operational level lesson 6 presentation hazardous materials for first responders, 3 rd ed

Operational Level Lesson 6 Presentation

Hazardous Materials for First Responders, 3rd Ed.

Operational Level6–2

Contamination Terms

• Contamination — The process of transferring a hazardous material from its source to people, animals, the environment, or equipment

• Decontamination– The process of removing hazardous materials to

prevent the spread of contaminants beyond a specific area and reduce the level of contamination to levels that are no longer harmful

– Is performed when a victim, responder, animal, or equipment leaves the hot zone (1 of 2)


Contamination Terms

• Secondary contamination — The contamination of people, equipment, or the environment outside of the hot zone

• Exposure — The process by which people, animals, the environment, and equipment are subjected to or actually come in contact with a hazardous material

• Hazard — The harm that can be done by a material

(2 of 2)


Types of Contamination

• Primary – The direct transfer of a hazardous material to

persons, equipment, and the environment– Occurs in the hot zone because of direct contact

with a hazardous material

(1 of 3)



• Secondary– The contamination of people, of equipment, or the

environment outside the hot zone– The contaminant is carried from the hot zone by

personnel’s clothing or tools, air currents, and runoff water.

– If personnel are not decontaminated before leaving the hot zone, they can contaminate whomever and whatever they touch thereafter.

(2 of 3)



• Surface– The contamination of the surface of a material– Does not penetrate, permeate, or soak into

materials

• Permeation– The penetration of a contaminant below the

surface of a material

(3 of 3)


Categories of Decontamination

• Gross decontamination– Quickly removing the worst surface contamination,

usually by rinsing with water from handheld hoselines, emergency showers, or other water sources

– Performed on the following people in the following situations:

– Entry team personnel before technical decontamination

– Victims during emergency decontamination– Persons requiring mass decontamination (1 of 4)



• Emergency decontamination– Removing contamination on individuals in potentially

life-threatening situations with or without the formal establishment of a decontamination corridor

– A type of gross decontamination

• Technical (formal) decontamination– Using chemical or physical methods to thoroughly

remove contaminants from responders (primarily entry team personnel) and their equipment

– Conducted within a formal decontamination line or corridor following a gross decontamination

(2 of 4)



• Mass decontamination — Conducting gross decontamination of multiple people at one time

• Secondary decontamination — Taking a shower after having completed a technical decontamination

• Definitive decontamination — Decontaminating further after technical decontamination (3 of 4)



• Patient decontamination — Decontaminating injured patients or victims

• Buddy decontamination — Performing decontamination between entry team personnel (or others), making it easier to rinse difficult-to-reach areas such as the back and backs of legs and knees

• Self decontamination — Conducting emergency decontamination on oneself, usually by rinsing with water or using a blotting/ absorption method (4 of 4)


Importance ofScene Control Procedures

• First responders must direct victims to a safe location to await decontamination and prevent victims from leaving the scene.

• Decontamination prevents secondary contamination to others.

• All first responders must be sure to also know the department’s plan for evacuation of uncontaminated persons from the hazard area.


Decontamination Methods

• Wet– Washing the contaminated surface with solutions or

flushing with a hose stream or safety shower– Usually necessitates the collection of runoff water in

wading pools or other liquid-retaining devices

• Dry– Scraping, brushing, and absorption– May be as simple as removing contaminated

clothing and putting into a 55-gallon (208 L) storage bag

– Does not create large amounts of contaminated runoff

(1 of 2)


Decontamination Methods

• Physical– Removes the contaminant from a contaminated

person without changing the material chemically– The contaminant is contained for disposal

• Chemical– To make the contaminant less harmful by

changing it through some kind of chemical process

(2 of 2)


Gross Decontamination

• Flushing with water from a hose stream, safety shower, or other water source


Emergency Decontamination

• When it is needed:– Failure of protective clothing– Accidental contamination of first responders– Heat illness or other injury suffered by emergency

workers in the hot zone– Immediate medical attention required for other

victims

(1 of 2)


Emergency Decontamination

• Advantages– Requires minimal equipment– Reduces contamination quickly– Does not require a formal contamination reduction

corridor or decontamination process

• Limitations– Does not always totally decontaminate the victim– Creates contaminated runoff that can harm the

environment and other exposures(2 of 2)


Steps in Emergency Decontamination

1. Remove the victim from the contaminated area.

2. Wash immediately any exposed body parts with flooding quantities of water.

3. Remove victim’s clothing and/or PPE rapidly – if possible, cutting from the top down in a matter that minimizes the spread of contaminants. (1 of 2)


