some measures to be taken to eliminate hazards and prevent accidents are:
i. All passageways, doorways and exits are clear at all times.
ii. All power cords are kept in good condition.
iii. When in use, all electrical cords are unwrapped.
iv. Power strips are kept at least 2 inches off the floor.
v. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.
vi. All file cabinet drawers are closed when not in use.
vii. Spills are cleaned immediately after they occur.
iix. All employees are informed about the location and use of the Material Safety Data Sheets (MSDS).
ix. All employees know the fire safety and evacuation plans.

MEG Lab System Monitors

MEG System Monitors evaluate the performance and integrity of MEG equipment. There are 3 monitors located in the MEG Lab.

PureAire Oxygen Monitor

1. The PureAire Oxygen Monitor - gives an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipment. Measures the percentage of oxygen (O2) in the MEG lab. Remote display located in the MEG Lab on the wall just outside the MSR (Magnetically Shielded Room).
Normal Atmosphere Oxygen Level 19.6-22% O2 level should be at about 20.9%
Enriched Atmosphere Oxygen 22.0% or more *can promote fires (burning)
Deficient Atmosphere Oxygen reading 19.5 or less *can lead to a loss of consciousness and/or asphyxiation
2. If the AirPure Oxygen Monitor Sounds due to low oxygen:
a. Open the door to the MSR;
b. Open both doors to the lab;
c. Evacuate the lab if necessary;
d. Notify MEG Lab staff immediately.

Gilmont Gas Flow Meter

1. ::The Gilmont Gas Flow Meter monitors the rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment. Located inside the MSR near the back-left wall.

Helium Boil-off Gas Flow Rate
Normal Gas Flow Rate 28
High Gas Flow Rate 40 (*alarm will sound)
*Please note that the gas flow rate level normally fluctuates within a certain range.


2. :: Normal Conditions When The Alarm Might Go Off:

a. If it is windy outside (until the wind subsides).
b. After a fill the flow rate might get as high as 40 (but should go back down to 28 within a reasonable period of time).

3. :: What to do if the Helium Boil-Off alarm goes off

a. Re-set the alarm - if you know that it is windy outside re-set the alarm. Instructions are next to the alarm.
b. If you are unsure about resetting the alarm please seek MEG staff for assistance.
c. Notify MEG Core Facility Staff.

Optalarm Flowmeter

1. The Optalarm Flow Meter monitors the HE exhaust gas flow / measures the total flow rate of the MEG system and gives audible and visual alarm if flow rate is outside normal range which is an indication of the general performance and integrity of the MEG Dewar and related equipment. There is a high alarm and low alarm setting.
2. The meter is located outside the MSR on the back-left wall
3. During a liquid helium fill, after removing the Vent Port Safety Relief Cap the flow rate might get as high as 100 causing the alarm to go off. To prevent this, the alarm can be turned off during the fill. The level should go back down to 50 within a reasonable period of time after the fill.
4. The exhaust pipe is located on the roof of the building and the alarm may go off when it is windy outside. The solution is simply to re-set the alarm. Usually, if the problem is the wind the alarm can be re-set by pushing the Alarm Reset button (twice).
5/ However, if the alarm does not turn off after being re-set (stays on continuously) this might be an indication that there is a problem with the integrity of the system which is causing more boil-off (exhaust) than normal. In this case, notify MEG staff as soon as possible.


Optalarm Helium Gas Flow Meter
If the alarm goes off Alarm Reset Procedure:


a. Press the RE-SET button twice.
b. If the alarm continues to go off or stays on continuously after re-setting notify the MEG lab staff immediately.

AMI Model 135 Liquid Helium Level Monitor

1. The AMI Model 135 Liquid Helium Level Monitor measures the amount of helium inside the MEG Dewar. It is located on the stand just outside the MSR. This monitor lets MEG staff know when it is time to perform a helium fill. This is used and attended to by MEG staff only; MEG Users should never need to check this monitor.
Liquid Helium Level in the Dewar
Normal Range 1 - 38
Upper Limit 39.0
Lower Limit 0
*Should never go below 0 (zero)
2. Checking the Helium Level in the Dewar:
a. Plug in the monitor cable. The plug is located inside the MSR near the back-left wall.
b. Check and record the reading on the QA / Maintenance Log.
c. If the level is approaching 0 (zero) a liquid Helium Fill should be performed; notify appropriate lab personnel.
d. When filled the Liquid Helium Level should not exceed 39.0.
e. If an overfill occurs:
f. Keep the door to the MSR open;
g. Leave the Dewar at 55 degrees for 12 to 24 hours.

