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bed bugs

Bedbugs are making a comeback all across the United States. Though they are a nuisance, they do not pose a health risk. Out-patient dialysis settings are not hospitable environments for bedbugs, therefore the risk of infestation is low. The following steps are recommended:

  1. Cover dialysis chair with white paper to easily identify bed bugs.
  2. Utilize active bed bug monitors to determine if bed bug infestation is present in facility. Traps such as those that emit carbon dioxide, may be used to monitor bed bug populations. Bugs captured can be evaluated.
  3. Educate the patient and staff. Provide instructions to patient for treatment of home and belongings that have had bed bugs. 
  4. Limit personal belongings being brought into clinic (blankets, bags, purses, clothing, etc.). This also includes wheelchairs from infested home.  Use large containers with smooth inner surface and lockable lids to hold patient belongings and patient clothing if needed while receiving dialysis. Bedbugs cannot climb smooth surfaces very well.
  5. Bag all of the patient’s belongings and have them dialyze in a disposable gown. Or as a less embarrassing alternative, give the patient directions to wash/dry the clothing s/he wears to dialysis on hot; put the clean clothes in a sealed container or garbage bag; s/he must take a shower and wash his/her hair/mustache/beard before putting on the clean clothes and coming to treatment (also assure that his/her shoes, coat, etc. are bed bug-free).
  6. Use dialysis chair at end of floor to best isolate bed bugs. Keep everything off of floor in vicinity of chair to isolate bed bugs. and restricting the chair for only that patient’s use, if possible.
  7. Consider investing in a heating box to treat the patient’s belongings. Dialysis facilities have used Portable heating units with success. All stages of bed bugs are susceptible to temperatures above 120°F. You can do a search on Amazon for ZappBug Oven or The Enviro CaseTM. There are many sizes/costs.
  8. Assist the patient in identifying sources of assistance for home fumigation. Provide community resources to assist patient with home treatment (Dept. of Health and Dept. of Aging, AKF, NKF, Salvation Army or Goodwill, Church groups).
  9. Waiting rooms, visitor lounges, common areas, laundry rooms, and equipment such as wheelchairs and food carts, should be regularly inspected for bed bugs.
  10. There are a number of products on the market to treat bed bugs. Isopropyl alcohol is quite effective at killing bed bugs. 91% alcohol is recommended. Facilities should review MSDSs of proposed insecticides/pesticides for safe applications in health care occupancy and on items in affected areas (i.e. – flame retardant properties of dialysis chairs, molecular size and absorption rate, etc)
  11. While bed bugs do not jump, they are excellent hitchhikers. Staff handling patients may have bed bugs transferred to their clothing. Therefore, the staff should practice changing into clean scrubs and putting the old scrubs into a hot dryer for 30 minutes. Shoes can also be put into the hot dryer.

Resources for Patients

Maryland Department of Health & Mental Hygiene's Bed Bug Fact Sheet

Baltimore City Health Department Healthy Home Bureau's Battling Bed Bugs Safely: A Guide to Preventing and Eliminating Bed Bugs Manual (English, Spanish)

Resources for Staff

EPA's Bed Bug Webpage

IPM Fact Sheet: Bed bugs are back! An IPM answer

Illinois Department of Health's Prevention & Control: Bed Bugs in Health Care Facilities

St. Joseph's Bed Bug Management Algorithm

MARC's Bed Bugs Webinar
June 2015