1. Management of spillage of
cytotoxic drugs

2. Cytotoxic waste
Spillage of cytotoxic medications or any body fluids of a
patient which are still considered to be contaminated
with the cytotoxic medication or less active metabolites
of treatment.
Cytotoxic medications are primarily eliminated from the
patient by renal and hepatic excretion. All body
substances may be contaminated with either the
unchanged drug or active drug metabolites.

3. Spillage
• Chemical spillage is defined as the uncontrolled release
of hazardous chemicals which maybe solid, liquid or gas.
• Worksite measures to reduce the potential for spills and
plans for responding to chemical spillage is necessary;
regardless of the type or quantity of hazardous chemical.
Preparations for chemical spillage include safety
equipment for spills and emergency procedures.

4. Cytotoxic Spill Management Procedure
The following step is recommended for dealing with cytotoxic spill
using a spill kit.
a. Notify surrounding personnel of the spill.
b. Open the spill kit and display the warning signage while
isolating the spill area.
c. Prevent the spill from spreading.
d. Put on the cytotoxic gown, booties, overshoes, gloves and
masks with isolation gown.
e. Obtain set of pre-mix cleaning detergent and start to prepare
5% decon 90 solution by pour all amounts liquid in a bottle A to
the bottle B. shake gently and 5% decon 90 solutions ready to
used.
f. Scoop up any broken glass. Place broken glass and any other
sharp items into the sharp bin.

5. g. Use gauge to clean up the actual spill using 5% decon 90
solution as necessary. Repeat several times. Dispose of all
waste into first cytotoxic waste bag.
h. Working from the area of least contamination to the
greatest clean with decon 90 solutions to remove all
spillage residues and rinse the area with distilled water
and dry. Repeat at least twice.
i. All contaminated equipment and gauze used in the
cleaning procedure must be discarded into the first
cytotoxic waste bag including unused cleaning solution.
Remove shoes cover and outer layer latex gloves, isolation
gown and discard into the first cytotoxic waste bag.

6. j. Seal the bag with the plastic ties.
k. Place the first bag into the second waste bag.
l. Remove the cytotoxic gown, masks and remaining
gloves and discard into the second cytotoxic waste bag.
Seal the second waste bag with the plastic tie.
m. Wash hand throughly.
n. Notify supervisor of the spill and complete an incident
report form as soon as possible.
o. Obtain a replacement spill kit immediately from
pharmacy services.

7. Contents of spill kits
Contents:
One tyvex cytotoxic gown one isolation gown
One pair shoe cover one surgical mask, one respirator mask

8. One protective eye goggles two pair latex gloves
Two cytotoxic waste bags,
Plastic ties with label
one sharps bin

9. One cytotoxic spill sign one set scoop and brush
One set of pre-mix
cleaning detergent one bottle distilled water

10. One pack gauze one spill management procedure