Decontamination casualty

Guidelines for Mass Casualty Decontamination During a Terrorist Chemical Agent Incident. Prepared by U.S. Army Soldier and Biological Chemical Command (SBCCOM). Aberdeen Proving Ground, MD (January) 2000. 

Minimally, all hospital personnel (e.g., nurses, physicians, security, and triage) who have a designated role in a HAZMAT response must be trained to the first responder awareness level (Levitin Siegelson, 2002). Staff must be comfortable with knowing how to locate and use personal protective equipment and with the decontamination process (see chapter 26, Mass Casualty Decontamination, for further discussion). 

Emergency departments have a unique role in mass casualty decontamination. Nurses must use the appropriate level of personal protective equipment in order to keep themselves safe and avoid becoming a victim. 

PHNs working in a receiving station who observes people arriving with what appears to be dust on their clothing, should assume that it is radioactive and don the appropriate level PPE, notify HAZMAT and refer people to them for decontamination. (See chapter 26, Mass Casualty Decontamination, for further discussion.)... 

Cancio, L.C. (1993). Chemical casualty decontamination by medical platoons in the 82nd airborne division. Mil. Med. 158 1-5. 

CBIRF s mission statement indicates that it has capabilities for nuclear, biological, and chemical (NBC) detection, identification, and reconnaissance casualty extraction casualty decontamination technical rescue provision of medical trauma supplies and explosive ordnance disposal. It works best if it can be pre-positioned. Its strengths include these ... 

A new course, Field Management of Chemical and Biological Casualties (FCBC), began in 1999. The focus of this course is on pre-hospital emergency treatment and casualty decontamination. It is available in both on-site and off-site versions. 

Unit. All units need to exercise their NBC capabilities. Depending on the mission of the unit, this training could include sample collection and management of suspected NBC agents, casualty decontamination and treatment, preventive medicine practices, and hazard assessments. Units need to determine and contact possible supporting and supported units. Contact should be made before deployment to allow for smoother operations. 

B. Casualty Decontamination. MTFs must coordinate with surrounding units to provide them with augmentees in case of contaminated casualties. 

Most importantly, medical care providers or rescuers must protect themselves from contamination. If the caregiver becomes contaminated, there will be one more casualty and one fewer rescuer. Protection of the rescuer can be achieved by physical means, such as masks, gloves, and aprons, or by ensuring that the casualty has been thoroughly decontaminated. The importance of casualty decontamination should be obvious, but, unfortunately, it is often forgotten or overlooked. There were reports that in several instances during the Iran-Iraq War (1981-1988), incompletely decontaminated mustard casualties who were transported to European medical centers for further care caused contamination of others, who then also became casualties. 

Medical facilities treating chemical casualties must divide their operations into two categories contaminated (dirty) and uncontaminated (clean). Contaminated operations include triage, emergency treatment, and patient decontamination. Uncontaminated operations include treatment and final disposition. All activities conducted in the Casualty Decontamination Center (CDC) and not inside a collective protection shelter must be conducted at MOPP 4. Operational flexibility is essential. Therefore, the number and arrangement of functional areas will be adapted to both medical and tactical situations. 

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