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lbb
03-03-2015, 08:15 AM
What's your protocol for dealing with blood on the mat? I'm thinking about both literally (as in "whoops, someone's bleeding" blood smears on the mat) and figuratively (someone has an injury and now there's blood on a gi/an open wound/something like that). What do you require for cleanup and (assuming no serious injury) continued training? For that matter, what are your thoughts about scabbed-over injuries?

(sorry to get graphic, but we've got one member who frequently trains with scabbed-over injuries on hands and feet, and I'm wondering if we insist that these should always be covered)

Marie Noelle Fequiere
03-03-2015, 10:02 AM
What's your protocol for dealing with blood on the mat? I'm thinking about both literally (as in "whoops, someone's bleeding" blood smears on the mat) and figuratively (someone has an injury and now there's blood on a gi/an open wound/something like that). What do you require for cleanup and (assuming no serious injury) continued training? For that matter, what are your thoughts about scabbed-over injuries?

(sorry to get graphic, but we've got one member who frequently trains with scabbed-over injuries on hands and feet, and I'm wondering if we insist that these should always be covered)

I'm not really sure how to remove blood stains from the mat, but please, do ask your student to cover his or her wounds properly before stepping in class. This is a sanitation issue.

Cliff Judge
03-03-2015, 10:36 AM
The days of "its just a flesh wound" are long past.

People who are bleeding must not be on the mat.

Blood must be cleaned with something like peroxide immediately after it is discovered.

MRSA is not fun.

kewms
03-03-2015, 10:39 AM
We use hydrogen peroxide for blood stains on the mat. Cleanup is the responsibility of the person bleeding, if known, or the person who notices the blood, otherwise.

(Bleach might be better, but we have a canvas mat cover and are concerned about damage to the fibers with undiluted bleach.)

We don't ask someone with blood on their gi to change it, but we do make sure the source of the blood is identified and dealt with. People with open wounds are expected to cover them securely before getting back on the mat.

Scabs... it depends on what it is. If it's something like a mat burn that is likely to be re-opened with training, it should be covered. If it's something like an incidental scratch on the hands -- from the person's cats or whatever -- then I'd be fine with leaving it alone.

Obviously (at least I hope it's obvious), something like poison ivy or any other contagious skin condition should be covered.

Katherine

Michael Hackett
03-03-2015, 11:15 AM
Our mat is a heavy vinyl material so blood and other spills are easier to clean than canvas or tatami matting. When someone bleeds, we immediately wipe down the spill or spots with peroxide and then clean again with Lysol. We clean our mat several times a week with bleach; a cup per gallon of water.

Blood on dogi will generally get sprayed down immediately with peroxide, depending on the amount. Since we haven't had an incident of heavy bleeding, that has sufficed. I imagine that if someone had more than just spots of blood, they would leave the mat and change gi.

While body fluids are certainly a health hazard, I personally think the invisible creatures like MRSA are realistically far more dangerous. We have never experienced either MRSA or a staph infection in the almost 25 years of our dojo.

Open or scabbed wounds are covered with band aids and then wrapped with tape to keep the band aid in place.

phitruong
03-03-2015, 11:22 AM
clean blood with peroxide. cover all open wounds with bandage/tape/duct tape/superglue. if it causes too much disruption, ask the person to sit out. consider michael jackson gloves or toe socks for covering too. compression clothing (like those advertised by under armour) under the gi would help too.

Janet Rosen
03-03-2015, 12:27 PM
Hydrogen Peroxide is ok where destruction of mat fiber (like cotton canvas) from chlorine bleach is an issue; otherwise chlorine bleach (diluted per label) is best.
It does not matter why there is a scab. If the scab may be rubbed off, it needs to have a dry dressing on it. Period.

lbb
03-03-2015, 12:43 PM
Thanks, all. We have Zebra mats. I'm not sure what they'd stand up to for cleaning. Anyone know?

Peroxide doesn't disinfect. It sure looks cool and it probably has some effectiveness in removing foreign matter from a wound because of the bubbling mechanical action, but its germicidal capability is vastly overstated. At that, to clean a cut, you're better off scrubbing with soap and water (people unwilling to scrub a cut may get away with letting peroxide do the scrubbing for them). As far as blood on a surface, I don't think peroxide does much of anything.

