Chemotherapy — Safe Handling
A single splash of cyclophosphamide on ungloved skin can cause mutagenic exposure — and the nurse, not the patient, becomes the victim. Safe handling isn't optional; it's self-preservation.
Core Concept
Chemotherapy agents are hazardous drugs classified by NIOSH — they can cause reproductive harm, cancer, and organ damage in healthcare workers through skin absorption, inhalation, or accidental ingestion. Personal protective equipment (PPE) for handling includes chemotherapy-rated double gloving, a closed-front disposable gown, eye protection, and a respirator when aerosolization risk exists. All preparation occurs in a biological safety cabinet (BSC) with vertical laminar airflow — never at the bedside or under a horizontal hood. Administration requires a closed-system transfer device (CSTD) to prevent drug escape. IV tubing must be primed with non-drug solution before attaching the chemotherapy bag. Spill kits must be immediately accessible on the unit; spills are cleaned inward to outward to avoid spreading. All contaminated materials — gowns, gloves, tubing, empty bags — go in yellow chemotherapy waste containers, not regular biohazard (red bag) trash. Body fluids of clients receiving chemo are considered hazardous for 48 hours post-administration; nurses and caregivers handling urine, stool, emesis, or linens within this window must wear chemotherapy-rated gloves. Pregnant nurses should not handle or administer chemotherapy under any circumstance.
Watch Out For
Don't confuse standard biohazard waste (red bag) with chemotherapy waste (yellow bag) — mixing them is a regulatory and safety violation. Students assume regular exam gloves are sufficient; only chemotherapy-tested gloves rated to ASTM D6978 prevent permeation. A horizontal laminar flow hood protects the drug's sterility but blows contaminants toward the preparer — a vertical BSC protects BOTH.
Clinical Pearl
Yellow means chemo. Yellow waste bag, yellow sharps container. If it touched chemo, it goes in yellow — including the tubing primed with plain saline that later carried the drug.
Test Your Knowledge
3 quick questions — see how well you understood Chemotherapy — Safe Handling