Liquid Waste Management and Disposal

In Part I of this series, the focus was proper fluid management by operating room (OR) personnel, their training, their awareness of state and city regulations, and annual competency testing. In Part II, we address the new technologies available and how to reduce costs associated with liquid waste disposal.

Products to Reduce Costs

MD Technologies provides a series of Suction-Drain systems, which provide fluid waste management for surgery, endoscopy and sterile processing department (SPD)/utility room applications, says Bill Merkle, president of MD Technologies.

With the Environ-mate DM6000 Series, compact, wall-mounted units are designed to collect fluids directly from the suction field and dispose of them directly to the sanitary sewer. The Environ-mate DM6000 Series units isolate healthcare workers from exposure to suctioned fluids, and the systems are designed to offer tremendous cost savings due to reduced requirements for disposable supplies, Merkle says. The first Environ-mate unit was placed into service in 1990. These systems are ideally suited to new construction or remodeling projects because they require installation of drain plumbing. The units connect to a central vacuum.

The advantages of the Environ-mate Suction- Drain systems include cost savings, floor space savings and isolation from suctioned fluids, he adds. Savings are realized on costs of disposable canisters and solidifying agents as well as waste disposal/incineration costs. Floor space is not required, due to the wall-mounted unit design. Isolation from suctioned fluids is exceptional because fluid is directly disposed of to the sewer, and no secondary operations are required, such as transporting containers to a central draining station.

There are three DM6000 Series units available. The DM6000 is used in SPD/Utility Rooms with an optional footswitch. The DM6000-2, intended for use in endoscopy applications, has two independent suction inputs for esophagogastroduodenoscopy (EGD), endoscopic retrograde cholangiopancreatography (ERCP), and bronchoscopy procedures, and can offer a backup suction source in single-field procedures (e.g., colonoscopies). The compact DM6000-2A has unlimited fluid capacity, and is useful in the operating room for arthroscopy, urology, and cystoscopy procedures. An optional fluid totalizer records fluid volume aspirated.

Installation of the Environ-mate DM6000 Suction-Drain Systems requires that drain plumbing be installed, which is most practical during new construction or remodeling, Merkle points out. The closed-system design of the system prevents having open drains in the procedure area, offering an improvement over fl ushing floor drains. Retrofi t installations are most common for utility rooms, although several facilities have also undertaken retrofi t of procedure rooms.

One of the ways we try to help reduce costs and provide innovative solutions for reducing red bag waste is through our SaniSorb and SaniSorb X products, says Peter Donnelly, market applications specialist at Multisorb. These can be used in a variety of places, but most often are used in suction canisters. Both products are an absorbent polymer packaged inside a water-soluble pouch. The package can be pre-administered into a suction canister, and once fluids hit it, it will burst open and solidify everything in the suction canister. Immediately, you go from a liquid waste to a solid waste. Just reducing splashing, reducing handling issues, is a significant improvement. SaniSorb X adds an agent that sanitizes the contents of the can to a point where it can be considered drain waste, as opposed to red bag waste, which tremendously reduces the cost.

SaniSorb X solidifi es the liquid; as it is solidifying, the sanitizing agent is designed to render neutral any of the biological agents in the canister. It could just be disposed of with regular hospital waste, but in some cases, with enough water, you can wash it down the drain. The caveat is that a lot of this is state-regulated, so in some states we do have the ability to make that claim and in some states we do not -- it depends on the tangled web of state regulations, Donnelly points out.

Another product that works in a similar fashion is the DriMop®. DriMop is similar to the SaniSorb products in that it is a super-absorbent polymer packaged inside a water-soluble pouch, says Donnelly. When liquids hit it, it bursts the pouch and captures the liquid and contains it. DriMop, though, we primarily use for test kits. Nowadays, a lot of test kits are processed in centralized laboratories, so you have multiple kits that go through a FedEx shipment. People will include a couple of DriMop pouches in the FedEx box, on the off chance that if a test tube or urine specimen bottle breaks open, instead of dripping all over and creating a nasty mess, it will be contained. We dont stop the spill, but we contain it inside that box.

The sanitizing effect works in a similar manner to a bleaching agent, although it does not include bleach. Its an antibiological and will kill any of the biologics inside the suction canister, he adds.

To better manage liquid waste in healthcare, Cardinal Health offers two solutions the SAFT Pump system for waste disposal and the CRD semi-rigid canister for waste collection, says Scott Leece, marketing manager of surgical products at Cardinal Health.

