SAFETY MANUAL
Virginia Commonwealth University
Medical College of Virginia Hospitals
and
MCV Associated Physicians

TABLE OF CONTENTS

EMERGENCY PROCEDURES .....................................................................EP-1

          EMERGENCY TELEPHONE NUMBERS ..............................................EP-1

          EMERGENCY TELEPHONE LOCATIONS ..........................................EP-2

          FIRE EMERGENCY & EVACUATION PROCEDURES .......................EP-4

          MEDICAL EMERGENCIES ....................................................................EP-5

          CHEMICAL SPILL RESPONSE .............................................................EP-7

          BIOLOGICAL/RADIATION EMERGENCY ..........................................EP-8

          BOMB THREAT EMERGENCY .............................................................EP-8

          UNUSUAL EVENT REPORTING ...........................................................EP-9

RESPONSIBILITY FOR SAFETY ..................................................................RS-1

          FACULTY, EMPLOYEES, VOLUNTEERS, AND STUDENTS..............RS-1

          SUPERVISORS ........................................................................................RS-1

          PATIENTS AND VISITORS ....................................................................RS-1

          CHAIRMAN OF ACADEMIC UNITS/DIRECTORS OF

                       NON-ACADEMIC UNITS .........................................................RS-1

          FACULTY AND STAFF LIABILITY ......................................................RS-1

          UNIVERSITY SAFETY COMMITTEES .................................................RS-2

                      UNIVERSITY SAFETY LIAISON COMMITTEE........................RS-2

                      ACADEMIC MEDICAL CENTER SAFETY COMMITTEE ........RS-2

                      RADIATION SAFETY COMMITTEE ..........................................RS-2

                      INSTITUTIONAL BIOSAFETY COMMITTEE ...........................RS-2

                      INSTITUTIONAL REVIEW BOARDS .........................................RS-2

          UNIVERSITY SAFETY SUPPORT SERVICES .......................................RS-3

                      OFFICE OF ENVIRONMENTAL HEALTH & SAFETY (OEHS).RS-3

                      PHYSICAL PLANT DIVISION .....................................................RS-3

                      MCVH PLANT OPERATIONS .....................................................RS-3

                      VCU CAMPUS POLICE ................................................................RS-3

                      MCVH SAFETY AND SECURITY ................................................RS-3

                      MCVH/MCVAP RISK MANAGEMENT OFFICE ........................RS-3

                      EMPLOYEE HEALTH SERVICE ...................................................RS-3

          SAFETY POLICY - SUPERVISOR'S RESPONSIBILITIES ......................RS-4

GENERAL SAFETY PROCEDURES ..............................................................GSP-1

          NON-EMERGENCY TELEPHONE NUMBER ........................................GSP-1

          CHEMICAL SAFETY ................................................................................GSP-2

                      HAZARD COMMUNICATION ....................................................GSP-2

                      MATERIAL SAFETY DATA SHEETS (MSDSS) ..........................GSP-3

                      LABELS AND OTHER FORMS OF WARNING ..........................GSP-4

                      SAFE HANDLING OF CHEMICALS ...........................................GSP-4

                      CHEMICAL WASTE DISPOSAL .................................................GSP-5

                      HAZARD COMMUNICATION PROGRAM ...............................GSP-6

                             EMPLOYEE RIGHT-TO-KNOW BROCHURE ....................GSP-10

                             WORKER RIGHT-TO-KNOW STATEMENT ......................GSP-11                       LABORATORY SAFETY PROGRAM .........................................GSP-13

                      LABORATORY SAFETY GUIDELINES ......................................GSP-15

                      ASBESTOS PROGRAM ................................................................GSP-16

                      ETHYLENE OXIDE PROGRAM ...................................................GSP-18

                      FORMALDEHYDE PROGRAM ....................................................GSP-19

                      GLUTARALDEHYDE (CIDEX) PROGRAM .................................GSP-20

                      LEAD PROGRAM ..........................................................................GSP-21

                      MERCURY HANDLING PROCEDURES .....................................GSP-21

                      NITROUS OXIDE PROGRAM ......................................................GSP-21

                      RESPIRATORY PROTECTION PROGRAM ................................GSP-22

                      INDOOR AIR QUALITY ...............................................................GSP-23

                      ODOR COMPLAINTS ..................................................................GSP-23

                      COMPRESSED GAS SAFETY GUIDELINES ..............................GSP-24

          BIOLOGICAL SAFETY .............................................................................GSP-28

                      REGULATED MEDICAL WASTE PROGRAM (UNIVERSITY)....GSP-28

                      PREGNANCY POLICY, MUTAGENIC,

                          TERATOGENIC AND INFECTIOUS AGENTS ........................GSP-29

                      BLOODBORNE PATHOGENS PROGRAM .................................GSP-29

          CHEMICAL/BIOLOGICAL SAFETY TRAINING ....................................GSP-30

          FIRE SAFETY .............................................................................................GSP-31

                      VCU GENERAL FIRE/EMERGENCY EVACUATION PROCEDURES                                                           ......................................................................GSP-31

