Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-C-1 – Smallpox

? Remove the cap from the pre-filled syringe. Take a 1.0 cc syringe and withdraw 0.25 mL from the opening in the pre-filled diluent syringe. Inject 0.25 mL of diluent in the 1.0cc syringe into the vaccine vial. ? Withdraw the needle and syringe and discard in a sharps disposalcontainer. ? Allow the vaccine vial to stand undisturbed for 3 -5 minutes and then, if necessary swirl the vial gently to effect complete reconstitution. ? Label the vaccine vial with the date and time the diluent was placed into the vaccine vial. ? Reconstituted vaccine may be used for up to 3 months if stored at 2 - 8 degreesC. ? The vaccine vial, stopper, diluent syringe and needle and all other material used to reconstitute the vaccine should be disposed of in a sharps disposal container or a red, biohazard bag. Administration of Reconstituted Vaccine ? Gloves should be worn on both hands when handling open vaccine vialsand when administering and evaluating the vaccination site. ? Remove aluminum seal from vaccine vial by pulling down the "tear off" tab. ? Remove the rubber stopper from the vaccine vial and place in a sterile container (stopper will be used to reseal vial vial). ? Chose a site that is accessible for both vaccination and evaluation of the vaccine take on post-vaccination day 7. The outer aspect of the upper arm over the insertion of the deltoid muscle should be used. ? Clean the site with an alcohol pad if soil is visible. Allow the alcohol to dry thoroughly to avoid inactivation of the vaccine deposited on theskin. ? Dip the bifurcated point of a sterile bifurcated needle into the vial of reconstituted vaccine and withdraw the needle holding it perpendicular to the floor. Do not redip the needle into the vaccine vial if the needle has touched theskin. ? Holding the skin of the upper arm taut, the vaccinator should place their wrist firmly on the recipient's arm. Holding the needle at a 90 degree angle (perpendicular) to the skin apply 15 up and down strokes within a 5 mm diameter area. The strokes should be made rapidly and be sufficiently vigorous to draw a trace of blood at the site. If a trace of blood does not appear the strokes have not been sufficiently vigorous and the procedure should be repeated. ? Dispose of the bifurcated needle in the syringe disposal container. These needles can be reprocessed. Consult instructions for reprocessing below. ? Cover the vaccination site with a porous bandage such as gauze until thescab has separated and the underlying skin is healed. Consult vaccination site care instructions. ? Recap the vial with the sterile cap and store the vaccine for subsequent use at 2 -8 degrees C.

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