Cardinal Healths SAF-T Pump system provides healthcare workers with an easy way to dispose of suction canister waste directly into the sanitary sewer while greatly reducing the potential for exposure to bloodborne pathogens often found in this waste, Leece explains. The SAF-T pump is a small, wall-mounted device installed simply by plumbing it into a water source and a sanitary sewer connection. Users bring full canisters to the SAF-T Pump, make one quick connection between the canister and the pump, and the liquid waste is drawn from the canister into the sanitary sewer via a closed pathway. This eliminates the risk of exposure to splashing waste or aerosol droplets that can form when canisters are emptied into open sinks. Powered entirely by tap water and no motorized or electrical components, it is designed to be extremely reliable and virtually maintenance-free. Using the SAF-T pump increases staff safety and eliminates the need to throw full or solidified canisters into red bag waste, thus greatly reducing red bag disposal costs.

Cardinal Health also recommends the CRD semi-rigid canister instead of hard canisters to reduce red bag disposal costs. CRD canisters weigh as much as 50 percent less than similar sized hard canisters, Leece says. This weight difference can translate into savings of nearly ten cents a canister for a typical healthcare facility (based on the national average red bag waste disposal cost of thirty cents per pound). In addition, CRD is designed to be sturdy yet lightweight, easily stacks for storage, and is readily compacted, thus minimizing the space required in the red bag trash.

Colby Manufacturing Corp. offers other solutions to keep the OR floor clean, dry, and safe in a cost-efficient manner. Colby specializes in products that help protect staff and patients from contact with potentially hazardous fluid waste, says John Phillips, director of sales and marketing at Colby.

When choosing a fluid waste management product, many factors should be taken into consideration: meeting OSHAs regulations for employee protection, concern for patient health, and cost effectiveness, he suggests. Using the right product based on the procedure will help achieve the protection youre looking for at a lower cost to the facility. 

Colby offers a selection of products designed to effectively control, contain, and dispose of fluids generated during wet procedures. These include:

• The WaterBoom Quiet Floor Suction Strip, which is designed to control fluids by strategically placing and creating a dam to hold back and quietly suction an unlimited amount of waste fluid. It contains fluids in selected areas with its low profile and conforming design, which are designed to provide strong suction of unlimited amounts of fluid while conforming to the OR floor. Dispose of the WaterBoom as potentially hazardous waste in accordance with the healthcare facilitys protocol. The Water- Boom attaches to standard suction and includes 12 of flexible tubing.

• The WaterBug® Quiet Floor Suction Device, which is designed to control fluids on the floor by easily maneuvering it with a push of the foot toward areas affected by fluids. Its raised design allows for easy repositioning, controlling fluids over a large floor area. It contains unlimited amounts of fluids from the top via drain holes as well as the bottom. Dispose of the WaterBug as potentially hazardous waste in accordance with the healthcare facilitys protocol. The WaterBug attaches to standard suction and includes 12 of flexible tubing.

• ViraSorb® Super Solidifier is designed to control fluids by quickly penetrating the canister contents, gelling quickly without stirring or agitation. It contains fluid by staying solid, facilitating safer handling and transport of medical waste. Dispose of ViraSorb in accordance with the healthcare facilitys protocol, and with state and local regulations, as Solid the facilitys amount of red bag waste.

• SurgiSafe® Absorbent Floor Mat is designed to control the flow of fluids by strategically placing the mat, helping to prevent the spreading of potentially hazardous fluids. SurgiSafe Mats alone control and contain fluid waste and should be disposed of as normal hazardous waste in accordance with the healthcare facilitys protocol.

Not all solidifiers are sanitizers, observes Kelly Ticco, marketing manager at Safetec of America Inc. Safetec manufactures products Red Z, Green Z and Yellow Z that will solidify liquid waste, but if they are used to clean up potentially infectious spills, you still need to dispose of that as red bag waste, she says. The cheapest way to dispose of waste is as white bag waste.

When youre trying to save money on disposal of medical waste, the weight of the item is one consideration, she continues. We have improved our formula so its more absorbent, so you use less and reduce the weight of what youd have to dispose of as red bag waste. Also important is making sure that when you are disposing of waste at your facility, you are not including pizza boxes [and other white bag trash] with the red bag waste. Make sure youre only including potentially infectious medical waste products, whether they are solidified blood and body fluids, needles, or anything else thats potentially infectious.

Proper fluid management is necessary no matter what type of healthcare facility you have; utilize the latest developments in fluid waste management to improve safety for both staff members and patients, and to reduce the cost associated with its disposal. Making the most of the newest technologies can not only improve safety and reduce the overall costs for the hospital to dispose of liquid waste, but also can reduce the amount of red bag waste to be discarded creating a win-win situation for both the hospital and the individual staff member.