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Tuesday
Dec062011

Decontamination

     Decontamination, whether it is for industrial chemicals, weaponized nerve or biological agents, or standard residues found on firefighter turn-out gear after any structure fire, adhere to the four basic principles of decontamination. Each of the four is equally important when forming a decontamination “Plan” to train your personnel in, requiring decontamination of “non-hazmat responders”. The critical difference of any pre-plan is centered on differences between this group and, "All other civilian persons”. Reasonably, you can expect these two groups to behave markedly different. Hazmat responders “know” the principles behind decontamination, and the time it takes to set up an operation before it commences, and the benefits of waiting calmly for a proper decontamination to begin. They know how critical it is to “properly” perform a thorough decontamination “before” moving to the next station of treatment and medical evaluation. They “know” how critical it is to reduce contamination from their person. This affects the overall recovery and reduces cross contamination to persons the exposed will make contact with.

The non-hazmat responder you can expect to be scared, agitated, impatient, and only concerned about their personal safety. In other words, gripped and dominated by their fear. This can cause cross contamination and deadly exposure to others not involved or even on-site. This of course, violates the goal of decontamination; namely removal of contaminant from affected victims, and keeping the contamination on-site.

     These four principles are regarded as the ABC’s of CPR; you cannot decontaminate that which has not yet been prioritized. Much like you cannot ventilate a patient until you secure an airway!

     The first principle of decontamination is to decontaminate by “PRIORITY”. Exposed persons, or “victims” do have a priority for entering the decontamination line. Victims located inside the exclusion zone {ground zero for the actual release or discharge} are going to suffer the highest level of exposure and hence the greatest fatality rate of all affected victims. Regardless of the contaminant, these victims will suffer the greatest challenge for survival and are the least likely to survive without immediate decontamination and care. The mantra of all mass casualty decontamination systems MUST be, “the best benefit, for the greatest number of victims”.

     The second principle; decontaminate only that which is “NECESSARY” can be successfully performed along with “PRIORITIZATION” by Command elements in the initial minutes while your “Decontamination Team” is building the system. Delaying decontamination team operations wastes life saving time, and detracts from the effectiveness of the third principle. The initial minutes of mass casualty decontamination must be solely “focused” on the best benefit for the greatest number of victims. Only decontaminate affected victims “first”.

     The third principle; is to decontaminate “AS SOON AS POSSIBLE”. Gentle large water droplet flushing has been found to provide the best method of decontaminating large numbers of affected victims. While various soaps, Foams, and other tools have increased the effectiveness of a decontamination system, it has also been discovered that the “time” required to implement these tools may increase fatality. Overall, any system you devise owes its success to three elements. Speed, Simplicity, Sustainability; the best result for the greatest number of victims will depend on the fastest decontamination system you can set-up and implement. Simple systems are quick and seldom fail during decontamination over an extended time period. Lastly, a system must be sustainable. If you cannot perform decontamination over a long incident, effectiveness will be compromised. The more complex the system becomes the more personnel must be dedicated towards its success. Depending on your manpower concerns this too, may cause ineffectiveness.

     The fourth principle is to decontaminate “AS FAR FORWARD AS POSSIBLE”. When concerning victims; this can and should include some degree of clothing removal. The more clothing removed increases the effectiveness of the decontamination system. Whether you are dealing with impropriety or extreme weather, or both, this as you can imagine adds another whole dimension to your decontamination system. When speaking of release sites, every area that has been exposed will need more thorough decontamination “AFTER” victims, rescue, and treatment has been accomplished. At this point in the incident the life safety issues have been addressed, allowing more thoughtful consideration for your teams’ next step. When considering future decisions for this site, security and denial of unaffected persons will minimize additional contamination.

                                                                          Haz Mat Mike   

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