Protect Your Liability: Hire a Certified Crime and Trauma Clean Up Company I. Agenda a. Introductions b. Why are we here? c. Common Bloodborne Pathogen Diseases d. Additional Health Risks e. Exposure Risks f. Compliance and Legal Requirements g. Why Aftermath? h. Q & A II. About Me Ted Lakus a. Marine Corps: 1979 1987, honorable discharge b. Cherokee County Sheriff s Office: 1987 1994 c. Major Crimes Investigator and Crime Scene Analyst d. Accident Reconstructionist and SWAT Team e. District Attorney s Office f. Investigator and Crime Scene Reconstructionist g. With Aftermath since 7/27/2011 III. Who We Are a. Nationwide Crime and Trauma Scene Cleanup Specialists b. Over Sixteen (16) Years Experience c. Professional Relationships IV. What We Do a. Suicides b. Homicides c. Unattended Deaths d. Filth/Hoarding e. Urine/Feces f. Tear Gas g. MRSA / H1N1 h. Personal Accidents/Injuries i. Industrial Accidents V. Additional Services a. Jail Cells b. Squad Cars c. Embalming Rooms d. Refrigerator Rooms e. Training (CEU) VI. Why Are We Here? a. Protect your liability i. Prevent your employees from entering a scene they may not be properly trained or equipped to handle. ii. Prevent your tenants from contracting diseases. iii. Keep families from having to see the physical remnants of their loved one. iv. Prevents cross- contamination
VII. VIII. Why Are We Here? (Cont d) a. Protect your health i. All of our employees are specially trained and certified to perform this type of work and will ensure that the scene is safe for you and the family to enter. ii. Most people do not realize the health risks that are involved when entering scenes. Scenario a. A tenant with HIV passes away in their home and is left unattended for 10 days. A general cleaning company comes into the home and cleans it up to the best of their ability. One of the employees gets cut while cleaning and thinks nothing of it. He later finds out that he has contracted HIV. b. How could this have been prevented? IX. What Do You Do? a. Secure and quarantine the scene. b. Common areas used by emergency responders should be secured as well. c. Call a qualified company to remediate the scene as soon as possible. d. This will protect your employees and tenants as well as help avoid cross- contamination and further structural damage. X. Common Bloodborne Pathogen Diseases a. What is a BB Pathogen? i. Pathogenic micro- organisms that are carried in the blood that can cause disease in humans. b. Human Immunodeficiency Virus (HIV) i. HIV is the virus that leads to AIDS which attacks the immune system. ii. 1.2 million people in the United States are living with HIV infection and 1 in 5 are unaware of their infection. iii. According to studies, HIV can survive for several hours to several years outside of the body. c. Hepatitis B (HBV) i. May lead to chronic liver disease, liver cancer, and death ii. Vaccination available since 1982 iii. HBV can survive for at least one week to several years in dried blood iv. Symptoms can occur 1-9 months after exposure v. 1 1.25 million Americans are chronically infected vi. Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting d. Hepatitis C (HCV) i. Hepatitis C is the most common chronic blood- borne infection in the United States. ii. Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting iii. May lead to chronic liver disease and death iv. More than 3 million people are chronically infected with the hepatitis C virus in the United States and about 170 million people have hepatitis C worldwide. e. Additional Health Scare Risks i. MRSA (Methicillin- Resistant Staphylococcus Aureus)
1. A type of Staph bacteria found on the skin and in the nose that is resistant to antibiotics. 2. More than 90,000 Americans get potentially deadly MRSA infections every year. 3. More deaths are linked to MRSA infections than AIDS. 4. Symptoms depend on where you ve been infected. ii. H1N1 (Swine Flu) 1. H1N1 ( Swine Flu ) is a new strain of the influenza virus that was first detected in 2009. 2. Studies have shown that influenza virus can survive and infect a person for 2 to 8 hours after being deposited on any surface. 3. The emergence of new and very different influenza viruses each year infect people and can cause an influenza pandemic. 4. Symptoms include fever or chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue. iii. Encephalitis 1. The irritation and swelling (inflammation) of the brain, usually due to infections. 2. The cause of encephalitis is often unknown, but the most commonly diagnoses is a viral infection. 3. Known causes of encephalitis may include: 4. Viruses 5. Bacteria 6. Fungi 7. Parasites 8. Symptoms include: 9. Fever that is not very high 10. Mild headache 11. Low energy and poor appetite 12. Clumsiness 13. Confusion 14. Drowsiness iv. Meningitis 1. A disease caused by inflammation from an infection of the fluid surrounding the brain and spinal cord 2. Exposure to viruses can occur through: 3. Breathing in respiratory droplets from an infected person 4. Contaminated food or drink 5. Insect bites 6. Skin contact 7. Symptoms include: 8. Fever and chills 9. Mental status changes 10. Nausea and vomiting 11. Sensitivity to light 12. Sever headache 13. Stiff neck v. C. Diff (Clostridium difficile) 1. C. diff is a bacterium that causes inflammation in the colon.
