Hotel Medical Emergencies: A Bloodborne Pathogen Risk

This hotel room could contain Bloodborne Pathogens

At some point in their career, many hotel employees might be required to respond to a medical incident. This is likely to happen if one of the following circumstances occurs:

  • Basic first aid is required for any individual on premises (e.g respiratory issues, cuts & wounds, cardiopulmonary resuscitation, assault, slip/trip/fall, etc.)
  • A Homicide occurs
  • A Suicide occurs
  • A Drug overdose occurs

Medical Incidents are Stressful

For a non-medical professional, responding to a medical incident could be stressful and unnerving. 

The COVID-19 pandemic has added to a growing list of concerns for first responders such as firefighters and EMT’s  along with the fear of being exposed to opioids and more specifically-  fentanyl. 

The fentanyl epidemic has heightened concerns about existing protocols for safely responding to medical episodes in hotels. 

With this being the case, it is essential to educate hotel staff on reasonable and acceptable practices based on current best practices, OSHA regulations, and the proper personal protective equipment (PPE) that is required.

Primary Responders: Rights and Responsibilities

Employees who are trained and certified in first aid (at least two per shift are recommended) must be the primary responders when medical episodes occur.

First responders should always carry their PPE (personal protective equipment) on their person whilst working. It goes without saying that all on premises hotel staff, and in particular, first responders must hold a current OSHA Bloodborne Pathogens Certificate.

Personal Protective Equipment (PPE) Requirements

PPE must consist of, at minimum: 

  • face mask (surgical grade)
  • Latex or nitrile gloves
  • mouth shield/guard for CPR and rescue breathing. 

Employees who have an increased likelihood of coming in contact with bloodborne pathogens, for example room attendants, janitorial staff, engineers, and first responders, must be offered the series of hepatitis B vaccinations, at no cost to the employee.

The Scourge of Fentanyl

With regard to fentanyl, first responders must be alert to any signs of potential illicit or prescribed drug use by the victim. 

This is to protect themselves from potentially fatal contact, either through skin absorption or airborne intake. 

Donning PPE prior to coming in contact with the victim offers a layer of protection but does not guarantee the first responder’s personal safety.

When there is evidence of fentanyl or other potentially lethal drugs, the first responder must visually and mentally note the condition of the environment and circumstances – then immediately retreat from the scene to notify and advise local authorities of their findings.

Training and Educational Programs

Independent hotels and hotel brands must develop educational programs for all employees that have access to guest rooms, and first responders.

Training programs should place emphasis on recognizing the signs of drug use by a person and within a guest room. 

These programs need to provide clear guidance on what employees should and should not do when exposed to a potentially toxic and lethal situation that places their life in jeopardy. 

Some example content that should be covered includes:

  • What is the process for the employee to escalate their findings to hotel leadership? 
  • Who will hotel leadership notify once their employee raises awareness of a potential drug-related issue? 

Grief counseling should be provided to staff who were involved in drug-related discoveries, particularly the discovery of a deceased person.

Hotels that are located near to medical facilities, specifically cancer treatment facilities or hospitals where cosmetic surgery is provided, must be aware of prescription fentanyl skin patches. 

When properly used, fentanyl patches pose little risk to the user. However, improper disposal of patches by the patient can potentially expose hotel employees to health risks.

Hotels provide services to guests to ensure their comfort and enjoyment during their stay. Without exception, hotels also provide housing, either by contract with rehabilitation facilities, local governments, or medical outpatient services, for guests who are recovering from drug addiction. 

This type of accommodation increases the level of training hotel employees need, as the risk of coming into contact with toxic drugs and sharps is part of their daily duties. 

In these circumstances, staff education must be more in-depth and should involve the local board of health for guidance.

Do Not Disturb?

The ‘Do Not Disturb’ signs available in some hotel rooms often lead the guest to assume that hotel employees will not knock on their room door or enter the guest room.

A hotel do not disturb sign
Do not disturb signs can be used by hotel guests to mask illicit activities

Hotels do have a responsibility to ownership to ensure that the property is adequately maintained by accessing each guestroom on a daily basis. 

This being the case, legacy ‘Do Not Disturb’ signs should be replaced with signs stating ‘Later Please’ or ‘Come Back Later’ wherever possible.

Due to the current economic situation and the resultant reduction in workforce, many hotels have transitioned from daily housekeeping services to limited servicing of guestrooms. 

Daily Checks are Essential

That aside, entering each guestroom on a daily basis, even if it is just to change the rubbish bag, is still vital to the operation of a safe hotel.

Employees may come across early warning signs and significantly reduce the chance of illicit acts happening.


A hotel has a duty of reasonable care to its staff, guests, and visitors to provide a reasonably safe and secure environment. 

Frontline hotel workers must be given the proper tools and training to prepare and protect themselves from harm and dangers such as bloodborne pathogens, and to allow them to properly respond to the victim of a medical emergency. 

Potential negative media exposure and the bad optics when a lack of training for employees is evident can be extremely damaging for a hotel’s brand. 

For example, where a clandestine drug lab was established in a hotel room, or where a hotel has a reputation for not cooperating with law enforcement to dissuade the use of their property as a party location.

Hotels, brands and owners are obligated to proactively develop written site-specific policies on how to safely respond to medical episodes, recognize the signs of illicit drug use and clandestine drug labs, and educate their employees accordingly. 

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