For blood on gi, my approach has been to give them tape (red duct tape) and have them cover it up, so it won't come into contact with their partners.

Michael and Cliff, I hear ya re: MRSA and staph. I think good basic hygiene takes care of this (I always wash my hands and wrists thoroughly before and after class). And Michael, I agree re: open or scabbed wounds.

mathewjgano
03-03-2015, 12:58 PM
What's your protocol for dealing with blood on the mat? I'm thinking about both literally (as in "whoops, someone's bleeding" blood smears on the mat) and figuratively (someone has an injury and now there's blood on a gi/an open wound/something like that). What do you require for cleanup and (assuming no serious injury) continued training? For that matter, what are your thoughts about scabbed-over injuries?

(sorry to get graphic, but we've got one member who frequently trains with scabbed-over injuries on hands and feet, and I'm wondering if we insist that these should always be covered)

If we have open sores that could bleed we have to cover them up or we'll be interfering with training since, as soon as we see any blood on the mat, whoever did it (if it's obvious) or is closest has to stop right away to clean it up. I think we just use water, but we have coated tatami that are relatively easy to wipe clean.

kewms
03-03-2015, 01:00 PM
The bubbling that hydrogen peroxide does is oxygen being liberated: the H2O2 molecule is unstable and breaks down to atomic oxygen and water. Anaerobic bacteria -- which includes most bloodborne nasties -- don't especially like being flooded with atomic oxygen. The oxygen also corrodes iron, including the iron in hemoglobin, which is why peroxide helps remove blood. So it's not a miracle cure, but it's not useless, either.

Assuming that it's fresh, that is. Because H2O2 is unstable, you'll want to rotate your supply on a regular basis. If it *doesn't* bubble and fizz, that's a pretty good sign that yours has turned itself into a bottle of water.

Katherine

jonreading
03-03-2015, 01:41 PM
Thanks, all. We have Zebra mats. I'm not sure what they'd stand up to for cleaning. Anyone know?

Peroxide doesn't disinfect. It sure looks cool and it probably has some effectiveness in removing foreign matter from a wound because of the bubbling mechanical action, but its germicidal capability is vastly overstated. At that, to clean a cut, you're better off scrubbing with soap and water (people unwilling to scrub a cut may get away with letting peroxide do the scrubbing for them). As far as blood on a surface, I don't think peroxide does much of anything.

For blood on gi, my approach has been to give them tape (red duct tape) and have them cover it up, so it won't come into contact with their partners.

Michael and Cliff, I hear ya re: MRSA and staph. I think good basic hygiene takes care of this (I always wash my hands and wrists thoroughly before and after class). And Michael, I agree re: open or scabbed wounds.

Zebra mats sells a product for cleaning their mats that is a disinfectant. It is what we use.

jonreading
03-04-2015, 09:41 AM
Now that I have a little more time and a keyboard:
http://www.zebramats.com/catalog/mat-cleaner

Bleach and Hydrogen Peroxide are best household products for cleanup but there are also specialized products for pathogen destruction. Obviously, the greatest risk is generally for whoever is doing the cleanup and anyone in direct contact with blood. We also keep gloves.

dps
03-05-2015, 01:50 AM
Lysol?

dps

danj
03-05-2015, 02:10 AM
We just follow accepted protocols from the sporting world in our country - it saves the second guessing and reinventing the wheel as a lot of effort has already been put into it

http://sma.org.au/resources-advice/policies-guidelines/infectious-diseases/

Thers info in the above on wider issues and complexity, which are good to draw on in making decisions on good practice in individual dojo
YMMV

Keith Larman
03-05-2015, 01:34 PM
Appropriate disinfectant for your mats (read up above). We keep a box of gloves in the office next to the blood clean up supplies. If you're cleaning up someone else's blood, gloves go on first. Then peroxide to clean the blood, then disinfect (a quick wipe with dilute bleach solution kills much of what peroxide can't -- use the peroxide first, wipe dry, then go with a very dilute bleach solution and allow to air dry).