a. Naturally present in the body but is controlled by other bacteria. b. Prolonged use of antibiotics kills these bacteria. 2. Spreads through contact with feces. a. Any surface (toilets, bath tubs, walls, etc.) that comes in contact with feces may be contaminated. 3. Can live for 70 90 days outside of the body. vi. Mold 1. Control zone needs to be disinfected to kill mold and mold spores 2. Health hazards causing allergic reaction and respiratory problems 3. Mold helps breakdown organic material (Tissue) vii. Bacteria 1. Health Concerns a. Respiratory b. Skin Contact c. PPE usage required 2. Pathogenic Bacteria a. Typhoid b. Pneumonia c. Sepsis 3. Vomit/Feces contain enough OIM to transfer viii. Bed Bugs 1. Found in cracks and crevices including mattress seams, sheets, furniture, behind baseboards, electrical outlet plates and picture frames. 2. Feed on human blood and other warm- blooded hosts. 3. The most effective way to get rid of bed bugs is to use IPM (Integrated Pest Management) which uses multiple tactics such as preventive measures, sanitation, and chemicals applied to targeted sites. 4. Aftermath DOES NOT perform bed bug cleanups. This kind of work requires separate training for the use of pesticides. f. Exposure Risks i. O.P.I.M. (Other Potentially Infectious Materials) 1. Blood 2. The fluids of the heart, lungs, joints, spine, and abdominal lining 3. Amniotic fluid 4. Saliva in dental procedures 5. Semen 6. Vaginal secretions 7. Vomit 8. Skin tissue, cell cultures 9. Tissue known to contain BBP 10. Any other bodily fluid ii. O.I.M. (Other Infectious Materials) 1. Mold 2. Bacteria
3. Vomit/Feces/Urine iii. Decomposition Timeline 1. 1 3 Days: Staining begins on the abdomen; the body begins to swell owing to gas formation. 2. 3 4 Days: The staining spreads and veins become discolored. 3. 5 6 Days: The abdomen swells with gas produced by the bacteria to decompose the body and the skin blisters. 4. 2 Weeks: The abdomen becomes very tight and swollen. 5. 3 Weeks: Tissues begin to soften; organs and cavities are bursting; the nails fall off. 6. 4 Weeks: Soft tissues begin to liquefy and the face becomes unrecognizable; the exact rate of decomposition is dependent upon many factors, such as weather, exposure & location. iv. Transmission Potential 1. Contact with another person s blood or bodily fluid that may contain blood 2. Mucous membranes: eyes, mouth, nose 3. Non- intact skin 4. Contaminated sharps/needles 5. Bodily Secretions v. Universal Precautions 1. Use of proper PPE 2. Treat all blood and bodily fluids as if they are contaminated 3. Proper cleanup and decontamination 4. Disposal of all contaminated material in the proper manner vi. Personal Protective Equipment (PPE) 1. Gloves 2. Suits 3. Eye Protection 4. Face Protection 5. Shoe Covers 6. Head Protection 7. Respiratory Protection vii. PPE Usage 1. Provides a layer of protection between your skin or personal clothing. 2. Supplements Engineering Controls and Decontamination Techniques. 3. OSHA Requires Protective Clothing and other Personal Protective Equipment to be the Last Line of Defense and not used as the sole personal protection. 4. PPE Usage is NOT an option and is expected to be used as part of standard operating procedures. DO NOT TAKE CHANCES! g. Compliance and Legal Requirements i. Biohazard Remediation Requirements 1. Certified through OSHA (Blood- borne Pathogen Training) 2. Employees Must be Hepatitis B Vaccinated 3. Written Exposure Control Plan for the Company 4. Written Chemical Control Program Outlining the Dangers of All Chemicals Used (MSDS)
5. Written Respiratory Program Outlining Minimal Requirements 6. Written Personal Protective Equipment Program (PPE) 7. Written Procedural Guidelines for Various Types of Clean- ups 8. Contract with Medical Disposal Company ii. Recordkeeping 1. Aftermath keeps detailed records of every job we perform. a. Pictures to document before, during, and after. i. This is for safety and liability issues. b. SCRR Site Compliance Remediation Report i. Ensures employees are following all rules and regulations. ii. Detailed breakdown for insurance issues. c. COT Certificate of Treatment i. Upon completion of recommended service, you will be presented with a Certificate of Treatment. ii. This will be helpful when renting or selling a home or place of business. iii. Regulated Medical Waste 1. Liquid or