• http://www.youtube.com/watch?v=NSAXkp9cqbk

DeconTag, You’re It!!!!

Brent Cox MS, CHEP, HAZMAT Tech

Why Be Concerned at all?

• Regulatory Agencies• Hospital Impact

TJC• EC 1.4 – Healthcare facility must be prepared

to decontaminate patients and have regular drills and exercises conducted to test preparedness. – An Incident Management system is required– Hazard vulnerability analysis conducted

OSHA

• First Responder Requirements• Published Best Practices for First Receivers

General Duty ClauseSec. 5. Duties(a) Each employer

(1) Shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees;

Equipment 29 CFR 1910.134

• Must be adequate for the type and exposure levels one can reasonably anticipate.– OSHA – Level C is adequate for medical centers.

Medial evaluations29 CFR 1910. 120 (f)

review with employee health to best implement.

it is debatable of where hospital decon teams fall as they do not meet the definition of a decontamination team.

Equipment 29 CFR 1910.134

• Equipment must be inspected and maintained• Respiratory equipment is routinely integrated

into medical surveillance program. – Infection control or employee health

Incident Command• TJC and OSHA• Using HEICS– Falls under operations– Separate Branch (HAZMAT)– On site

• HAZMAT Commander (OSIC)• Safety Officer• Medical Officer • Triage Officer

So who’s it?

• Fire Departments Role

So who’s it?

• Hospitals Role

So who’s it?

• Working Together

Building a Team

• What is a Decon Team– Call it…

• How many people?– American Hospital Association recommends

for a 48 hour response time:Recommends 50 clinicians for metropolitan medical centers

20 at non-metropolitan healthcare facilities

Small facilities should aim for a two person team 24/7.

Building a Team• Who do we use?– Nurses• Floor - ER• Home health

– Engineering/Maintenance - Respiratory– Medical Records -Environmentalist– Security - Admissions– PCT’s - Education– Physical Therapy

Building a Team

Team Issues• Turn over• So many needs, so few people.

Team Considerations• Turn over rate• Availability• Normal Job Function• Desire vs. Ability

Training

No Set Standards or Requirements for

First Receivers

• Meet TJC requirements• Meet OSHA requirements– First Responder Requirements

AwarenessOperations

Training

How often and long should we train?• Research being conducted.

Training

What content should be covered?

State Wide Need

• No one is alone– Critical access – Level 1 Trauma

• So what options do we have– Work alone and hope for the best– Develop Regional and State Teams

State Wide Need

• How would Regional Teams help?– When and When Not– How effective?

• Where to begin?

Conclusion

Tag, You’re It!!Where do we go from here?