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Hospital Decontamination Training

June 2014 marked the official re-certification of the Hospital Decontamination Team. The photographs had to be removed per our customer, sorry.  The Training was topped off with a scenario based practical having the students/Team members setting up their “Zumro” decontamination tent for an actual mock incident.

Many elements should be considered as to a hospital decontamination team and how it operates. From the receiving facilities point of view, some key points should review;

1] How are designated color “codes” activated and what is the length of response times?

Each hospital facility has a designated code known to employees for activation of major or non-common situations or incidents. This accomplishes two (2) goals. The first is to not alarm or cause panic within the confines of the hospital where civilians are located. Untrained persons not used to emergency operations frequently become panicked and can easily start negative mob activities that will further stress hospital operations using up valuable manpower for controlling occupants. The second goal is to alert trained hospital personnel with an uncommon word triggering a remembrance of their training and directing them through their past training, to their assigned location and duties. The hospital emergency management staff should frequently re-affirm this code and quiz hospital responders on their duties. This feature is critical to insure all hospital responders assume their pre-chosen roles. If manpower is limited, ALL responders on duty must arrive at their posts for your decontamination operation to be implemented.  

2] Does your Team have designated responsibilities?

The grouping of responders is an efficient way to handle these issues. Within a decontamination Team, it is functional for each member of the unit to have pre-described duties. This can be accomplished by different divisions being responsible for different set-up or operational functions of your decontamination plan. In training, have one area of the hospital responsible for set-up and mechanical operation of the decontamination tent/device, such as engineering or building services. In this manner, once your decontamination begins, you will have a designated mini-Team handling the responsibility of the operations sustainability over a long period of time. While other designated groups such as service groups, may be inside the tent/device performing decontamination on arriving patients. This type of “system” allows each sub-group within your team the ability to focus on his or hers duties thus performing a competent and thorough decontamination procedure to your emergency management hospital specifications.

3] Is a response available during off shifts?

What is your hospitals decontamination Teams manpower requirements? Can they be met on every shift? Can additional sub-group workers that have been trained be called into work in a reasonable time? All these questions and more revolve around “shift manpower.” Most operations have a much lower number of responders in the afternoons and evenings compared to daytime hours. The emergency manager must be assured that ample manpower is available for decontamination operations on a 24 hour basis. This may include training additional Team members or restriction of time-off for those individuals needed. Management of off duty hours must be coordinated so that all your decontamination “night-shift” members are not off work on the same date.

4] What form of Team communication is used?

Even at close contact to your decontamination and support system workers, a portable communication device becomes essential. Communication from actual decontamination process to the rotation of decon workers to support personnel, all at remote locations from time to time due to the duties required to sustain lengthy decontamination operations is difficult. A portable radio communicator becomes a functional answer to this problem in many cases. We shall look further into this particular piece of equipment next month. There are many considerations to weigh before committing to one particular device or platform for communication. Will they be issued and part of regular hospital uniform? Will they be kept by emergency management and only issued during an emergency? How will the workers become familiar and comfortable using this device if this happens? Will they be secure? Who will keep them charged? These and many more issues will be looked into in the coming month. But for now, one thing is sure. You must find some method of insuring that interpersonal communication is established between all members of your hospital decontamination Team. Without communication, systems usually fail within a short time. This of course, allows contamination inside the perimeter of your hospitals walls. When contamination is allowed on the inside of the hospital, you may lose the ability to safely function and expose more patients to dangerous contaminants.

5] Is chemical identification possible?

All on-scene emergency responders, Haz Mat, Fire, Police, and Military are trained to identify the hazard before making entry. Except in the case of life threatening situations, this is accomplished well over 95% of the time. Along with this information, they are trained to always send copies of this data to the receiving hospitals involved. Ideally, this information and identification should go directly to your ICP (Hospital Command Post) which should contain your head Toxicologist and Decontamination Team Leader. Together, these persons can not only determine how patients are to be treated, but how to decontaminate them BEFORE they enter and contaminate YOUR hospital facility. These persons are critical to your overall operation and must be looked at from the perspective just as the emergency responders look at their first two (2) objectives: identify, and prioritize. The concept here is simple. The Toxicologist can assist the Decontamination Team Leader with proper decontamination procedure techniques, BEFORE the patient enters the hospital interior perimeter. Then, toxicologists can determine the appropriate treatment for the decontaminated patients. Located in the “links” section of a link to the WISER App can be found. This tool gives the hospital decontamination Team Leader instant data on chemicals and hazards that are reported in BEFORE patients arrive. This App is free and can be of immense value to the occasional user. Also included is data from the CDC for emergency medical treatment that may very well be of value to your operation.

6] Are there enough supplies for a long term decontamination situation?

Most groups utilize disposable hospital gown packs for the decontamination patient to wear after discarding clothing and proceeding through the process. How many do you have on call? What happens when you run out and still have incoming patients? Ultimately, hospital gowns or scrubs come to mind. IF a long-term incident activates this option, your organization will be forced to embed the hospital laundry service as part of the team function. Worn scrubs will need secure transport to your washing facility, while clean units will need transportation to the “clean” end of the decontamination tent/device ready to issue to decontaminated patients before hospital entry and treatment. This means, that emergency management must include a system of training and response for the hospital laundry staff. This may not need to be decontamination procedures, but certainly would include the proper protection and handling of these used garments.  

                                              Haz Mat Mike

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