Steps in Emergency Decontamination

4. Perform a quick cycle of head-to-toe rinse, wash, and rinse.

5. Transfer the victim to treatment personnel for assessment, first aid, and medical treatment.

6. Ensure that ambulance and hospital personnel are told about the contaminant involved.

(2 of 2)


Technical (Formal) Decontamination

• Absorption– Picking up liquid contaminants with absorbents– Advantage — Absorbents are inexpensive and

readily available– Limitations

– Absorbents do not alter the hazardous material– Absorbents have limited use on protective

clothing and vertical surfaces– Absorbent disposal may be a problem

(1 of 9)


Technical (Formal)Decontamination

• Adsorption– Process in which a hazardous liquid interacts with

(or is bound to) the surface of a sorbent material

• Brushing or scraping– Removing large particles of contaminant or

contaminated materials such as mud from boots or other PPE

– Is not sufficient decontamination– Is used before other types of decontamination

(2 of 9)



• Chemical degradation– Using another material to change the chemical

structure of a hazardous material– Commonly used materials

– Household bleach– Isopropyl alcohol– Hydrated lime– Household drain cleaner– Baking soda– Liquid detergents

(3 of 9)



• Chemical degradation– Advantage — Can reduce cleanup costs and the

risk posed to the first responder– Limitations

– Takes time to determine the right chemical to use and set up the process

– Can be harmful to first responders if the process creates heat and toxic vapors

(4 of 9)



• Dilution– Using water to flush contaminants from

contaminated victims or objects and diluting water-soluble hazardous materials to safe levels

– Advantage — The accessibility, speed, and economy of using water

– Limitations– Water may cause a reaction and create even

more serious problems.– Runoff water from the process is still

contaminated and must be confined and then disposed of properly. (5 of 9)



• Neutralization– Changing the pH of a corrosive, raising, or

lowering, it towards 7 (neutral) on the pH scale

• Sanitization, disinfection, or sterilization– Sanitization — Reduces the number of

microorganisms to a safe level (such as by washing hands with soap and water)

– Disinfection — Kills most of the organisms present– Sterilization — Kills all microorganisms present,

with chemicals, steam, heat, or radiation (6 of 9)



• Solidification — Process that treats a hazardous liquid chemically so that it turns into a solid

• Vacuuming — Process using high efficiency particulate air (HEPA) filter vacuum cleaners to vacuum solid materials such as fibers, dusts, powders, and particulates from surfaces

(7 of 9)



• Washing– Process similar to dilution, but also involves using

prepared solutions such as solvents, soap, and/or detergents mixed with water in order to make the contaminant more water-soluble before rinsing with plain water

• Evaporation– Can be accomplished by simply waiting long

enough for hazardous materials to evaporate

(8 of 9)



• Isolation and disposal– Isolating the contaminated items by collecting

them in some fashion and then disposing of them in accordance with applicable regulations and laws

(9 of 9)


Mass Decontamination

• The process of conducting gross decontamination of multiple people at one time in emergency situations

• Is initiated where the number of victims and time constraints do not allow the establishment of an in-depth decontamination process

• Uses large volumes of low-pressure water to reduce the level of contamination

• Check with LERP or SOPs for exact procedures


Patient Decontamination

• Is necessary whenever victims have been contaminated yet need medical attention

• Uses the same techniques as other types of decontamination, but gives special consideration to the injuries and medical conditions of the victims

(1 of 2)



• Ambulatory patients– Victims who are able to understand directions, talk,

and walk unassisted– Most are triaged as minimal– Factors for determining priority

– Casualties closest to the point of release– Casualties reporting exposure to the hazardous

material– Casualties with evidence of contamination on

their clothing or skin– Casualties with serious medical symptoms– Casualties with conventional injuries (2 of 2)


Decontamination Steps for Ambulatory Patients

1. Direct patients by voice, PA system amplification, and/or hand signals to the gross decontamination area inside the hot zone but away from the high-risk areas.

2. Direct patients to remove their clothing down to their underwear.

3. Place the patient's clothing in trash barrels whenever possible, separating valuable personal effects into clear plastic bags, and placing the patient’s name or a unique identifying number on the bags whenever possible.