Laboratory Gas Safety / Safe Handling of Laboratory Gases

Liquid Helium
Users of Liquid Helium will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices.
1. All MEG staff and users must familiarize themselves with the properties of Liquid Helium. Refer to the Material Safety and Data Sheet (MSDS) Manual.
2. The contents of Liquid Helium Storage Dewars must be identified with decals, stencils, or other markings on the outside of the Dewar.
a. Color codes alone or tags hung on the outside of the Dewar are not acceptable.
b. Dewars lacking proper identification must not be accepted from the vendors.
3. Liquid Helium Storage Dewars are transported by using the handle to pull the Dewar; they must never be pushed. Always keep the Dewar in the upright position.
4. Liquid Helium Storage Dewar will be transported with the Relief Isolation Valve OPEN so that pressure does not build up in the storage dewar.
5. The cylinder contents must be permanently attached to the outside of the Dewar. This identification shall not be removed, covered or defaced.
6. Liquid Helium will not be used in environmental rooms unless there is adequate ventilation and/or an oxygen monitor with an audible alarm is present and permission has been granted by the Safety Officer.
7. Liquid Helium will be handled using the appropriate care and protective equipment, i.e., face shield and cryogloves, as necessary because contact can cause severe frostbite.
8. The safety warnings located on the Helium Storage Dewar will always be followed.
9. Empty cylinders will be marked “EMPTY”.
What to do if there is a Helium Cylinder / Storage Dewar Leak
Indication:

You might hearing hissing sound coming from the helium gas cylinder and / or feel air coming from the container.

Course of Action:
1. Cylinder Leak – if this happens:
a. Notify MEG Core Staff immediately
b. If there are reasons to believe that a cylinder is leaking, test for the leak by painting soapy water over the valves and connections. This will indicate most gas leaks.
c. Do not attempt to repair leaks caused by loose valve stem packing.
e. Leaking storage Dewars of liquid helium will be moved to a well-ventilated area. There is no potential harm if helium does not critically displace the amount of oxygen.
f. The Dewar must be labeled indicating the problem.
g. The vendor will be called for pickup.
h. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
*Note: Leaks from cylinders of toxic or flammable gases require immediate attention.


What to do if there is an MEG Dewar Leak / Spontaneous Warm Up
Indication:
1. MEG Dewar Leak - If there is condensation on the inside of the dewar helmet, it is likely that the inside of the helmet is becoming "soft" (has developed a leak).
2. Spontaneous MEG Dewar Warm Up- If the vacuum on the inside of the Dewar becomes soft a spontaneous warm up of the liquid Helium will likely occur resulting in:
a. Leaking of helium;
b. Helium Level Meter reading will likely increase dramatically causing the Helium Boil-Off Alarm to go off.
c. Pressure inside the Dewar MIGHT possibly build up causing helium to leak from the ports on the top of the dewar resulting in helium escaping into the magnetically shielded room (MSR) causing the Oxygen Alarm to go off.
Course of Action:
1. MEG Dewar Leak Notify MEG Core Facility Staff immediately
2. Spontaneous MEG Dewar Warm Up- if this happens:
a. Open the door and evacuate the MSR.
b. Open the door to the MEG lab.
c. Turn off the rack. Discontinue scanning; the system can not be operated in the warm state.
d. Turn off the Helium Alarm.
e. Turn off the Oxygen Alarm.
g. Notify MEG Core Facility Staff immediately


Compressed Helium Gas
Users of Compressed Helium Gas will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices. Refer to the Material Safety and Data Sheets (MSDS) located in the MEG Lab.


