How to Clean Up Blood in a Customer Home

Why this matters

A tech cuts a hand on a duct edge or a broken pane, the bleeding gets handled, and then there is a trail of blood across the customer's hallway. What happens next decides two things: whether anyone else, a coworker or a child of the house, comes into contact with that blood, and whether the customer finds out what happened from the tech or from a brown stain on the runner a week later. Wiping it up with a shop rag gets neither right.

The injured person always comes first (see related: The First Five Minutes After Someone Is Hurt). This card starts once the bleeding is controlled and the person is cared for.

Who should do the cleaning

Blood can carry hepatitis B, hepatitis C and HIV, and hepatitis B in dried blood can stay infectious on a surface for days. If the shop assigns cleanup of blood as part of anyone's job, that is occupational exposure under OSHA's Bloodborne Pathogens Standard, 29 CFR 1910.1030, and the shop owes that person training, protective equipment and the rest of the program (see related: Bloodborne Pathogens and Helping a Bleeding Coworker). In practice: the person who cleans should be someone the shop has trained and equipped for it, usually the crew's designated first-aid responder, and never the person who was cut, whose wound is open.

A large amount of blood, blood soaked into upholstery or a mattress, or anything beyond what a few towels can absorb is past this card. Stop after containing it and have the office arrange a professional cleaning service.

The steps

1. Keep everyone else away from it. Ask the customer to keep children and pets out of the area, and put something across a hallway if needed. A dog walking through a spill spreads it across three rooms, and a toddler finds the one drop you missed. If this is skipped, the cleanup becomes a hunt.

2. Put on gloves and eye protection. Disposable nitrile gloves at minimum, a second pair over the first if there is much blood or anything sharp. Safety glasses if you will be scrubbing, spraying or working at face height, since spatter from a scrubbed surface is a real route into the eye. Skip it and the cleaner becomes the next exposure, the one the whole procedure exists to prevent.

3. Pick up anything sharp first, without fingers. Broken glass, sheet metal offcuts or a utility blade with blood on it go into a rigid container (a coffee can, a heavy plastic bottle) using pliers, tongs or a dustpan. A bloody sharp is the most efficient way blood gets through skin, and a glove does not stop an edge.

4. Absorb, from the outside in. Lay disposable paper towels or an absorbent pad over the blood and let them soak it up, working from the edge toward the center so you do not spread it. Do not spray a disinfectant hard onto a pool of blood; the spray can kick spatter up. Blot, do not scrub, on anything soft.

5. Clean before you disinfect. Wash the area with detergent and water and wipe it dry. Disinfectants work poorly through blood and dirt; a disinfectant applied over residue mostly disinfects the residue. This is the step people skip because the surface already looks clean after step 4.

6. Disinfect, and leave it wet for the time the label says. Use either:

• An EPA-registered disinfectant whose label claims effectiveness against HIV and hepatitis B, used exactly as the label directs. EPA keeps a published list of such products, and the label states the contact time (how long the surface must stay visibly wet). Wiping it dry in ten seconds is not disinfecting, whatever the product.
• Household bleach diluted in fresh water, mixed that day. CDC's environmental infection control guidance uses about 1 part bleach to 99 parts water for small spills on hard surfaces after cleaning, and about 1 part to 9 parts where there is a lot of blood. For a quart of water, that is roughly 2 teaspoons of bleach for the first, and a little under half a cup for the second. Those figures assume ordinary household bleach; a concentrated bleach changes them, so follow the bleach label's own disinfection directions where they differ.

Two rules ride with bleach, both about the air. Never mix bleach with ammonia-based cleaners or with acids (some toilet bowl and rust cleaners); the first makes chloramine gas and the second chlorine gas, both serious inhalation hazards in a small room (see related: Inhalation Exposure First Response). And open a window or run a fan if you are using it in a bathroom or closet.

Match the product to the surface. Bleach will discolor fabric and wool, can etch natural stone and dull some wood finishes. Test on a hidden spot of any finished surface, or use a registered disinfectant whose label lists that surface. Porous surfaces (carpet, rugs, unsealed wood, upholstery, bare drywall) cannot be reliably disinfected with a wipe. Blot, clean what you can with cold water and detergent (hot water sets blood), and tell the customer straight that it may need professional cleaning or replacement. Do not promise that it is disinfected.

7. Bag the waste, and know which kind it is. OSHA defines regulated waste in 1910.1030(b): liquid or semi-liquid blood, items that would release blood if compressed, and items caked with dried blood that could flake off during handling. That kind goes in a closable, labeled or red biohazard bag or container and is disposed of under the shop's arrangement and your state's medical waste rules. Lightly soiled towels and gloves that would not release blood if squeezed are not regulated waste federally; many states let them go in ordinary trash, double-bagged, but state rules vary, so check yours. Either way, take it with you. A bloody bag in the customer's kitchen bin is a conversation you do not want.

