How to Safely Respond to Medical Episodes in a Hotel

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At some point in their careers, hotel employees may be required to respond to a medical episode in one of the following circumstances:

  • Basic first aid (respiratory, wounds, cardiopulmonary resuscitation, assault, slip/fall, etc.)
  • Homicide
  • Suicide
  • Drug overdose

For the non-medical career professional, responding to a medical episode may be unnerving. The COVID-19 pandemic has added to the growing list of concerns of first responders along with the fear of being exposed to opioids—specifically fentanyl. This epidemic has heightened concerns about existing protocols for safely responding to medical episodes in a hotel. Thus, it is crucial to educate hotel employees on reasonable and acceptable practices based on what we know and the proper protective equipment that is available as of this writing.

Primary Responders

Employees who are trained and credentialed in first aid (at least two per shift are suggested) must be the primary responders in the event of medical episodes. First responders should always carry their personal protective equipment on their person while working, consisting of, at a minimum: a (surgical) face mask, latex gloves, and a mouth shield/guard for rescue breathing/CPR. Employees who have an increased likelihood of coming in contact with blood-borne pathogens (e.g., room attendants, engineers, first responders) must be offered the series of hepatitis B vaccinations, free of charge to the employee.

With regard to fentanyl, first responders must be cognizant of any signs of potential drug use by the victim, illicit or prescribed, to protect themselves from potentially fatal contact, either through skin absorption or airborne intake. Wearing 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 lethal drugs, the first responder must visually and mentally note the condition of the environment and circumstances and immediately back away from the scene to notify and advise local authorities of their findings.

Independent hotels and hotel brands must develop educational programs for employees with access to guestrooms and first responders, with an emphasis on the signs of drug use by a person and within a guestroom. 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 peril. How is the employee expected to escalate their findings to hotel leadership? Who will hotel leadership notify once their employee raises awareness of a potential drug-related issue? Moreover, grief counseling should be provided for employees who were involved in drug-related discoveries, particularly the discovery of a deceased person.

Hotels that are located near hospitals, specifically cancer treatment facilities or hospitals where cosmetic surgery is prominent, must be aware of prescription fentanyl skin patches. When properly used, these patches pose little risk to the user. However, improper disposal of the patches by the patient can potentially expose hotel employees to severe health risks.

Hotels are, by nature, extremely accommodating, providing services to guests to ensure their comfort and enjoyment during their visit. 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 heightens the level of education hotel employees need, as the risk of coming into contact with toxic drugs and sharps is part of their daily routine. In these circumstances, employee training must be more comprehensive and should involve the local board of health for guidance.

The “Do Not Disturb” signs available in hotel rooms often lead the guest to assume that hotel employees will not knock on their room door or enter the guestroom. Hotels have a responsibility to ownership to ensure that the property is adequately maintained by accessing each guestroom on a daily basis. With that in mind, “Do Not Disturb” signs should be changed to signs reading “Later Please” or “Come Back Later.”

Due to the recent pandemic and the reduction in workforce, many hotels have transitioned from daily housekeeping services to limited servicing of each guestroom. However, entering each guestroom on a daily basis (even if it is just to change the trash bag) is vital to the operation of a safe hotel, as employees may come across early warning signs and thus reduce the chances of illicit acts.

In summary, a hotel has a duty of reasonable care to its employees, guests, and visitors to provide a reasonably safe and secure environment. Frontline hotel workers must be given the proper tools and education to prepare and protect themselves from harm and to allow them to properly respond to the victim of a medical episode. Equally damaging to the hotel are the potential negative media exposure and the bad optics when a lack of training for employees is evident, where a clandestine drug lab was established in a hotel, or where a hotel has a reputation for not cooperating with law enforcement to dissuade the use of their property as a “party hotel.”

Hotels, brands and ownership 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 drug labs, and educate their employees accordingly. 

To get more information and resources on how to safely respond to medical episodes in a hotel, visit: Checklist on Responding to Medical Episodes.

About the Authors:

Stephen Barth, author of Hospitality Law and coauthor of Restaurant Law Basics, is an attorney, the founder of, the annual Hospitality Law Conference series, and the Global Travel Risk Summit Series. As a professor at the Conrad N. Hilton College of Hotel and Restaurant Management, University of Houston, he teaches courses in hospitality law and leadership. He is #3 on Global Guru’s Top 30 Hospitality Thought Leaders & Influencers for 2023.

Salvatore Caccavale spent 35 years with Hilton as a director of safety & security in such notable Hilton-branded hotels as the Palmer House in Chicago and The Waldorf-Astoria in New York City. He later served as Hilton’s corporate director of safety & security with oversight for the Americas. Sal now provides consulting in the fields of worker safety, physical security, policy development, and guidance to the hospitality industry, and is an Expert Witness on hospitality legal matters.

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