1. Compressed Helium Gas Cylinders:
a. The contents of Compressed Helium cylinders must be identified with decals, stencils, or other markings on the cylinders. Color codes alone or tags hung around the necks of the cylinders are not acceptable. Cylinders lacking proper identification must not be accepted from the vendors.
b. Helium Cylinders will not be accepted from the vendors unless the valve safety covers are in place and properly tightened.
c. Compressed Helium cylinders will be secured always so they cannot fall.
d. Valve safety covers will be in place until pressure regulators are ready to be attached.
e. The cylinder contents are permanently attached to the cylinders. This identification shall not be removed, covered or defaced.
f. Cylinders will be moved on chain equipped hand trucks or carts; they are never rolled or dragged.
g. Employees will not attempt to repair cylinders or cylinder valves, or to force stuck or frozen cylinder valves.
h. The cylinder valve will not be opened or cracked without first attaching the proper pressure regulator.
2. Pressure Regulators and Needle Valves:
a. The valve fittings of Liquid Helium cylinders must be valves attachments that are safe for use with Liquid Helium. Use of adapters to connect regulators to cylinder valves defeats this safeguard and is not authorized. Only pressure regulators and needle valves approved for the compressed Liquid Helium gases may be used.
b. Threads and points of unions must be clean. These surfaces must be inspected before they are connected.
c. When attaching regulators or needle valves, the connections must be tightened firmly. Wrenches of the proper size should be used. Pliers should not be used as they damage the soft brass nuts.
d. Do not apply excessive force when attaching the regulator or valve. Need for excessive force often indicates that the regulators or needle valves do not fit the cylinders.
e. Leaks at the unions between the regulators and the cylinder valves are usually due to damage to the faces of the connections. Attempts to force a tight fit may damage the previously undamaged half of the connection.
f. If the cylinder valve faces are damaged, the cylinders will be returned to the vendors. Employees will not attempt to repair them.
g. Damaged regulators will not be used until repaired.


3. Cylinder Leaks:
a. Unless there are reasons to believe that cylinders are leaking, testing for leaks may be done after the pressure regulators are attached to the cylinder valves and the valves opened.
b. Soapy water painted over the valves and connections will be performed if a leak is suspected.
c. Personnel will not attempt to repair leaks caused by loose valve stem packing.
d. Leaking cylinder of compressed Helium gas will be returned to the vendor.
e. Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.


4. Empty Cylinders:
a. A small amount of gas must be left in the cylinders and the cylinder valves must be closed to prevent contamination of the inside of the cylinders.
b. Empty cylinders should be marked “EMPTY”.
c. Valve safety covers and the labels showing contents must be in place.
d. Empty cylinders should be stored separately from full cylinders.
e. Empty cylinders must be secured at all times so they can not fall.

Emergency Procedures

The MEG Lab has established emergency procedures, which are consistent with the Clinical Center's policies and procedures, to be followed in response to various potential emergency events.

Emergency Evacuation Plan

The Emergency Evacuation Plan has been created in order to facilitate the safe and orderly evacuation of staff, visitors and volunteers from the lab and/or building in case of an emergency. Refer to the MEG Emergency Evacuation Floor Plan Map which is posted inside the MEG Lab at each door and also outside the B1/D65B door.

1. One person will be designated the primary Evacuation Team Leader (ETL) for the MEG Core Facility. The evacuation team leader will be responsible for leading the evacuation and accounting for all staff, subjects, and visitors.
MEG Lab Emergency Evacuation Team Leaders (ETL)
Building 10 / Floor: B1; Corridor D; Room: 65B
Primary ETL: Anna Namyst (lab manager)
Phone: 301.402.2445
Bldg/Rm: 10 / B1D65B
Secondary ETL: Dr. Tom Holroyd
Phone: 301.402.2362
Bldg/Rm: 10 / B1D65A
2. In the event that an evacuation is ordered, the ETL and/or other MEG Core Facility staff will evacuate the lab including all subjects / visitors.
3. All staff and subjects and visitors will report to ETL.
4. Individuals with disabilities will be assisted by one or more persons (aides) assigned by the ETL. The aides will assist the individual(s) to the nearest elevator lobby to await evacuation by the fire department.
5. Elevators must NEVER be used for emergency evacuation unless the elevators are under the direction of the fire department, or are equipped with special systems and are pre-approved for evacuation.
6. Alternate exits should also be used if the primary exit is inaccessible. Refer to the MEG Emergency Evacuation Floor Plan.
7. Upon exiting the building, assemble far enough away as not to interfere with the arrival of fire apparatus and the activities of emergency responders, in an area that provides adequate safety for evacuees. Report to the ETL so that everyone is accounted for then wait for further instruction from the ETL.
8. Occupants may return to the building only when authorized by the Senior Fire Officer, Police Officer, or the Occupant Emergency Coordinator (OEC).
9. The nearest Fire Extinguisher is located just outside the MEG Core Facility.
10. Fire Alarm Pull Stations are located at each end of the NMR Center main corridor and at all Emergency Exits.

