Disasters and Hazardous Materials

1. Chapter 33 Disasters and Hazardous Materials

2. Case History You respond to a call for an overturned truck. You approach the scene from upwind and observe a flaming tanker approximately 200 yards in the distance. There are several cars involved in the incident.

3. Hazardous Materials(HAZMAT) • Definition: Any substance (solid, liquid, or gas) capable of creating harm to people, property, and the environment. • HAZMAT can contaminate or physically remain on or in a person, animal, the environment, or equipment, creating a continuing risk of injury or a risk of exposure to others.

4. Hazardous Materials(HAZMAT) • EMT’s primary responsibility – provide medical care and maintain safety, preventing unnecessary contamination of themselves and others.

5. Hazardous Materials(HAZMAT) • May be flammable, toxic, infectious, corrosive, radioactive, oxidizing, or reactive

6. OSHA Hazardous Waste Operations and Emergency Response Standard • First responder/awareness • First responder/operations • Hazardous materials technician • Hazardous materials specialist • On-site incident commander

7. Safety • First and ongoing concern • Position vehicle and crew upwind and uphill from incident. • Ascertain information about incident from a safe distance. • Keep unnecessary people away from the affected area.

8. Properties of Hazardous Materials • Routes by which hazardous materials can enter the body: • Inhalation • Absorption • Ingestion • Injection • Can be alone or in combination

9. Control Zones

10. Personal Protective Equipment • Those who enter a potentially contaminated area should have: • Special training • Specialized protective equipment • Specifically compatible with the hazard • Breathing apparatus

11. Decontamination • Dilution • Absorption • Chemical washes • Disposal and isolation

12. HAZMAT Warning Placards

13. Incident Management System • Organized system of roles, responsibilities, and SOPs used to manage emergency operation • Central authority for incident • Three essential components • Command • Triage • Transportation

14. Structure

15. Structure

16. Role – Individuals • Individuals are assigned roles in one of the sectors. • EMT should report to the sector officer. • EMT should complete the task and report back to the sector officer.

17. Safety • EMS command is responsible for scene safety. • Priorities of safety concerns: • Rescuer • Public • Victim • Do not add to the number of victims.

18. Triage • Three stages • First • No treatment • Victims are tagged by category of injury. • Second • Begins after patients removed to safe area • More thorough assessment • Treatment • Third • Field hospital, if necessary

19. Triage Priorities • Red – Highest priority • Patients with life threats who have greatest chance for survival • Require hospital care within 1 hour • Examples: • Readily controllable bleeding • Compound fractures • Mechanical respiratory problems

20. Triage Priorities • Yellow – Second priority • Potential life threats who must be treated within a few hours • No systemic signs of shock • Examples • Multiple or major fractures

21. Triage Priorities • Green – Lowest priority • No life-threatening injuries • Ambulatory • Black – Last priority • No signs of life • Obvious mortal injuries

22. START Triage System

23. Special Considerations • Children should be kept with parents when possible. • Hysterical patients should be removed to another area.

24. Transportation • Drivers should remain with their vehicles or leave keys with transport officer. • When ambulance leaves site with patients, transport office notifies receiving hospitals • To keep airwaves clear, EMS crew should not communicate with hospital. • Hospital selection – per local protocol