Decontamination initial

To address the myriad of issues a chemical attack would present to a community, a response template plan with national applicabihfy, referred to as the Off-Site Triage, Treatment and Transport Center, was formulated. The concept was designed to address the non-critical and non-exposed patients who can be expected to seek medical help. This concept requires the set-up of an ancillary medical fadhty to handle the large number of walking wounded and worried well casualties that are expected from a terrorist attack. The facihty would be a temporary site that supplements existing assets, since many of these centers can be set-up as are deemed necessary. The care envisioned to be provided in such a center includes decontamination, initial entry into the medical care system for patients not processed at the scene, care for non-critical patients, transportation to medical facilities for patients in need, and mental health care. 

WOUND DECONTAMINATION Initial Decontamination General Considerations Thickened Agents Off-Gassing Foreign Material... 

Economic Considerations. The principal economic consideration is, of course, total installed system cost, including the initial cost of the flow primary, flow secondary, and related ancillary equipment as well as material and labor required for installation. Other typical considerations are operating costs and the requirements for scheduled maintenance. An economic factor of increasing importance is the cost of disposal at the end of normal flow meter service life. This may involve meter decontamination if hazardous fluids have been measured. 

Like decontamination, directions for proper waste disposal should be indicated in the initial technology package. In some cases, the client company should be very involved in how certain wastes are handled and disposed of, and may even maintain control over this part of the toll. Both parties have vested interest in assuring waste disposal is properly completed and adequately documented prior to termination of contract. 

Casualties/personnel Speed in decontamination is absolutely essential. To be effective, decontamination must be completed within 2 minutes after postexposure. However, decontamination after the initial 2 minutes should still be undertaken in order to prevent additional percutaneous absorption of the agent leading to systemic toxicity. Remove all clothing as it may continue to emit "trapped" agent vapor after contact with the vapor cloud has ceased. Shower using copious amounts of soap and water. Ensure that the hair has been washed and rinsed to remove potentially trapped vapor. To be effective, decontamination must be completed within 2 minutes of exposure. If there is a potential that the eyes have been exposed to vesicants, irrigate with water or 0.9% saline solution for a minimum of 15 minutes. 

Standard burials are acceptable when contamination levels are low enough to allow bodies to be handled without wearing additional protective equipment. Cremation may be required if remains cannot be completely decontaminated. Although arsenic vesicant agents are destroyed at the operating temperature of a commercial crematorium (i.e., above 1000°F), the initial heating phase may volatilize some of the agents and allow vapors to escape. Additionally, combustion will produce toxic and potentially volatile arsenic oxides. 

Strength County-GIS personnel supported operations through continuous production of maps that were distributed to all agencies. EOC (Emergency Operations Center) staff worked to procure buses for initial evacuation and for transport from decontamination... 

Improvement Item Mass casualty plan was not implemented initially due to communication difficulties. Communication of patient status at decontamination was not well-coordinated with Red Cross shelter representatives. Persons at shelters were registered, but if they were sent to the hospital or left with friends/family, their status was unknown. 

The primary mission of the Decontamination Element is to turn chemical/biological victims into patients through mass decontamination procedures by establishing a site capable of providing initial and sustained operational decontamination of Force personnel (rescue workers), ambulatory, and non-ambulatory patients. The Decontamination Element also handles decontamination of CBIRF members, attachments, vehicles, and equipment that have entered the incident site controls access into and out of the incident site handles processing of surety material and evidence while maintaining chain of custody through the site and handles limited area decontamination of the incident site. 

Nerve agent intoxication requires rapid decontamination to prevent further absorption by the patient and to prevent exposure to others, ventilation when necessary, administration of antidotes, as well as supportive therapy. Skin decontamination is not necessary with exposure to vapor alone, but clothing should be removed to get rid of any trapped vapor. With nerve agents, there can be high airway resistance due to bronchoconstric-tion and secretions, and initial ventilation is often difficult. The restriction will decrease with atropine administration. Copious secretions which maybe thickened by atropine also impede ventilatory actions and will require frequent suctioning. For inhalation exposure to nerve agents, ventilation support is essential. 

Treatment — Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.2. The initial... 

There is a strong need to train of new professionals in commercial or governmental initiatives, and teach them mastery the scientific background of biological decontamination and specific features of in-field applications. As the most relevant pollution problems are localised in the less developed countries, training per se may not suffice. 

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