semi- liquid blood or other potentially infectious material(opim) 2. Contaminated items that would release blood or OPIM when compressed 3. Contaminated sharps 4. Pathological and microbiological waste containing blood or OPIM iv. Signs and Labels 1. Labels must include the universal biohazard symbol, and the term Biohazard must be attached to: a. Containers of regulated biohazard waste b. Refrigerators or freezers containing blood or OPIM c. Containers used to store, transport, or ship blood or OPIM v. Medical Waste Requirements 1. Biohazardous Waste Transporter License a. Several states require anyone who hauls biohazardous or medical waste, including the transportation of waste from a trauma scene to a waste pick- up site or disposal location, to maintain a state waste transportation license. 2. Medical Waste Disposal/Transporter Company Contract a. States have specific licensing requirements and/or guidelines that medical waste haulers must follow when disposing of medical waste. Medical waste disposal companies are subject to DOT requirements and should follow EPA requirements as well. vi. U.S. Department of Transportation (DOT) Requirements 1. US Dot Number a. Required of all vehicles in interstate commerce (w/ GVW of 14,000 lbs. or more). Also required for vehicles that transport hazardous materials (the US DOT defines
an infectious substance and regulated medical waste as hazardous waste) in intrastate commerce and interstate commerce. b. 49 C.F.R. Part 390, Subpart A 2. Biohazard Placard a. Required signage on vehicles for transportation of biohazardous materials. b. 49 C.F.R. Part 172, Subpart D 3. Packaging for Hazardous Materials a. Outlines specific requirements for packaging regulated medical waste. b. 49 C.F.R. Part 173, Subpart E and 49 C.F.R. Part 173.6 Subpart A 4. Financial Responsibility Minimum Levels a. Outlines a financial minimum of $1,000,000 of liability coverage for vehicles with a GVW rating of 10,001 or more pounds that transport hazardous materials in interstate and intrastate commerce (in any quantity). b. 49 C.F.R. Part 387, Subpart A vii. Licensing Requirements 1. All vehicles must be licensed to transport regulated medical waste (RMW). 2. OSHA requires cradle to grave certification of RMW. 3. Contracts with medical waste disposal companies throughout the your area to meet this requirement. viii. Insurance Mandates 1. Liability (insured, licensed & bonded for biohazard work) 2. Worker s Compensation 3. Employees VS. sub- contractors 4. Cheaper isn t better ix. Why Choose Aftermath? 1. What Sets Us Apart? a. Over 16 Years of Experience b. OSHA Blood- borne Pathogen Certified c. We meet or exceed every local, state and federal regulation regarding removal, transport, storage and disposal of bio medical waste d. Employees Re- Certified Yearly on Updated Training for New Procedures e. Extensive Hiring Program f. 24- Hour Nationwide Emergency Response 2. 27- Point Checklist 3. Special Government Rates 4. Housing Authorities We ve Worked With 5. Past Clients x. 27- Point Checklist 1. What to look for in a biohazard company 2. Aftermath is the only bio remediation company that can claim and prove that we meet all 27 criteria. xi. Special Government Rates
1. B2B Rate Agreement a. Flat hourly rate b. Not a binding contract c. Includes: i. Job Setup & Preparation ii. Supplies & Equipment iii. Bio Boxes and Disposal 1. Boxes are not left behind for another company to pick up d. Photo Documentation 2. Dedicated Dispatch Lines for B2B 3. One Call, One Company xii. Partnerships 1. Aftermath has formed partnerships with the nation s top industry leaders and associations to provide customers with any of the additional services that may be needed following the crime scene cleanup process. 2. Here are just a few of our partners: a. Stanley Steemer b. Brotherhood for the Fallen c. National Sheriffs Association d. International Association of Chiefs of Police 3. We are happy to announce the latest addition to our Partnership Network, Empire Today a. Customer Service Oriented: Empire will sit down with the family and bring carpet samples to allow the family to choose the carpet. b. Quick Response: Empire has a 1 3 day turnaround time vs. going through the insurance which can take anywhere from 3 4 weeks. xiii. List of just some of the Housing Authorities we have worked with xiv. Past Clients xv. Q & A