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Ricin: Control Measures Overview for Responders and Clinicians

Healthcare Facility

Emergency Preparedness

  • Be prepared for victim(s) who may present to an emergency department without prior warning.
  • Direct the emergency department ventilation exhaust away from the fresh air intake to limit re-entrainment of any airborne contaminant from victims who present to and enter the emergency department.
  • Comply with healthcare facility’s Emergency Response Plan.
  • Prepare for mass casualties by establishing patient triage, registration, decontamination, treatment, transportation, and stabilization zones/areas for hospital admission(s).
  • Perform hazard vulnerability analysis to determine if hospital can manage the anticipated number of victims.
  • Determine if lockdown (shelter-in-place) is necessary, and secure area to control access and contain contamination.

Surge Capacity

  • Prepare for public health surge capacity and cooperate with other healthcare facilities, local, state, and federal authorities when:
    • It is determined that healthcare facility cannot manage anticipated number of victims.
    • Services expand beyond normal from large scale event.

Infection Control Practitioner

  • Even though ricin is sometimes referred to as a biological agent, it is a protein extracted from plant material and is not a living organism. There is no antidote for ricin poisoning. For more on ricin pathogenesis, see Epidemiological Overview for Clinicians.
  • Maintain heightened awareness for evidence of ricin-exposed patients and collaborate with clinicians and laboratory to ensure immediate notification of local and state public health department officials when ricin poising is suspected
  • Ensure that telephone numbers for notification of appropriate healthcare facility and public health agencies are current and distributed to the appropriate healthcare facility departments and personnel.
  • Communicate with the laboratories that receive specimens for testing.

Exposure Follow-up

  • Healthcare personnel or laboratory workers sustaining exposure via sharps injury, cuts, or abrasions should immediately wash the exposed site with a soap and water.
  • Potentially exposed healthcare personnel should be advised to remove all PPE carefully, wash hands thoroughly with soap and water, refrain from any hand-to-mouth activities, and shower.
  • When exposure to eyes occurs, flush eyes with copious amounts of water or eye wash solution for at least 15 minutes.
  • Follow standard facility policy regarding workplace exposure.

Patient Education

Incident Site

Protecting Emergency/First Responders

Decontamination

Emergency Response Resources

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