Emergency Evacuation Routes

1. If an evacuation is ordered, MEG Core Facility staff will evacuate the lab, including all subjects / visitors via the primary evacuation route (the nearest exit) as directed by the ETL. The secondary exit should be used if the primary exit is inaccessible. And the alternate route should only be used if both the primary and secondary exit are not an option.
PRIMARY EVACUATION ROUTE – To Loading Dock:
 *There are 4 or 5 stairs leading down to the sidewalk.
• From the MEG Corridor, turn left down the main NMR Center corridor.
• Turn RIGHT at the first corridor (MRI Corridor).
• At the end of the MRI Corridor, turn left down the
Animal Corridor; go through the double doors.
• Turn right at the exit sign to the loading dock.
• Go through the EMERGENCY EXIT double doors to the back loading dock.


If for some reason the primary evacuation route is blocked by smoke or inaccessible the WEST SIDE (SECONDARY) EMERGENCY EXIT may be used to evacuate the building.
SECONDARY EVACUATION ROUTE – West Side Emergency Exit / outside Bld. 10:
         *There are 6 or 7 stairs leading down to this exit.
• From the MEG corridor, proceed left down the main NMR Center corridor towards room B1D67
(past the signs for the Laboratory of Cardiac Energetics).
• Go through the EMERGENCY ONLY EXIT door down the stairs to the outside of the building.
• This exit leads to the west side of Building 10.


If during an emergency, the Primary Evacuation and the Secondary Evacuation Routes are blocked by smoke or other hazards use the Alternate Exit. The Alternate Exit should only be used if the Secondary Exit is inaccessible.
ALTERNATE EVACUATION ROUTE– Towards Cafeteria/ Elevators / Front of Building 10:
• From the MEG corridor, turn right down the main NMR Center corridor towards the nearest exit.
• Go through the EXIT door.
• Follow the sign to the cafeteria.
• This exit leads to the main building towards the cafeteria and elevators,
i.e., toward the front of Building 10


Fire Safety Plan

The MEG Lab has established a Fire Safety Plan in order to define the scope and method for immediate, positive and orderly action to safeguard life and property during a fire emergency.
1. The NIH utilizes a zoned evacuation system. When and if the fire alarm signal sounds and the flashing emergency strobe light has been activated in a particular area the occupants in that zone or area of the building must evacuate the building. This alarm is usually followed by recorded instructions to the occupants. Other areas may not be required to evacuate unless their zone fire alarm system has been activated as well.


2. The MEG Core Facility Evacuation Team Leader(s) (ETL) may designate Assistant Team Leaders (ATL) to help with the evacuation.
3. During a fire emergency:
a. The ETL will be responsible for the orderly evacuation of and accounting for all staff, subjects and visitors;
b. The ATL will help to carry out the instructions of the ETL and assists all patients / visitors in the case of an evacuation.
Remember:
R.A.C.E.
R - Rescue anyone in danger.
A - Activate the nearest fire alarm box and
Dial 911 to notify others in the area of the emergency.
C - Confine the fire by closing all doors.
E - Evacuate the lab.
4. If there is a small fire which may be contained using a fire extinguisher:
a. The nearest fire extinguisher is located outside the MEG Lab.
b. Extinguish the fire only if it can be done without endangering anyone, after notifying the NIH Fire Department.
c. When using a fire extinguisher, fight the fire from a position accessible to an exit to avoid entrapment; if in doubt, evacuate the area and wait for the NIH Fire Department to arrive.
Remember:
P.A.S.S.
A. Pull the safety pin
B. Aim the nozzle
C. Squeeze the handle and
D. Sweep from side to side at the
base of the fire until it goes out.
5. Fire Evacuation Procedures:
a. Close all doors as you leave (close the MSR door if safe to do so).
b. Walk to the nearest FIRE ALARM PULL STATION which is located in the NMR Center main corridor on the wall between the Waiting Area and the door leading to the main building; activate the alarm.
c. Dial 111 from the nearest phone.
d. All staff, subjects, users and visitors must evacuate the zone or the building using the Primary Evacuation Route.
e. If the Primary Evacuation Route is blocked or inaccessible use the Secondary Route.
f. The ETL will designate a place away from the building for everyone to meet.
g. Everyone (all staff, subjects, users and visitors) will report to the ETL and remain
outside at the designated area until all persons have been accounted for or until otherwise instructed by the ETL.
h. Refer to the MEG Emergency Evacuation Floor Plan Map which is posted inside the MEG Lab at each door and also outside the B1/D65B door.