If it's a kid who has a scrape, the instructor cleans up making sure to follow protocols (gloves first, peroxide, etc.).

The student leaves the mat and must properly clean up and cover the "leak" before they can return. Gi with blood must be removed and washed before coming back.

Pretty straightforward, actually.

Susan Dalton
03-05-2015, 07:23 PM
We also clean up blood with hydrogen peroxide and mop the mat after every class with Swifter wet mop pads. But we're thinking we're just pushing the germs around. We like the "everybody grabs a rag and wipes a section of mat" approach, but that doesn't always seem sanitary either. Does anyone use vinegar water to clean vinyl-covered mats? At the college we use what maintenance recommends because they buy the supplies: ionized water once a week and ionized water/disinfectant once a week.

Janet Rosen
03-05-2015, 11:52 PM
Susan:
1. WHY "ionized water"?
2. WHY vinegar?

Susan Dalton
03-06-2015, 06:17 AM
Janet,
We use ionized water because that's what our maintenance department recommends and will provide for free. It does seem to have made our mats look better. We haven't started using a vinegar/water solution in the dojo, but it's what one person suggested. I take from your questions that you do not recommend either?

Janet Rosen
03-06-2015, 11:19 AM
Janet,
We use ionized water because that's what our maintenance department recommends and will provide for free. It does seem to have made our mats look better. We haven't started using a vinegar/water solution in the dojo, but it's what one person suggested. I take from your questions that you do not recommend either?

Vinegar is good for gram negative bacteria like e coli and salmonella but those are primarily gastrointestinal issues - it does nothing against the most common skin pathogens we worry about on the mat, which are gram positive: staph and strep. It is not listed anywhere as a recognized effective agent against hepatitis or HIV.
So my takeaway on vinegar is: good for in-home use in bathroom or kitchen. I routinely use a mix of vinegar with a very little bit of water and a very little bit of dish soap at home. But at the dojo - where I have bathroom duty - I use bleach.

Keith Larman
03-06-2015, 11:41 AM
FWIW I worked my way through college working the back room of a dental place doing the disinfection. This was at the time AIDS was first appearing, so lots of nervousness and lots of research going on then. FWIW the biggest takeaway is to PUT ON GLOVES FIRST. Than clean really, really, really, (did I say really enough? No? Okay, really, really...) well, wear gloves when you do it (did I repeat myself? Oh, and eye protection if you can), and then, absent stronger medical disinfectants (or an autoclave) a dilute solution of bleach is your bestest friend ever. Seriously, it is your BFF. Honestly a good cleaning with a soapy warm water will remove most things (not kill them all, mind you, but remove them) then the bleach for what's left to make sure most stuff is dead. Give the dilute bleach a minute or two to sit on the area then clean off.

Oh, and keep a bunch of plastic bags for tossing all the stuff that might have touched the blood. Everything goes in the bag, gloves included. Even if you don't think it touched the blood, if it's something you can toss, toss it in the bag and seal it.

Think of it like kata. No matter how small, no matter how insignificant, you put on the gloves, get the cleaner, get the bleach, put it all in the bag, ... Walk through it like a kata and don't miss anything.

Yes, my wife is still in the medical world so I get this drilled in to me regularly.

kewms
03-06-2015, 11:50 AM
Think of it like kata. No matter how small, no matter how insignificant, you put on the gloves, get the cleaner, get the bleach, put it all in the bag, ... Walk through it like a kata and don't miss anything.

Best advice in this thread so far. Even in hospitals, it turns out that simply making and following a checklist has an enormous impact on secondary infections: http://www.nytimes.com/2009/12/24/books/24book.html?pagewanted=all&_r=0

Katherine

dps
03-06-2015, 03:11 PM
Shouldn't the waste be marked as biohazard?

dps

Keith Larman
03-06-2015, 07:33 PM
Shouldn't the waste be marked as biohazard?

dps

Can I put soiled bandages, medical gloves and disposable bed linens in the trash?