                      EVACUATION PROCEDURES FOR INDIVIDUALS

                            WITH DISABILITIES ................................................................GSP-34

                      FIRE EXTINGUISHERS ..................................................................GSP-34

          OCCUPATIONAL SAFETY .......................................................................GSP-35

                      PROPER LIFTING TECHNIQUES .................................................GSP-35

                      REPORTING OF ON-THE-JOB INJURIES ...................................GSP-36

                      MCVAP REPORTING OF ON-THE-JOB INJURIES ....................GSP-37

          PERSONAL SAFETY PRECAUTIONS .....................................................GSP-41

                      VCU CAMPUS POLICE .................................................................GSP-42

                      MCVH SAFETY AND SECURITY OFFICE ..................................GSP-42

                      EMERGENCY TELEPHONES ........................................................GSP-42

          HAZARDOUS ENERGY CONTROL (LOCKOUT/TAGOUT)

               PROGRAM POLICY ..............................................................................GSP-43

                      APPENDIX A - HAZARDOUS ENERGY CONTROL

                        (LOCKOUT/TAGOUT) DEFINITIONS .......................................GSP-45

                      APPENDIX B - HAZARDOUS ENERGY CONTROL

                         PROCEDURE (LOCKOUT/TAGOUT) .......................................GSP-47

          DEPARTMENTAL AUDITS....................................................................... GSP-51

                      SAMPLE SELF-SURVEY REQUEST MEMO ...............................GSP-51

                      SAFETY PROFILE - GENERAL SAFETY .....................................GSP-52

                      SAFETY PROFILE - FIRE & DISASTER .......................................GSP-53

                      SAFETY PROFILE - HALLWAYS, STAIRS & EXIT PATHS....... GSP-54

                      SAFETY PROFILE - ELECTRICAL SAFETY ................................GSP-55

                      SAFETY PROFILE - LABORATORY ............................................GSP-56

                      SAFETY PROFILE - VEHICLES ....................................................GSP-57

                      SAFE USE & STORAGE OF FLAMMABLE MATERIAL GUIDELINES                                                                  ...............................................................GSP-59

                      HOLIDAY DECORATIONS GUIDELINE .....................................GSP-60

                      GENERAL SAFETY GUIDELINES FOR ALL AREAS ..................GSP-61

                      SAFETY GUIDELINES FOR ADMINISTRATIVE & OFFICE AREAS                                                                   ..............................................................GSP-62

                      HOUSEKEEPING AND ENVIRONMENTAL SERVICES

                          SAFETY GUIDELINES ...............................................................GSP-63

                      FOOD AND NUTRITIONAL SERVICE SAFETY GUIDELINES .GSP-65

                      SHOP SAFETY GUIDELINES ........................................................GSP-67

                      HOT WORKS PERMIT PROGRAM ..............................................GSP-70

                      TRANSPORTATION SAFETY GUIDELINES ..............................GSP-71

                      FIRE AND OCCUPATIONAL SAFETY TRAINING ....................GSP-72

MCVH/MCVAP POLICIES .............................................................................MCVH-1

          MCVH HAZARD COMMUNICATION POLICY ...................................MCVH-2

RADIOACTIVE MATERIALS .............................................................................RM-1

          RADIATION SAFETY TRAINING ...............................................................RM-1

          RADIATION SAFETY PROGRAM ...............................................................RM-2

          PROCEDURE FOR OBTAINING APPROVAL FOR USE OF RADIOACTIVE

            MATERIALS OR RADIATION PRODUCING DEVICES IN HUMANS ...RM-4

          RATIONALE AND GUIDELINES FOR DEVELOPMENT OF RADIATION

              RISK STATEMENT TO BE INCLUDED IN CONSENT FORMS FOR

                 RESEARCH INVOLVING HUMAN SUBJECTS................................... RM-5

          RADIATION EMERGENCY PLAN ..............................................................RM- 10

DEPARTMENTAL SAFETY PROGRAM ............................................................DS-1

          DEPARTMENT SURVEY ...............................................................................DS-2

          POLICY AND PROCEDURE REVIEW ..........................................................DS-7


 
OEHS