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Module 6 Decontamination

Module 6 Decontamination. Decontamination. Reduction or removal of agents by physical means or by chemical neutralization Physical means: flushing, scraping, and powders Neutralization: soap, bleach, and special solutions. Purposes of Decontamination.

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Module 6 Decontamination

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  1. Module 6Decontamination

  2. Decontamination • Reduction or removal of agents by physical means or by chemical neutralization • Physical means: flushing, scraping, and powders • Neutralization: soap, bleach, and special solutions

  3. Purposes of Decontamination • Prevent further damage from chemical exposure • Prevent secondary or cross contamination

  4. Module Organization • Overview of decontamination concepts • Current practices • 3 case studies • Special considerations

  5. Basic Concepts • Must be done immediately • Must be done effectively • Clothes must be removed to eliminate possible contamination

  6. Three Decontamination Types • Personal • self • buddy • Casualty • non-ambulatory • Personnel • non-exposed • ambulatory

  7. Liquid versus Vapor • Decontamination is needed for both liquid and vapor exposure • Vapor is absorbed by clothing and hair • Rigorous decontamination is needed for liquid exposure • Less rigorous decontamination is needed for vapor exposure

  8. Decontamination Solution • Soap and water is the preferred solution • as effective as diluted bleach solution • less caustic • takes less time than diluted bleach solution • Don’t delay decontamination if only water is readily available

  9. Secondary Contamination • Case Study: Tokyo Sarin release • Case Study: New York HAZMAT • Case Study: Louisiana Mustard Exposure • Lessons learned • need appropriate PPE and training • need to isolate persons exposed • need to follow standardized protocols and procedures

  10. Tokyo Subway Sarin IncidentMarch 20, 1995 • 3 subway lines attacked in morning rush hour • Estimated 5,500 persons exposed • No on-scene decontamination • Decontamination initiated at medical facilities 3 hours afterexposure • Secondary contamination at hospitals was a major problem

  11. Tokyo Subway Sarin Incident • Decontamination initiated at medical facilities 3 hours after exposure • Hospitals lacked space and equipment to handle large number of victims • Secondary contamination at hospitals was a major problem

  12. NY State HAZMAT Event • Dimethoate (systemic insecticide) overheated and released fumes • Quickly resulted in respiratory problems • Eleven workers self-reported to hospital ED • ED staff become ill; HAZMAT called • Evacuated ED and decontaminated victims and ER staff (1 hour)

  13. NY State HAZMAT Event • ER washed down by hospital staff and reopened 2 hours later • No testing conducted or reentry criteria used

  14. NY State HAZMAT Event • No screening • No training of ER staff in signs and symptoms • Lack of communication and info on chemicals • No containment area for victims • Separate facilities unavailable • No testing conducted or reentry criteria used

  15. Mustard Exposure in Vinyl Chloride Plant • Inadvertently produce nitrogen and sulfur mustard in Louisiana chemical facility • Over 150 workers exposed during hydro-blasting operation, 3 seriously • Latent symptoms emc.ornl.gov/CSEPPweb/.../m6_decon_2007.ppt

  16. Mustard Exposure in Vinyl Chloride Plant • 150 people report symptoms 2 days later • OSHA involved after 3rd hospitalization • Over a week to determine mustard involved • Considerable secondary contamination from worker’s clothing to spouses

  17. Mustard Exposure in Vinyl Chloride Plant Findings: • Personnel decontamination not performed • No control of contaminated personnel or clothing • Secondary contamination at unknown levels • Local physicians do not know how to treat victims • Agents were not initially identified • Commercial laboratory analysis inadequate • PPE not used or used improperly

  18. Mustard Exposure in Vinyl Chloride Plant • Follow-up 6 years later

  19. Current Practices • Self- and buddy-decontamination • Decontamination station • Ambulatory decontamination • Non-ambulatory decontamination • Mass decontamination • Animal decontamination

  20. Self- and Buddy-Decontamination • Insufficient time to set up decontamination station • Need to instruct public to do it themselves • Self: Do it on your own • Buddy: Help others to do it • Followed by technical decontamination

  21. Self- and Buddy-Decontamination • Anticipate that not all people will follow instructions

  22. Field and Hospital Decontamination • Siting the facility • upwind, uphill, and upstream • allow for security to control scene • Establish reception area for initial screening • Establish triage area for rapid medical evaluation and classification • Simple Triage and Rapid Treatment (START)

  23. Decontamination Station2 lines

  24. Decontamination Station3 lines

  25. Important Considerations • Deployment • portable for field use • permanent facilities at HCFs • At least two lines, ideally 3 • ambulatory (mixed or male only) • non-ambulatory • female ambulatory • Warm water supply • Privacy • Run-off control

  26. Decontamination Priorities • People who are known or suspected of being contaminated and who require prompt medical attention due to agent exposure or other severe injury • People who are exhibiting signs/symptoms of agent exposure • People who are known to be contaminated but are not exhibiting signs/symptoms and don't urgently require medical attention • People who are suspected of being contaminated but show no signs of agent toxicity • Animals that provide critical support to humans (e.g., seeing eye dogs) that are known or suspected to be contaminated

  27. Ambulatory Decontamination • Receive, triage and tag • Treat wounds (optional) • Remove and bag all effects • Thoroughly shower with soap and water

  28. Ambulatory Decontamination • Rinse and dry • Don clean clothes and tag • Remove to clean zone

  29. Non-Ambulatory Decontamination • Receive, triage, and tag • Send through line on backboard • Clothing cut away and bagged

  30. Non-ambulatory cont. • Flushed with soap solution, scrubbed, rinsed with clean water and dried • Tagged and covered • Transferred to clean zone for treatment

  31. Mass Decontamination • Used to process large number of people • Water only is recommended • Several options: Ladder and Truck Over-head Shower

  32. Mass Decontamination • Run-off water and EPA

  33. Animal Decontamination • PETS Act (2006) • Pets, livestock, and service animals can be contaminated in a variety of disasters • Need plan to set up decontamination facility for animals • Scrub with liquid soap and water and dry

  34. Animal Decontamination • Need plan to set up decontamination facility for animals • Scrub with liquid soap and water and dry

  35. Animal Decontamination • Animals evaluated for treatment • Handling issues of owner/animal separation http://emc.ornl.gov/CSEPPweb/animals/animals_emergencies_owner.htm http://emc.ornl.gov/CSEPPweb/animals/Animals_Emergencies_Planners.htm

  36. Special Considerations • Infants, children and elderly • People with disabilities

  37. Special Considerations • Cold weather • Psychological effects

  38. Special Considerations • Considerations for biological contamination

  39. Special Considerations • Considerations for radiological contamination

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