8. Take off the gloves the right way, then wash. Peel the first glove off by the cuff so it turns inside out, hold it in the gloved hand, slide a finger under the second cuff and peel it over the first. Then wash with soap and running water for a good 20 seconds; the standard calls for handwashing as soon as feasible after gloves come off, at 1910.1030(d)(2). Use the customer's sink with their permission, or the van's water if you carry it.

9. Tell the customer what happened and what you did. Plain facts, in this order: someone on the crew got a cut, the bleeding was handled, here is where blood landed, here is what we used on each spot, here is anything that still needs attention, and here is who at the office will follow up. Show them the spots. Tell them how long to keep kids and pets off a surface that is still wet. Do not talk fault, insurance or blame; this is a report, not a negotiation.

10. Write it on the job. In the job notes: what surfaces were affected, the product and dilution used, what was flagged to the customer, who did the cleaning. The injury itself goes in the shop's incident report (see related: Accident and Incident Reporting SOP). If the runner turns out stained next week, the note is what shows the customer was told the same day.

Worked example: a hallway, a runner and a door casing

An installer, Jamal, slices a fingertip on a register boot edge while working in an upstairs hallway. He walks to the bathroom holding his hand, dripping. His crew lead, Erin, the crew's designated responder, gets the bleeding stopped and a dressing on him, then looks at the scene.

What she finds. About eight feet of drops on the finished oak hallway floor, a palm-sized spot on a wool hallway runner, and a smear on the white painted door casing where Jamal steadied himself. No sharps besides the boot itself, which she handles by its far edge.

Steps 1 and 2. She asks the homeowner to keep the dog downstairs for twenty minutes, and puts on two pairs of nitrile gloves and her safety glasses.

Oak floor. Small drops, hard sealed surface. She blots each drop, washes the trail with detergent and water and dries it. The floor is finished wood, so instead of bleach she uses the van's EPA-registered disinfectant, whose label lists HIV and hepatitis B and finished wood floors, and keeps it wet for the label's contact time before wiping.

Painted casing. Hard, nonporous, white. She cleans it, tests the same disinfectant on the back edge of the casing, sees no change, and disinfects the smear with it.

Wool runner. Porous, and bleach would bleach the wool. She blots with cold water and a little detergent until no more color lifts, and does not claim to have disinfected it.

Waste. Eight paper towels, two sets of gloves. Nothing is dripping, nothing would release blood if squeezed, so under the federal definition it is not regulated waste. Her state allows ordinary disposal of this kind of waste, so it goes into a bag, then a second bag, and into the van. She peels both pairs of gloves off inside out and washes her hands at the hall bathroom sink, with the homeowner's permission.

Step 9, what she tells the homeowner. "Jamal cut his finger on a piece of duct; he's fine and has a dressing on it. Some blood got on the hall floor, the runner and the door frame. I cleaned the floor and the frame and disinfected them with a product made for that, and they're dry now. The runner is wool, so I couldn't disinfect it without ruining it. I got out what I could, but it may need a professional cleaning, and the office will call you today about that. Keep the dog off it until then."

Step 10. The job note records the three surfaces, the disinfectant used on two, cold water and detergent on the third, that the runner was flagged, and that Erin did the work. The office calls the homeowner that afternoon and arranges the cleaning.

What would have changed it. A pool of blood on a tile bathroom floor would have taken the stronger 1-to-9 bleach mix, or the registered product at the label's directions, after absorbing it, and a towel soaked enough to drip would have been regulated waste needing a biohazard bag and the shop's disposal route. Blood soaked into a mattress or sofa would have stopped Erin at containment and gone straight to a professional cleaner.

The failure this prevents. Without the procedure, the floor gets wiped with a shop rag, the rag goes back in the tool bag, the runner is never mentioned, and the customer finds a stain and a story the next week.

References

• OSHA, Bloodborne Pathogens, 29 CFR 1910.1030 (regulated waste definition, handwashing, housekeeping)
• CDC, Guidelines for Environmental Infection Control (blood spill cleanup and bleach dilutions)
• U.S. EPA, registered antimicrobial products effective against HIV and hepatitis B
• See related: Bloodborne Pathogens and Helping a Bleeding Coworker; The First Five Minutes After Someone Is Hurt
• See related: How to Respond When a Customer Is Hurt in Your Work Area; Accident and Incident Reporting SOP