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DECON TEAM REQUIREMENTS/ SITE CONSIDERATIONS. Objectives. Who should be on the Decon team? Discuss OSHA First Receivers standard. Roles of various team members. Discuss decontamination site selection. Hospital Decontamination Teams. Core Trained Group Originally only ER staff
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Objectives • Who should be on the Decon team? • Discuss OSHA First Receivers standard. • Roles of various team members. • Discuss decontamination site selection. Decontamination Team
Hospital Decontamination Teams • Core Trained Group • Originally only ER staff • Now core includes many more than ER staff • Members available 24/7 • Pager • Stipend for responding and training • Accountability for equipment and access Decontamination Team
Who will do Decon?Who should not do DECON? • Administrators • ED Clinicians • Firefighters/EMS • Housekeeping • Facilities • Military • Techs and non-medical support • Security Decontamination Team
OSHA First Receivers Guidelines • Created in January 2005 • It is an extension of the standards for personnel involved in responding to hazardous chemical spills • Specifically addresses hospital providers • Available at www.osha.org Decontamination Team
Security Team • Control all access to hospital entrance/exits. • May have to recruit non-security staff. • PPE requirements risk/benefit analysis. • Might be the first person to “greet” a contaminated patient. Decontamination Team
Decontamination Team • Patient transport – entry and exit (does not enter tent) • To the tent (guide/non-ambulatory) • Cut clothes if non-ambulatory • Triage - pre and/or post decontamination (does not normally enter tent) • Decontamination personnel • Ambulatory (1 per side – post DECON) • Non-ambulatory (minimum of 4 (?) per patient) • Agent specific monitoring for success (another person?) Decontamination Team
Decontamination Clinical Team Decides if immediate treatment is needed prior to decontamination • MARK 1 kits • Amyl nitrate • Decide what type of decontamination is needed • Deceased/expectant patients assessment Decontamination Team
Perfect World • Decon zone personnel = 9 people • Safety Monitor - 1 • Security - 1 • Clinical/Triage - 1 • Litter bearers/escorts – 2 • Decontaminators – 4 • Decon zone personnel = 30 people • Safety Monitor - 1 • Security – 1 to 4 • Clinicians – 2 to 5 • Litter bearers/escorts – 14 • Decontaminators – 8 Decontamination Team
Decontamination Site • Large outdoor area • Fixed lines vs. deployable shelters • Control run off (EPA) • Non-permeable surface if possible • Utilities & Water • Hot & cold • No tears soap • Down wind of the facility • Controlled access to the DECON site and the healthcare facility!!!!!!!!! Decontamination Team
DecontaminationEquipment • Ownership • Accessible • Mobile as site may change • Maintained and Inspected regularly Decontamination Team
Hospital Secure Entry Control Point DecontaminationSite Triage Station Immediate Treatment ? Wet Decon Dry Decon Litter Decon Secondary Facility ? Decontamination Team
Dry Decon Litter Decon Wet Decon Decontamination Team
Summary • Personnel need to … • Understand the decontamination plan • Understand the difference in requirements between the RELEASE SITE (HAZMAT) and HOSPITAL ENTRY DECON zones • Be trained and medically cleared for their specific roles • Equipped with Level C PPE if working in the decon zone • Scale response to the size of the event • Establish a decontamination site Decontamination Team
Thank you! Questions?