(1 of 2)


Decontamination Steps forAmbulatory Patients

4. Vacuum, brush, or wipe all particulate matter off the contaminated patients.

5. Have patients close their mouth and eyes.

6. Using handheld sprayers containing tepid water and/or diluted bleach solution, rinse the patient from head to toe for 1 minute.

7. Direct patients to proceed to the cold zone.

(2 of 2)



• Nonambulatory patients– Victims who are unconscious, unresponsive, or

unable to move unassisted


Decontamination Steps for Nonambulatory Patients

1. Remove the person from the high-risk area in the quickest way possible and carry the patient to the edge of the hot zone bordering the warm zone.

2. Remove the patient’s clothing, cutting it off as necessary, down to the underwear.

3. Place the patient’s clothes in a trash barrel, separating personal effects into clear plastic bags, and placing the patient’s name or a unique identifying number on the bags whenever possible. (1 of 4)


Decontamination Steps forNonambulatory Patients

4. Vacuum, brush, or wipe off all particulate matter from the patient.

5. Close the patient’s mouth and pinch the nose shut if the patient cannot do so.

6. Using the handheld sprayer or hoseline, rinse the patient with tepid water for 1 minute, beginning with the face and airway and proceeding to open wounds.

7. Ensure that the armpits, genitalia, and the back are rinsed.

(2 of 4)



8. Rinse the backboard before transferring the patient to the cold zone, unless switching to clean basin.

9. Apply a C-collar as soon as possible if a C-spine injury is suspected and a collar is available.

(3 of 4)



10. Determine whether secondary decontamination will be done. If not, carry the patient into a decontamination alley to be quickly dried, covered, wrapped in an enclosing blanket, and then carried to the cold zone on a backboard.

11. Scan the patient with detection equipment and report the results to the treatment team if a radiological agent is involved.

12. Transfer the patient to properly protected cold-zone personnel who will perform indicated patient care. (4 of 4)


Factors to Consider when Choosing a Decontamination Site

• Accessibility– Must be away from hazards, but adjacent to the

hot zone– Crucial time periods to consider

– Travel time in the hot zone– Time allotted to work in the hot zone– Travel time back to the decontamination site– Decontamination time

(1 of 4)



• Terrain and surface material– The decontamination site ideally slopes toward the

hot zone.– Diking around the site prevents accidental

contamination escaping.– It is best if the site has a hard, nonporous surface to

prevent ground contamination.– When a hard-surface driveway, parking lot, or street

is not accessible, some type of impervious covering may be used to cover the ground.

– Use covers or sheeting to form the decontamination corridor regardless of whether the surface is porous. (2 of 4)



• Lighting (and electrical supply)– A site illuminated by streetlights, floodlights, or

other type of permanent lighting reduces the need for portable lighting

• Drains and waterways– Avoid locating a site near storm or sewer drains,

ponds, ditches, and other waterways.

• Water supply– Water (and sometimes detergent) must be

available. (3 of 4)



• Weather– Set up the site upwind in order to prevent the

spread of contaminants into clean areas.– Make every attempt to shield victims from cold

winds while they are removing protective clothing.

(4 of 4)


Setting up aDecontamination Corridor

• Ensure privacy.– Provide a private, restricted area in which to

conduct decontamination.– Use female responders to assist whenever

possible when decontaminating women.

(1 of 2)


Setting up aDecontamination Corridor

• Bag and tag contaminated clothing/effects carefully.– Label bags whenever possible.– Separate personal effects into clear plastic bags

clearly marked with the person’s name.– Mark all personal effects so that they can be

returned to their proper ownders after the incident without confusion.

• Make the corridor visually recognizable – with barrier tape, safety cones, etc. (2 of 2)


Decontamination Corridor


Collecting Evidenceat Crime Scenes

• Minimize disturbance to possible crime-scene evidence, while still making life safety the top priority.

• Take notes or pictures documenting where victims were located and how the scene looked upon arrival.

• Dead victims at crime scenes must go through a decontamination process before transport to the medical examiner.


Terminating an Incident

• Hold a debriefing for those involved in the incident as soon as possible.

• Provide exposed persons with as much information as possible about the delayed health effects of the materials involved in the incident.

• Schedule follow-up examinations with medical personnel if necessary.

Operational Level Lesson 6 Presentation

Hazardous Materials for First Responders, 3rd Ed.

operational level lesson 6 presentation hazardous materials for first responders, 3 rd ed

Documents

equipment decontamination

decontamination corridor

level of contamination

contamination of people

time secondary decontamination

formal decontamination

operational level lesson

types of contamination