Power Failure

In the event of a power failure, the appropriate action will be determined by the MEG Evacuation Team Leader (ETL). If the power fails, the emergency backup lights in the lab and the MSR will automatically activate. The ETL will determine whether to evacuate the MEG Lab; if evacuation is necessary the Lab will be evacuated in a safe and orderly manner.
1. Discontinue testing and evacuate all staff and subjects / patients.
2. Turn off all computers and other electrical equipment, if safe to do so.
3. Call / contact Maintenance at 496-5862 to report the power outage.
4. Notify MEG Core staff.
5. If determined appropriate, evacuate to the nearest area which does have power; listen for emergency communications/ announcements over the PA system.
6. Return to the facility when power has been restored and / or when it has been determined that it is safe to do so.
7. All emergency backup lights and flashlights will be tested once a year to assure that they are operable.


Flashlights are located on the top shelf of the "Supply Cabinet' nearest the B1D65B door. Batteries are located in the "Equipment Cabinet".

Chemical / Biological Incident

1. If a biological incident were to occur, it is important to take immediate and appropriate action in order to:
a. limit exposure to the potentially harmful chemical or biological substances
b. to evacuate the immediate area of the contamination and
c. to contain or close-off the contaminated area.
2. Procedure:
a. Evacuate the room and close doors.
b. Call the Fire Department by dialing 111 (on campus).
c. Notify MEG Core Facility staff immediately.
d. Remove contaminated clothing and wash any parts of the body which may have come in contact with the hazardous material.
e. Do not permit anyone to enter the room/area until the appropriate authorities determine that the area is safe.
f. After safely evacuating, any person(s) who may have become contaminated should be restricted to a single staging area and not permitted to move freely to other locations. Moving to other locations may create a contamination concern to other occupants and/or other areas of the building.
g. If a patient or subject is involved, notify the physician in charge and the Chief of Nursing Service or the Nursing Supervisor, along with the institute clinical director
The nearest Emergency Eye Wash Stations in the NMR Center are located in the Patient Prep Rooms (B1D 302 and B1D 304).
The nearest showers are located on the 1st floor directly above the MEG Lab (Rm 1D 070).

Medical Emergency - Possible Seizure Event

In the event a possible seizure / medical emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. A seizure is a medical condition where a person may or may not lose consciousness. There might be jerking of a body part, incontinence, tongue biting, a lack of responsiveness / blank stare or other neurological symptoms. It is important that any person observing the event assures that the victim does not injure him/herself and that they get immediate assistance / medical care, if at all indicated.


1. In the event of a suspected seizure without loss of consciousness:

a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition.
b. If seated, slide the subject/person out of the chair; If necessary, help the person lie down on the floor. Do not attempt to operate the controls for the chair.
c. Assure that the person does not injure himself. Try to remove harmful objects from the person's pathway or coax the person away from those objects.
d. Do not try to restrain the person; you cannot stop the seizure. Do not agitate the person.
e. If the person appears to be angry or aggressive, do not approach the person if you are alone.
f. Observe and document details of the event:
i. Record the sequence of events.
ii. Note body parts involved.
iii. Record length of event.
g. Assess the subject’s level of consciousness.
h. Stay with the individual.
i. After the event escort victim (or transport via wheelchair) to the Clinical Center office of Occupational Medical Services (OMS) 10/6C306 7:30 am-4:00pm and / or recommend that the subject seek immediate medical care from their physician.
j. Ask subject if they have a history of seizures; ask subject if he has any memory of the event. Document information.
k. If the subject subsequently loses consciousness and/or the seizure does not terminate after about 5-10 minutes call a Code Blue (111).
l. Notify MEG Core Facility Staff
2 In the event of a suspected seizure WITH loss of consciousness:
a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition.
b. Slide the subject out of the chair down to the floor; do not attempt to operate the controls for the chair.
c. Assure that the subject does not injure himself.
i. Put something soft under the head.
ii. Remove any eyeglasses.
iii. Loosen any tight clothes.
iv. Clear the area of sharp or hard objects.
d. DO NOT force anything into the subject’s mouth.
e. Do not try to restrain the person; you cannot stop the seizure.
f. Observe and document details of the event.
i. Record the sequence of events.
ii. Note body parts involved.
iii. Record length of event.
g. Assess the subject’s level of consciousness.
h. Stay with the individual.
i. Call 111 to report a Medical Emergency.
j. If the subject recovers before emergency personnel arrive, turn the person to one side (rescue position) to allow saliva to drain from the mouth.
k. Do not offer the person any fluid or drink.
l. Access/monitor for respiratory or cardiac compromise. If necessary, begin rescue breathing or CPR until emergency medical personnel arrives.
m. Notify MEG Core Facility Staff

Medical Emergency - Suspected Cardiac or Respiratory Event

In the event a possible cardiac or respiratory emergency were to occur in the MEG Lab the following steps should be taken to provide immediate action. It is important that any person at the scene provide immediate aide and call for medical assistance as soon as possible.


