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Tuesday
Nov042014

Ebola Response for Emergency Responders

With all the concern over PPE/CPC protection for the Ebola crisis, remember there are a number of elements when applying these ideas to the Emergency Response arena. Basically there are Five (5) concepts that Fire Trainers, Emergency Managers, and Coordinators must consider.

Let’s take a look at some of these considerations BEFORE you decide on up-grades for your response group. We have created an adaptable course in a one (1) day format that can easily be adapted to all emergency response organizations. We primarily offer Instruction for the Michigan, Ohio, Illinois, and Indiana areas. You can get more information through this LINK.

First and foremost, the concept of Emergency Responder application of a Training program and protocol adaptation does have one aspect above and beyond other response groups. We always build into any system a 15 to 1 safety margin. Second, the concept of “workability” which is highlighted in my first book “Practical Haz Mat” (found on this website) MUST be brought into your response group. Third, decontamination practices MUST be adhered to. Fourth, rotation of personnel greatly decreases contamination. Five, PPE/CPC for designated work tasks.

1] Almost all protocols are written at the level of “minimal standards.” The reason for this concept is much too lengthy to discuss in this format. Suffice to say, this should become the starting point for your groups considerations. By meeting the “minimal standards” you have no additional safety factor in place when the “human element” comes into play. We all know this will, people tire, become apathetic, and basically wear-out. Haz Mat Teams build this 15 to 1 safety factor WITH the anticipation; of during a lengthy event 7 to 8 of these safety factors will be violated. This concept leaves additional safety factors in place for the human element already described. Why does this work? Because, you rarely see injured Haz Mat Responders injured in the line of duty. It is because of this concept that every time an incident occurs, you do NOT see crowded emergency rooms filled with Haz Mat workers. This concept has proven favorable results.

 

2] Workability, “The ability to be properly protected and remain viable to accomplish the desired task at hand.” This concept is a system of balance for the responder. Too much protection reduces functionality, while too little reduces the 15 to 1 safety factor. The decision to reduce safety in favor of workability DOES NOT equal “speed.” Increasing the speed of on-site operations will always result in contamination. Do one “thing-at-a-time” WELL and then, and only then, move onto the next task. Speed injures responders, contaminates personnel, all for the needless name of “quick?” What is the hurry? Where are you going? Slow down, perform the processes the way you designed them, and carefully rotate exhausted personnel to avoid contamination. The threat from Ebola-like viruses is a single contact. Once you breach your safety factors you ARE exposed. In this case your next step “after” decontamination/disinfection is to report to a monitored quarantine, because you now have entered the world of an exposed victim. Workability balance MUST be viewed from the perspective of “safety vs. task completion.” If any consideration is ever given to rate, it is always to SLOW the incident to INCREASE the workability/safety factors. Never hesitate to increase the 15 to 1 workability margin as long as it maintains your workability function for your response group.

3] Decontamination practices must be adhered to. For the VHF (Viral Hemorrhagic Fever) class or Ebola-like contaminants, a bleach solution is the “best-practices” solution. This too, is far to lengthy for this article to explain in its proper manner, other than to say much research has been done on bleach solutions for weapon-ized threats. The key has been the “practices.” The solution must be fresh, (every 24hours or cloudy) the length of time exposed to the contaminated surface must be timed and practiced, 1 to 5 minutes depending on the work practice. These and many more decontamination/disinfection elements in your program MUST be followed exactly as you pre-plan them. Remember, if these finite details are ignored your safety factor of 15 to 1 reduces, closer and closer to contamination. How close will you go?

4] Personnel rotation MUST be considered. At the end of the day, I would wager the contamination/exposures we have seen of late were caused by this factor. I have seen contaminated responders at frequent incident sites where their exhaustion has not been factored in to the response equation. AS a result, accidents always occur. Once you have decided this situation is not going to be mitigated in the next 30 minutes, SLOW-DOWN, and re-think your priorities. The process of re-assessment should at least be the same length of time that you have spent from the initial activation of your team to the present point. Water, food, rest, and rotation can eliminate exposure in almost all situations.

5] CPC/PPE for designated work tasks. If you look closely at the millennia of “Ebola” videos from all the various news media you will find discrepancies within CPC/PPE garments. This is because all the responders you see are not performing the same work task. Remember; the CPC/PPE is an “ensemble” this means a collection of elements suited to the “specific” tasks. As an example, when the heavier outer glove is seen on West Africa workers, this denotes a body team member. The longer a victim has this virus, the more contaminant exists. The “Ebola Virus” has an additive affect on the victim in terms of the sheer volume of contaminant. The longer infection continues the more contaminant. Therefore, the deceased have a large volume of virus contaminant on their person; hence heavier gloves are needed for body movement and personnel protection. This is another example of “workability.” The same principle should be adjusted to your “ensemble” whether you respond to the street (FD), or the emergency room (hospital personnel) or any other incident scene at your facility. Lastly, the concept of proper fit is often ignored. A XL sized level “B” suit will fit snugly on a 6’1” 180 lb. person. This means that most responders should begin the fitting process at the 2XL size. This gives needed room for bending, reaching and other work activities without exposing skin to infectious contact. This principle needs constant monitoring for proper personnel protection.

How will all these principles affect your operation? Well, you will have to cross-train your responders in the discipline necessary to wear CPC for the proper protection. Your Haz-Mat Trainer does not have to turn them into “Technicians” as they fall under the training regulations as a “specialized employee.” Additional space will be needed for PPE/CPC storage depending on your response vehicle. A monitoring system will need to be written for exposed employees. Where will you send them? How will I decontaminate the vehicle? All these and more need to be “pre-planned.” If they are quarantined, how will I replace these members? How much extra resources will be required, and from where? What legal options does my facility have at hand that can be implemented? Depending on your specific operation dictates the training to be delivered.

If you have any question on these practices feel free to contact us at contactus@hazmatmike.com we will be glad to help you with your unique situation.

                                  Haz Mat Mike

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