Bringing a patient who may have been contaminated into a department runs the risk of contaminating you, the emergency department and even the hospital.

Other people in the waiting room may also be contaminated, and the department may become unusable.

The important organisational concept is to have seperate ‘dirty’ and ‘clean’ or ‘hot’ and ‘cold’ areas, which are divided by a very definite line across which only the patient should pass once decontaminated [6].

Staff performing the decontamination must be very aware of whether they are ‘dirty’ or ‘clean’ and stay that way until relieved, or stood down.


A patient arriving in the waiting room should be asked to wait outside and be spoken to and assessed at a safe distance. It can then be decided if they need decontamination.

A second patient arriving with the same complaint requires the chemical plan to be activated, but dealing with the first patient should not be delayed.

Once decontaminated, they can enter the department and be treated.

Learning bite

The department must be separated into ‘dirty’ and ‘clean’ areas. [Evidence grade: 4, grade of recommendation: D].