1.Adult Victim: The most common medical emergency in an adult victim is usually a heart attack. Symptoms of a heart attack might include: pressure / achy pain in the chest, back (between the shoulder blades), jaw, perhaps radiating to the arm, nausea, dizziness, sweating, agitation, indigestion, denial on the part of the subject.


'
The greatest impact on improving the survival from adult sudden cardiac arrest is immediate bystander CPR and defibrillation within 5 minutes.

The key to survival is early defibrillation. For an adult victim call first.


2. Child/Pediatric Victim: The most common cause of sudden cardiac arrest in kids (infants and children) is a lack of oxygen to the heart muscle and brain caused by severe breathing emergencies, respiratory arrest, or shock. Symptoms of a choking victim might include: gasping for air, hand around the neck, cyanosis or pallor and eventually loss of consciousness.


'
The greatest impact on improving the survival chances of a pediatric victim and the key survival to is early ventilation.

For a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.


3. Procedure:
a. Immediately go into the MSR to assist the subject. It is not necessary to stop the acquisition
b. Do not attempt to operate the controls for the chair; simply slide the subject out of the chair down to the floor.
c. Check for victim's responsiveness.
d. Shout out for "HELP!" / have the other (second) MEG operator/observer go get /call help.
e. Call X111 for the emergency medical team.
Remember: For an adult victim call first; for a pediatric victim call EMS after 5 cycles (or 2 minutes) of CPR.
f. Assess the victim / Initiate CPR:
i. Open airway;
ii. Look, listen, feel for breathing;
iii. Attempt 2 breaths;
iv. If breathes do NOT go in / unable to ventilate there is possibly an obstruction:
• Re-position the head and attempt ventilation again; if still unable to ventilate;
• Give 5 abdominal thrusts (if pregnant or obese - chest thrusts);
• Open then check mouth, sweep to remove seen objects;
• Attempt to ventilate, if no air goes in, re-position and try again, etc. Continue to try to ventilate along with abdominal thrusts until successful in dislodging obstruction or victim begins breathing on his own.
v. Check for pulse and respiration after 2 minutes (5 cycles).
vi. Check for signs of circulation (or lack thereof) – respiration & heart beat / pulse.
•. If NO pulse (no circulation) and NO respiration, begin chest compressions and continue to ventilate;
• If NO pulse (no circulation) but there is respiration, perform chest compressions only,
• If pulse is present, but NO respiration continue to ventilate by giving rescue breaths,
vii. If heartbeat and breathing present, turn victim onto the side (in the Rescue or Recovery position to maintain the airway.
An Emergency Cardiac Defibrillator is located in the NMR Center main corridor on the wall next to Room B1D69 (the NMR Center Office) opposite the entrance to the Signa Corridor.
*Guidelines and instructions for performing CPR:
https://www.ors.od.nih.gov/sr/dohs/Documents/CPR%20Study%20Guide%20041106_revised_1.pdf

Emergency Contact Information / Numbers

In case of an emergency contact:
MEG Director: Dr. Allison Nugent, 301/451-8863
MEG Lab Manager: Anna Namyst, 301/405-2445
MEG Staff Scientist: Dr. Tom Holroyd, 301/402-2362
FOR LIFE-THREATENING EMERGENCIES
(e.g., Fire, Explosion, Chemical Spill, Radiation Release, Natural Gas Odor, Suspicious/Dangerous Activity)
Fire / Ambulance call 911 or
301 / 496-9911 from cell phone
Police call 911 or
301 / 496-9911 from cell phone
Chemical / Biological / Radiological call 911 or
301 / 496-9911 from cell phone
Engineering call 108 or
301 / 496-9911 from cell phone
Bdg 10 Employee/Visitor life threatening emergency* call 111
*otherwise report to OMS 10/6C306 496-4411 7:30am – 4:00pm


FOR NON-LIFE-THREATENING EMERGENCIES
(e.g., Damaging Leaks / Flood, Power Outage)
Fire Department 301 / 496-2372
Police 301 / 496-5685
Occupational Medical Service / Work Related Injuries 301 / 496-4411
Building Maintenance 301/ 435-8000

Emergency Communications Center
Emergency Evacuation Coordinator Bldg. 10/4A13 – Jim Wilson 301/496-2862
The Emergency Communication Center can be contacted for the following:
• Locked out of a lab or office
• Reporting lost or stolen NIH property or personal property
• Additional assistance for non-life-threatening emergencies
311 (from campus phone) or 301 / 496-4685 (from cell phone)


