Disaster Site Worker Safety

1
Disaster Site Worker Safety

• Module 8
• Decontamination

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Objectives

• Describe the decontamination corridor.
• Identify the purposes and effects of
  decontamination.
• Perform proper self-decontamination.
• Identify steps taken to enhance safety of all
  personnel while conducting decontamination.

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Purpose for Decontamination

• The three most important reasons for
  decontaminating exposed victims are
• To remove the agent from the victims skin and
  clothing.
• To protect responders from secondary transfer
  exposures.
• To provide victims with psychological comfort.

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Physical Removal of Contaminant

• Aeration
• Scraping, sweeping, brushing, or vacuuming
• Hosing
• Absorbent material
• Soap and water

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Chemical Removal of Contaminants

• 0.5 bleach solution (hypochlorite)
• Soap and water

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Mass Decontamination

• Is time constrained
• Saves lives by reducing agent from skin of
  victims
• Also known as emergency, gross, hasty, immediate

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Technical Decontamination

• Not time constrained
• Complete decontamination of the residual hazard
• Usually for responders, their PPE, equipment, and
  facilities
• Also known as thorough, deliberate, detailed,
  responder, definitive

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Emergency Decontamination

• Can occur at any time during a decon procedure
• Speed is crucial Conduct rapid decon followed by
  response to the emergency

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Decontamination Issues

• Field decontamination
• Victim transportation
• Hospital decontamination facilities
• Decon at mass care facilities
• Contaminated clothing and equipment disposal
• Disposition of the deceased
• Environmental decontamination

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Field Decontamination

• Establish zones
• Site security
• Dealing with ambulatory casualties
• Gender-separate facilities
• Garments for victims
• Handling property
• Preservation of chain of evidence
• Collection of all contaminated material
• Recordkeeping

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Decontamination Considerations

• Modesty
• Weather
• Cover
• Triage, treatment, and transport area

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Personnel Safety

• Use proper PPE level.
• Minimize contact.
• Practice contamination avoidance.
• Know agent signs and symptoms.
• Observe bloodborne pathogen universal precautions.

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Isolate and Organize Ambulatory Victims

• Isolate casualties/fatalities
• Communicate directions
• Move victims away from hazard (upwind, uphill,
  and upstream)
• Segregate
• Collect personal items
• Elderly and children considerations

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Types of Decontaminants

• Chemical
• HTH, washing soda, bleach, ammonia, and caustic
  soda
• Natural
• Steam, adsorbents, soap and water, ultraviolet
  light, and gels
• Military
• M258, M291, M295, STB, and DS2

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Absorbents

• Use
• Physical removal of gross chemical agent
  quantities
• Application
• No preparation required (earth, sawdust, ashes,
  and rags)
• Risks
• Does not neutralize
• Absorbent is hazardous waste

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Non-Aqueous Methods

• Dry
• Gelled
• Powder
• M291 / M295
• Reactive foams

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Ultraviolet

• Use
• Most biological agents (not spores)
• Application
• Natural degradation/ exposure
• Risk
• Availability

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Decontamination Corridor
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Decontaminate Ambulatory Victims

• To decontaminate victims
• Communicate directions
• Arms out/legs apart
• Wash from top down
• If mustard BLOT first
• If biological or radiological WET while
  removing clothes

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Decontaminate Non-Ambulatory Patients

• Speed and efficiency are crucial
• Minimize exposure
• Handling victims during cut-out
• Monitor responders for contamination

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Technical Decontamination

• Set-up away from mass decon
• Emphasis on neutralization not speed
• Focus on cross-contamination avoidance
• Self-decontamination

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Summary

• Safety of all responders is of paramount
  importance.
• Emergency decontamination of victims must be
  accomplished quickly.
• As decontaminants
• Water is good.
• Soap and water is better (best in mass decon).
• Bleach is best (in technical decon).