Approaching the Incident Key Actions

If called to a potential chemical scene, the approach should be cautious, uphill and upwind from the release. 

On arrival, all medical staff should identily the officer in charge of the incident— the incident commander (this will usually be a senior fire or police officer), the incident command centre if it is already set up. The presence of each worker and any special skills, equipment or knowledge that they have can then be logged. Preparation should be made for the use of PPE at this time (see Chap. 4). Respiratory protection is the most important aspect of this and respirators should be kept close by to allow rapid domiing if the situation deteriorates and there is immediate airborne contamination (e.g. from a change in wind direction). 

At this time, emergency responders will be given a precise role, e.g. medical commander, hazard advisor or triage officer. It is important to keep to this allocated role so that dupUcation and confusion are minimised. As with the 

Once the overall scene has been assessed by the incident commander, implementation of any local pre-agreed on- or oflF-site plans or major incident policies can be instituted. 

One of the main difficulties of a chemical incident is obtaining rapid information on the identity of the chemical or mix of chemicals involved and their health hazards. Disseminating this information is vital and allows medical management to proceed on an adequately informed basis. Evidence of the nature of the released chemical will come from the detection equipment deployed by the fire and special ambulance services and also from the primary assessment of the signs and symptoms of casualties to try and identify characteristic toxidromes. These are considered in Chap. 6. 

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