In Case of an Emergency - you might need to know where to locate these items:
FIRE EXTINGUISHER - The nearest Fire Extinguisher is located just outside the MEG Core Facility.
FIRE ALARM PULL STATION - Fire Alarm Pull Stations are located at each end of the NMR Center main corridor and at all Emergency Exits.
EMERGENCY EYE WASH STATION - The Emergency Eye Wash Station in the NMR Center is located in room B1D 302 and B1D 304.
SHOWER - The nearest shower is located on the 1st floor directly above the MEG Lab - Rm. 1D-70.

Infection Control

In order to interrupt the spread of infection at the point of transmission between the source and host, the following policies and procedures have been established. All staff, MEG Lab users and subjects are required to comply with NIH Clinical Centers infection prevention / infection control policies and procedures, in addition to MEG Lab practices.

Hand Hygiene

Hand Hygiene is one of the most important steps in infection control in order to prevent the spread of germs. Cleaning your hands often using either soap and water or alcohol hand gel is required by the NIH Clinical Center and the MEG Lab.
1. In general, it is important to wash / clean your hands in each of these situations:
a. After reporting to work (at the beginning of your shift).
b. Before and after subject / patient contact.
c. Before donning gloves.
d. After removing gloves and other personal protective equipment.
e. After touching objects that are likely to be contaminated with microorganisms (e.g., equipment or other items, keyboards, telephones / cell phones, doorknobs, stair banister, elevator buttons, etc.
f. Whenever hand are visibly soiled.
g. After sneezing, coughing or blowing your nose.
h. After contact with blood, or other potentially infectious material and equipment or articles.
i. When hands are likely to be contaminated with blood, body fluids, secretions or excretions.
j. After handling any equipment that comes in contact with subjects with a known infection.
2. In addition when in the MEG Lab, it is important to wash / clean your hands in each of these situations:
a. At the beginning and end of each MEG scan.
b. Before setting up a subject.
c. After setting up an EEG / EMG subject.
d. After abrading the skin.
e. After applying, handling and processing electrodes.
f. After Brainsight coregistration.
3. If you use Alcohol Hand Gel to clean your hands, you must wash your hands with soap and water if they are visibly soil and/or after every 10 uses of gel.

The Centers for Disease Control also have useful information on the use of hand sanitizer: Handwashing: Show Me the Science

Use of Personal Protective Equipment (PPE) / Protective Barriers

Personal Protective Equipment (PPE) - gloves, gown, plastic apron, masks, protective goggles and impervious barrier will be used, if transfer, aerosolization or splattering of particulate matter is likely to occur. If item(s) are visibly soiled dispose of in a Medical Pathological Waste (MPW) Box otherwise disposed in the trash.
1. Gloves will be used when:
a. Abrading skin,
b. Cleaning, disinfecting or handling equipment used on abraded skin,
c. Handling all soiled instruments and equipment,
d. In contact with a patient/subject with a known infectious disease,
e. During Brainsight localization,
f. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
2. Workspace Protective Impervious Barrier are used: -
a. To cover the work area when abrading the skin to place “contaminated/used” equipment or supplies.
b. When temporarily maintaining any item considered contaminated if needed for additional use,
c. To place all soiled instruments and equipment,
d. To place items that have come in contact with a patient/subject with a known infectious disease,
e. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
f. Any items placed on this barrier will be considered contaminated and must be disposed of or cleaned using Dispatch or Asepti-Wipe II.
g. The barrier will be discarded after each use and the physical work surface will be disinfected using Hydrogen Peroxide Disinfectant, Dispatch or Asepti-Wipe II.

Studies Requiring A Blood Draw or Infusion/Injection during a MEG Scan

During an MEG scan that involves drawing blood or Infusion/Injection MEG infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab Infection Prevention / Infection Control Policies and Procedures and must comply with all Clinical Center Infection Control Policies and Procedures.
1. All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.
2. Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.
3. “Contaminated” gloves will be discarded before touching any other items in the MEG lab.
4. After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.
5. All surfaces (prep table, cabinets) will be wiped with Dispatch after use.
6. All MEG Lab staff will monitor participants for compliance.


