how to tie a red bag

How to Tie a Red Bag

Bags that are used to dispose of biohazardous waste are typically referred to as “red bags,” since they are red in color. Safe handling and packaging of regulated medical waste (RMW) is a crucial part of the medical waste disposal process.

During this step, mistakes can lead to unnecessary accidents and possible exposure for you, your staff, and your waste services provider. Before we go into detail about how to properly tie a red bag, let’s look at why they’re used and what should be placed in them.

Why Use a Red Bag

Using red bags to contain RMW gives a visible warning to both healthcare employees and medical waste disposal workers. RMW should be handled with extra caution and a red bag easily identifies that waste as biohazardous. The use of special containers, such as red bags, for RMW disposal is mandated by several governmental agencies, including the Department of Transportation (DoT), OSHA, and the Environmental Protection Agency (EPA). State guidelines follow these rules and are strictly enforced.

What Goes in the Red Bag ?

You are responsible for determining whether your waste should be classified as RMW. It all comes down to how much blood or other potentially infectious materials (OPIM) an item contains. This means that you need to consider the potential for generation of bulk blood or OPIM through dripping or flaking off material that contains blood or OPIM. Some common RWM waste would be saturated gauze and bandages, visibly bloody empty intravenous bags/tubing, and visibly contaminated PPE. As a RMW generator, it is your responsibility to train your staff on what goes in the red biohazard bag.

Loose sharps should never be placed in a red bag. Only a sharps container that is closed and locked may go into a red bag. Also, pharmaceutical waste and chemotherapy waste should be handled separately and never placed in a red bag. All pharmaceutical and chemotherapy waste must be incinerated. RMW can be treated and disposed of in a different manner.

Preparing to Tie a Red Bag: Wear Gloves!

The first, and arguably the most important step, is to put on a pair of gloves. It’s easy to get in a hurry and skip this very important part of the process. You might be surprised at how many accidents/exposures happen due to careless, hurried behavior. It’s important to take your time and make sure you follow the correct procedures. Gloves must be used when handling medical waste. Here are some important reminders:

  • Only use impermeable gloves (nitrile and neoprene are preferred choices).
  • Uncontained sharps waste should not be handled – even while wearing gloves. Use tongs to pick up individual sharps and place them in a sharps container.
  • If you accidentally puncture or tear a glove, discard it. Wash your hands and put on a new pair of gloves.
  • After removing your gloves, wash your hands.

Appropriate Personal Protective Equipment (PPE), which includes covering arms and other skin surfaces that might be exposed to infectious agents, should be worn by all employees who handle potentially infectious waste. In order to meet compliance regulations, you should understand all guidelines for PPE and your practice.

Preparing to Tie a Red Bag: Don’t Overfill!

Next, you’ll want to make sure the bag is not overfilled. This is another important step in the process because an overfilled bag can easily leak or puncture. Also, do not compress the waste. Compressing waste with your hands, feet, or by any other means can cause the bag to be punctured or to burst. There should be a minimum of entrapped air, but do not get rid of the air by compressing the waste.

How to Tie a Red Bag

Red biohazardous bags require a very secure knot. The preferred choice is a hand-tied gooseneck knot. We have a couple of videos, below, that show: 1) how to tie a red bag and 2) how NOT to tie a red bag. After you read through these steps, you may want to watch them.

Step 1: Gather the top of the bag and twist the “neck” about 10 to 14 inches.

Step 2: Fold the end over your hand holding the bag to make a loop with the twisted end.

Step 3:  Seal the loop tightly with either packing tape or a zip tie*.

*A zip tie may also be used; however, you should be able to hold the bag upside down without any leakage from the contents.

Packing Tape or Duct Tape

We recommend that you use packing tape as opposed to duct tape. Why? Duct tape may lose some of its adhesion in extreme hot or cold weather. Packing tape can stand up to a wide variety of temperatures and provides the secure seal required for packaging medical waste.

What About a Hand-Tied Single Knot?

Some instructions say that a single knot may be used if the neck of the bag is twisted first. We recommend that you check with your state regulations, if in doubt. Again, the goal is to make sure that there is absolutely no leakage from the bag contents. In our experience, we find the hand-tied gooseneck knot to be the most effective.

What Knot Should Never Be Used?

There are two common types of knots that should never be used in securing red bag waste. The first is a single knot, where the ends of the bag are simply gathered and tied or sealed without being twisted. The second type of knot that should not be used is a “bunny ear” or bow knot, where the ends are tied together to seal the bag.

Your Red Bag is Securely Tied; Now What?

Now that you’ve properly tied your red bag, it can be placed into another container that is approved for medical waste. You should not be able to see the bag after the secondary container is closed. The container must be properly labeled for transport. Make sure you know how to prepare medical waste for pickup. And remember, red bags can only be collected and disposed of by a licensed medical waste contractor.

Still have questions about preparing your biohazardous waste for pickup? Our medical waste specialists are ready to help. TriHaz Solutions’ experts are available to help your facility manage its waste at each step along the disposal process. Hazardous waste generators have cradle-to- grave liability and our chain of custody protocols help ensure that your waste is properly managed in accordance with RCRA requirements.

To learn more about biohazardous waste disposal, including how our full-service medical waste collection, treatment, and disposal services help you safely dispose of regulated medical waste, contact TriHaz today.

How to Tie a Red Bag: Watch the Video

How NOT to Tie a Red Bag: Watch the Video


Simplify your job and stay up-to-date on medical and hazardous waste compliance for healthcare and industry.

    By subscribing to our blog you agree to our Privacy Policy.