Decontamination
Purpose for Decontamination
the three most important reasons for
decontaminating exposed victims are:
to remove the agent from the victim’s skin and clothing.
to protect responders from secondary transfer exposures.
to provide victims with psychological comfort.
Physical Removal of Contaminant
aeration
scraping, sweeping, brushing, or
vacuuming
hosing
absorbent material
soap and water
Chemical Removal of Contaminants
0.5% bleach solution (hypochlorite)
Soap and water
Mass Decontamination
Is time constrained
Saves lives by reducing agent from skin
of victims
Also known as emergency, gross, hasty,
immediate
Technical Decontamination
Not time constrained
Complete decontamination of the
residual hazard
Usually
for responders, their PPE, equipment, and facilities
Also known as thorough, deliberate,
detailed, responder, definitive
Emergency Decontamination
Can occur at any time during a decon
procedure
Speed is crucial: Conduct rapid decon
followed by response to the emergency
Decontamination Procedures
Self decontamination
Emergency decontamination
Technical decontamination
Patient decontamination
Mass decontamination
Self Decontamination
Use soap and water if available
Be
careful to keep rinse from entering eyes or open wounds
Disrobe – remove all clothing
Emergency Decontamination
Use copious amounts of water
Best
efforts should be made to capture as much contaminated water as possible
(however life safety must come first)
Disrobe
Peel
clothing from inside (minimize contact with chemical on clothing)
Technical Decontamination
Use soap and water or dilute bleach
solution
Capture run-off in pools or bladder (for
removal as hazardous waste)
Technical Decontamination
Technical Decontamination
Decontamination Corridor
Decontaminate Ambulatory Victims
To decontaminate victims:
Communicate
directions
Arms
out/legs apart
Wash
from top down
If
mustard – BLOT first
If
biological or radiological – WET while removing clothes
Decontaminate Non-Ambulatory Patients
Speed and efficiency are crucial
Minimize exposure
Handling victims during cut-out
Monitor responders for contamination
Technical Decontamination
Set-up away from mass decon
Emphasis on neutralization; not speed
Focus on cross-contamination avoidance
Self-decontamination
Decon
Options
Outdoors (wading pools)
Tents
Outside
Inside
RAM Decon
Trailers
Indoors
Multipurpose
room
Dedicated
room
“Mass” Decon Unit
Basic Requirements
Contain contamination
Control environment
Protect staff
Allow decon
Contain runoff
Allow cleanup or disposal
Patient through-put
Standards?
American Institute of Architects
For
rooms
NFPA and ASTM
For
some field devices
NIOSH eventually
Really, it’s still caveat emptor
Try before you buy
Staff PPE
Levels of PPE
A: big suit, big tank
B: little suit, big tank
C: little suit, little mask
D: no suit, no mask
Level A for entry
Level C for known hazard
Level B or C for unknown?
Level C with PAPR
Standard (Universal) Precautions
Gown
Gloves
Mask
N95
HEPA, to upgrade for plague or smallpox
RESPIRATORY
PRECAUTIONS
Shoe covers
Level B vs. Level C
Training time
8
hours vs. 40 hours
B
training requires escape bottles (OSHA)
Equipment Cost
About
$4000 per person for B
About
$1000 per person for C
But is C safe???
