Wednesday, March 12, 2008

Decontamination Infosheet by Aftershock

Biological, Chemicle & Radiological Decontamination

Decontamination is defined as the process of removing or neutralizing a hazard from the environment, property, or life form. The principal objectives of this process are to prevent further harm and optimize the chance for full clinical recovery or restoration of the object exposed to the dangerous hazard. Military and civilian research suggests that upwards to 97% of dangerous contaminants can be removed through simple decontamination procedures for both ambulatory and non-ambulatory victims. Medical triage should occur first and then decontamination. There are two types of decontamination procedures: Site and Field. Site decontamination is what is done on the location where victims are first encountered. This could be indoors or outdoors and should be treated accordingly. Field is a area set up at a Crisis Center, where other supplies and more fixed infrastructure is.


Decontamination Procedures:

  • Always ensure your own health, do not engage in activities that will put you at undue risk.

  • Decontamination always occur after the 30 second standard Medical triage.

  • Prioritize non-ambulatory victims first

  • Keep ambulatory victims from moving around and spreading or “embedding' contaminates

  • Move all patients, if feasible, from contaminated sites and barring this find reasonable shelter to resist further or re-contamination.

  • Remove patients clothes (with medic shears). Estimates suggest 70% of decontaminates are on clothes (and approx.25% of them will transfer in time to the body).

  • Perform a quick 1 minute rinse staring from head and going to feet (there are more orifices and larger pores in the top part of the body). You will need about 2 gallons of water

  • If there is time rinse again with a dilution of some cleaning agent (e.g. Soap). The idea is the added molecular weight and possible chemical adhesion will occur and remove more contaminants. You will need about 2 gallons of water and a 1/100 part solution to maximize resources and effectiveness.

  • Re-cloth the body (obviously not with the old soiled clothes). The easiest and best way to do this is with garbage bags. The plastic allows for an effective barrier and is somewhat resistant to “contaminant travel” due to its non-porous nature. The uniformity in color also helps spot decontaminates. One could also use emergency blankets to meet the same need.

  • Soiled clothes should be bagged and sealed if possible or lumped together. A note saying “HAZ/MAT” is enough to alert others not to touch or go near it.

  • Shears should be rinsed before returning to your bag and gloves, face masks and or other personal emergency protection should be left in the HAZ/MAT bag or pile.


Decontamination Procedures:

  • You should set up at least two field decontamination sites. One for each Gender.

  • To avoid trouble or slowing down, try to ensure at least some privacy, a complete tent like structure is optimal .

  • The structure should have a clearly marked entrance and exit.

  • Containers with lids or bags, should be provided for people to discard their clothes, while they wait in line.

  • On the other side of the path 9across from the dumping ground) should be new clothes, robes, towels, or something. It should be very close so people can get it at the same time they are dropping of contaminated clothes.

  • Hoses or buckets attached to pulleys or rigged in some other way above the people should be available.

  • People will move ideally through three connected sections of the tent.

  • First will have a lot of water 3-4 gallons or 30 seconds of 15 psi hose (about the strength of a garden hose).

  • Stage 2 will have the cleaning solution and half the water of stage 1 (scale the above step)

  • Stage 3 will have the same amount of water as the previous stage but no cleaning solution.

  • There will be another receptacle for the newly contaminated cloth and new coverings.

  • The exit path should veer off immediately to the left or right as close to a 90 degree angle as avoid contaminating mist, ensure greater privacy and to avoid congestion.

  • There should be clear directions to the medical triage station and all people should head that way.

Non-Ambulatory Patients in a Field Contamination Station

  • For the most part follow the same procedure as above

  • Non-ambulatory people should go first

  • There should be a throw away on the stretcher being used (if you have no material for throw-aways then wash it down with a gallon of 1/50 solution and have at least 3 alternating stretchers)

  • Do NOT flip the patient (this could cause greater injury than the contamination)

  • Rescuers escorting the stretcher should be wearing maximum personal protection gear and that gear should be disposed of AFTER all escorting is done.

  • Having a roller system or stretchers on ropes, is the best way to avoid escort contamination

Other Notes about Decontamination:

  • If You Do Not Have Water: Follow the procedures but use sand, flour, talc powder or similar substance. Then use a soft broom to brush it off.

  • What about Babies & Infants They must always be escorted and one must make sure to protect them from inhaling water. One can use less water on children and babies.

  • What about water Run Off the research seems to suggest that for most decontaminates it is not that big of a deal. You will need to have some pallets or what not if there are many, because it will get muddy. I think for us it would be ideal to collect the water, to keep it seeping into the soil or entering the sewer.

  • Escorts should go through Decontamination escorts even with full protective gear should still go through decontamination after their shift is done.

  • How about bleach never use bleach with chemical or radiological decontamination, it can make it worse. Bleach must be administered very carefully and should only be used by ambulatory patients and in very diluted amounts (½ cap-full per gallon)

  • Cleaning tools To save time and avoid mistakes, all possibly contaminated tools should be put in a container or bag together. Then water with 50% solution should be added to container. Soaked for at least 5 minutes. Dumped out and spread over a piece of plastic,tarp, canvass or on concrete. Then tools should be hosed down and then carefully rotated and hosed again. All tools should be allowed to dry before using again. All tools should be marked with red (tape, spray paint, markers, etc.) and should be considered Hot even after cleaning. They should be kept separate from other tools so there is no mix up.

No comments: