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Friday
Mar012013

Phase 2 Exposures

Exposure rates and medical consequence vary among patients. This is one reason accurate data regarding vast arrays of medicinal products require lengthy testing with varying subjects, extended over time under low level exposure conditions, and even some varying environmental conditions depending on the product and its intended use. Thus, the continuing struggle concerned with the recording of “relative” accurate and sustainable toxicological data to rely on when considering a large exposure to a variance of persons exposed. One of the reasons contributing to the “unknown” values is for the subject to yield data; he/she must be exposed to low levels of a probable harmful toxin for an extended time. This idea is difficult to sell when soliciting human test subjects.

With many “unknowns” all the more reason for a Haz-Mat Team to have a specific protocol for generic treatment in the field, of known chemical families. “Hydrocarbon” exposure treatment may be markedly different from “Halogen” exposure treatment in an uncontrolled environment such as a hazardous materials incident as we saw in the last months’ article. Medical authorities already have varying treatment protocols in the field for differing events. A heart attack is treated quite differently from a trauma incident. Why then, would it not be reasonable to offer Haz Mat Team “clinics” to responders for varying chemical families? During the inclement weather, “clinics” could be easily integrated into monthly training for Haz-Mat Medics. This would not only foster paramedic field training, but afford emergency responders with the tools to keep “abreast” of new agents, treatments, and subsequent innovative research all designed to increase the professional “standard of care” already found in the emergency medical system. All that is required is interest, passion for your field, and pre-planning.

As an example, many newer techniques have been developed that can be integrated into your EMS protocols for specific treatment of patients on scene. The accepted practice is to decontaminate, stabilize, and transport. Does this serve the public well? Is the steadfast stoic format of constant therapy “without” accepting new medical initiatives “always” the best medicine? This debate takes on much political bantering from the training corps all the way up to the medical directors. This being fact; let us look at our original example.

Improving HF (Hydrogen Fluoride or Hydro-Fluoric Acid) is a particularly nasty yet needed chemical used for the high technology and medical fields. Exposure to concentrated HF over 2% of the body, or to 50 ppm in the atmosphere can lead to death. This strong acid causes excruciating pain and severe burns. The material itself is transported in a variety of specialty containers as its aggressiveness will decompose glass! In dilute solutions the molecule absorbs through the skin and disassociates into the deeper tissue. The fluoride ion then binds with calcium, magnesium, sodium, and potassium all found in cellular form within the body. The result; cell death, bone demineralization, organ failure, and arrhythmias. These symptoms may occur slowly and the damage can continue several days after the exposure.

Conventional medical treatment for skin exposure calls for flushing with water for 15 minutes followed by medical assistance. However, it is much better to flush with water for 5 minutes and apply 2.5% calcium gluconate gel (a 0.13% benzalkonium chloride solution) and then seek medical help. The important point of our HazMat “clinics” is to keep abreast of potential new treatments and possibly take part in field studies currently on the cutting edge. One such endeavor is hexafluorine, a proprietary chelating agent manufactured by “Prevor Laboratory” in Valmondois, France. This product appears to have great promise as a neutralizing wash, research time will tell.

The value of a Haz Mat Medic thoroughly versed in breaking techniques and with frequently updated treatment protocols for hazardous materials could mean the difference between one fatality and ten. In the case of a mass contamination from a release, these principles and immediate knowledge activities could be even more critical towards a successful emergency operation. Adapting decontamination rinse “time” from 15 to 5 minutes could change the implementation of your decontamination line immeasurably! Next month, we will wrap-up our series with the third element for emergency responders regarding decontamination. Join us for “Decontamination 3.”

                              Haz Mat Mike

 

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