Dealing with trauma scenes

Date Published: 
July, 2005
Original Author: 
Dan Hannan
Assured Decontamination Services
Original Publication: 
ICFM Magazine, July 2005

When dealing with the scene of a death means more than a simple removal, what help can a funeral director offer the family? What should you look for in a trauma scene contractor before recommending one to families?

For families dealing with a death that occurred in the home, the loss may be compounded by the need to remove the visible signs of the tragedy.

In these cases, the role of the funeral director in providing grieving family members with complete and compassionate care should include helping them arrange for their home
to be returned to good order.

This means the funeral director should know what professional trauma scene services are available in the area and know enough about them to feel comfortable recommending them to the family.

What trauma scene contractors do
A good trauma scene contractor will properly complete the cleanup of all blood and bodily fluids to ensure a sanitary home environment and allow family members to move forward.

In one crucial aspect, a good trauma scene contractor should resemble a good funeral home:
The relatives of the deceased and/or the owner of the home or other property being cleaned must feel confident that the company will be discrete and respectful about its work.

The contractor's job is to remove any visible signs of the remains and disinfect the affected areas. All blood and bodily fluid material must be removed to ensure a sanitary condition, meaning no odor can be detected and nothing is left that would provide a food source for insects or rodents.

Trauma scene cleanup differs from environmental scene cleanup in that there are no enforceable standards for removal of blood or bodily fluids.

Complete disinfection is difficult to measure onsite at the time of the cleanup. The standard is therefore very much a self-imposed "best effort," consisting of sight and smell criteria.

In some cases, a contractor may decide that a stain cannot be cleaned up and the contaminated surface—carpet and pad, wallboard (sheetrock), subfloor, fixtures or personal effects—must be removed.

The following examples illustrate what can be involved in handling a trauma scene:
1. The deceased was an elderly man who had died in bed; it was at least a week before his son found him. The decomposition of the body had saturated the bed mattress, box spring and the carpet under the bed.

The trauma scene contractor (recommended to the son by the local funeral home) dispatched three technicians. The mattress, box spring and affected carpeting were removed and placed in containers for disposal. All waste materials were delivered to a contracted autoclave (sterilization) facility able to handle wastes containing biological hazards.

The technicians also vacuumed the entire bedroom, offered to remove the spoiled food from the refrigerator and boxed-up personal effects that were of immediate importance. Before leaving, the technicians deodorized the home.

2. After a man committed suicide at home, in the garage, his son-in-law asked for a trauma scene contractor to handle the cleanup.

The contractor met the next of kin at the property to gain access to the garage and learn what items were of monetary or sentimental value and would need to be cleaned and returned, if possible, rather than discarded.

During the course of the cleanup, the contractor discovered several sizable bone fragments and notified the medical examiner. The unpainted sheetrock walls and ceiling could not be effectively cleaned, so the technicians removed them after discussing the situation with the son-in-law and getting his approval.

Throughout the cleanup, the contractor took photos for use in preparing a report and invoice to send to the insurance company.

These cases show why trauma scene cleanup requires more than the typical janitorial service can offer. At a minimum, all field personnel must prove compliance with the Occupational Safety and Health Administration blood borne pathogen standard 1910.1030.

Evaluating contractors
To ensure the best possible service for your families, you should recommend only qualified trauma scene response contractors.

At this time there are no national certification requirements, and only a few states require companies offering these services to register with the state health department to demonstrate their qualifications.

What criteria should a funeral director use in screening a trauma scene contractor? A competent, compliant and professional contractor should be able to answer the following questions to your satisfaction:

• Does the company have a blood borne pathogen control program, and does it conform to all of the requirements of the OSHA 1910.1030 standard?
• If required, is the contractor registered or licensed by the state or county?

• Does the company have a contract with a licensed disposal facility to incinerate or autoclave waste?

• Does the company have equipment and personnel dedicated to trauma scene response? Does it offer services 24 hours a day, seven days a week, all year? (In other words, will it be timely in its response?)

• Does the company have a quality control program or can it show you its standard operating procedures (SOPs) and a generic health and safety plan (HASP), which offer an indication that it can do the job?

• Does the company have commercial Insurance, including general and professional liability and errors and omissions?

• Does the company, or its personnel, hold any accreditations? Does it belong to any professional associations?

• What experience do the company and its staff have? How many cleanups have they performed?

When a family's loss is compounded by having to deal with a trauma scene, the funeral director can offer complete care by being prepared to help the family find a company to handle the cleanup quickly, completely and with discretion.