Non-Disposable Equipment in Contact with Abraded Skin

All non-disposable electrodes, EEG caps and other equipment that comes in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization. It is the responsibility of the MEG User to place any used / "contaminated" equipment in a hospital approved transport container, fill out the appropriate SPS form and then place the container on the SPS cart in the MEG lab. SPS staff will collect and transport all MEG equipment that requires disinfection/sterilization.
Each User - will be responsible for preparing the “used / contaminated” item(s) for disinfection/sterilization by SPS after each use.
Sterile Processing Services (SPS) - will provide disinfection and sterilization services in compliance with standard operating procedures.

- will be responsible for transporting the equipment to SPS for disinfection/sterilization.

MEG Core Staff - will provide each user instructions regarding preparing “used”/contaminated MEG equipment for disinfection/sterilization.
1. Non-Disposable Electrodes
REMEMBER!
Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes and all non-disposable electrodes that come in contact with skin that has been abraded will be considered “contaminated” and must be sent to Sterile Processing Services (SPS) for disinfection / sterilization.


a. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
b. Place the disk end of the electrode in the zippered section of the 2 pocket zip lock plastic bag.
c. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
d. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
e. Place the lid on the Biohazard Container.
f. Place the Biohazard Container on the top shelf of the CHS Processing Cart.
g. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
h. SPS staff will collect the Biohazard Container and take to their facilities for disinfection/sterilization.
i. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.


2. Non-Disposable EEG Cap – i.e., Easy Cap
All EEG caps, including the EasyCap, that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization.
a. Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
b. All electrodes will be removed from the cap and processed separately from the electrodes.
c. The cap will be placed in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
d. The Biohazard Container will then be placed on the top shelf of the SPS processing cart.
e. Place the lid on the Biohazard Container.
f. The Sterilization Request Form will be filled out for each container and placed on top of the appropriate closed container.
g. MEG staff will transport the Biohazard Container to SPS for disinfection / sterilization.


3. The VSM EasyCap and Electrodes
Currently, VSM EasyCap and electrodes are used exclusively by the NINDS EEG Department. VSM EasyCap and electrodes will be cleaned and disinfected per manufacturers’ instructions in the NINDS EEG Department. Cleaning / disinfection will be performed using NIH approved chemical disinfectants according to Hospital Epidemiology Service requirements in hospital approved designated area(s) only. Additional laboratories wishing to use the VSM EasyCap should work with the MEG Core Facility and Hospital Epidemiology Service to deploy appropriate cleaning / disinfection procedures.
4. Other Non-Disposable Equipment
All Electrode Bars / Stimulating Bars / Twisted Pair / Ground Electrodes that come in contact with skin that has been abraded will be considered “contaminated” and taken to Sterile Processing Services (SPS) for disinfection / sterilization.
a. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.
b. Place the disk / bar / electrode end in the zippered section of the 2 pocket zip lock plastic bag.
c. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.
d. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
e. Place the lid on the Biohazard Container.
f. Place the Biohazard Container on the top shelf of the SPS Processing Cart.
g. Fill out a “Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
h. SPS staff will collect the Biohazard Container and take to their facilities for disinfection/sterilization.
i. Biohazard Containers with “contaminated” equipment will be logged in and out according to SPS procedures.

Non-Disposable Equipment in Contact with Non-abraded Skin

1. All Portable Non-Disposable equipment, i.e., head localization coils and Brainsight stylus, that comes in contact with un-abraded and otherwise intact skin (including sweat) will be cleaned using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol.
a. Wash hands.
b. Wipe the Head Localization Coils with alcohol.
c. Adhesive Remover may be used occasionally to remove any adhesive buildup or sticky residue.
d. Wash hands.
2. Known Infectious Disease (Abraded or Un-Abraded Skin)
a. All Portable Non-Disposable / Reusable Equipment used by a patient with a known infectious disease will treated as equipment used on abraded skin ( See Non-Disposable Equipment in Contact with Abraded Skin) and be sent to Sterile Processing Services for disinfection /sterilization.

Disposable / single use equipment

1. Routine Procedure for Single Use Equipment used on Abraded or Un-abraded Skin
a. All Disposable / Single Use Equipment used abraded skin will be disposed of in the trash. Gloves will be used when abrading the skin.
2. Known Infectious Disease (Single Use Equipment)
b. All Disposable / Single Use Equipment used by a patient with a known infectious disease must be disposed of in a Medical Pathological Waste (MPW) Box.

Non-portable non-disposable / reusable equipment

1. All Non-Disposable Immobile or Non-Immersable equipment that comes in contact with a subject/patient will be routinely cleaned by the person(s) conducting the MEG scan using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol after each subject/patient use.