Contaminated wound dressings, disposable sheets and pads, gloves, and dialysis machine filters may be double-bagged in a standard plastic garbage bag and securely fastened. This material may then be combined with other household garbage for disposal.

Healthcare providers and facilities are required to adhere to federal and state regulations, including the Occupational Safety and Health Administration standards. Please consult your state for additional handling requirements for bloodborne pathogens.

Keith Larman
03-06-2015, 07:36 PM
I should add that the above was from the "Waste Management" website. They're one of the largest trash collection services in the United States. Your mileage may vary.

In general, what I was told was that for individuals and non-medical people, double bagging and disposing is fine. Healthcare workers have more involved protocols.

And of course the issue with needles ("sharps") is another special case.

So, in general, double bag and toss. Mark it if you wish but unless someone cuts off a limb, most of us won't be dealing with huge volumes of blood. At least I hope not.

kewms
03-07-2015, 01:38 AM
If you have students who are generating sharps on a regular basis -- diabetics testing blood sugar, for instance -- getting a sharps disposal container would be a polite safety measure for whoever empties your trash.

Otherwise, meh. What do you do with soiled bandaids and such at home? If your dojo is generating enough volume to have real biological waste disposal concerns, you might need to re-examine your teaching protocols...

Katherine

Janet Rosen
03-07-2015, 04:49 PM
If you have students who are generating sharps on a regular basis -- diabetics testing blood sugar, for instance -- getting a sharps disposal container would be a polite safety measure for whoever empties your trash.

Otherwise, meh. What do you do with soiled bandaids and such at home? If your dojo is generating enough volume to have real biological waste disposal concerns, you might need to re-examine your teaching protocols...

Katherine

Students should have no need to generate sharps at the dojo in any quantity.
You are also right there should be no need for a dojo to routinely put things on level of biowaste hazard.

FWIW, our protocol for our clients who inject is I have them use an empty bleach container - they are incredibly puncture resistant - and when it is full I tape it shut with red tape and mark it and bring it to our local dump - er, county waste management facility - for appropriate disposal. I have a feeling some simply seal the bleach containers, bag em and throw them away.

jurasketu
03-07-2015, 05:17 PM
http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

tarik
03-09-2015, 03:26 PM
Personally, I like to lick the blood up, but I'm a berserker and we berserk that way. :dead:

Nice to see the list of more modern good advice though.

Janet Rosen
03-09-2015, 05:27 PM
Personally, I like to lick the blood up, but I'm a berserker and we berserk that way. :dead:.

If we disembowel 'em we can make blood sausage! :D

JP3
03-15-2015, 12:54 PM
IMO open wound of any size should be covered, as not only is it not a good thing for the person to train with an open wound of whatever size, it may carry health hazards for others. That, and make a hard-to-clean mess of the mat/tatami and/or workout wear, such as yawagi/shitagi (jacket/pant).

If someone gets a bad injury, open wound with bleeding (a guy in my class had a freakish fall once, got himself twisted up while the partner accidentally stepped on a foot caused a tib-fib fracture just above his ankle, open wound with bleeding), you cover it immediately witht he cleanest cloth you have to hand, then get assistance at the level you need (we called the ambulance as there was no way he was going to get into a car, and he definitely needed surgery).

FOr the smaller stuff, a little bandage with tape is fine, again IMO. I'm not squeamish about scabbed over sites, but they do have an irritating tendency to open up, so you have to watch them. If there's a lot of them, say someone was riding a bike and fell forward and tore up their palms but it's healing... that's a judgment call both for player and instructor - keep the wounds closed. If they don't stay closed, see above for bandaging to continue practice.

I don't "think" that there is a risk of transmitting infection through a closed/scabbed site, but I might be wrong on that.

Janet Rosen
03-15-2015, 04:42 PM
I don't "think" that there is a risk of transmitting infection through a closed/scabbed site, but I might be wrong on that.

The risk is if the scab tears or comes off.
I also take a hard look at rashes to make sure there are no blisters that might open or weeping areas. Once as a very very junior member of a dojo pulled rank as a nurse to politely tell somebody to get those lesions covered before bowing in.