Awareness Level Hazardous Materials Training

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Awareness Level Hazardous Materials Training

• HOSPITALS NAME HERE

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INTRODUCTION

• Hospitals are sometimes called upon to treat
  patients who were accidentally or intentionally
  exposed to (contaminated by) hazardous materials
  (haz mat).

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INTRODUCTION

• Haz mat includes three main categories of
  substances -- nuclear, chemical and biological --
  that could pose risks to health or safety.

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INTRODUCTION

• Because haz mat substances can be harmful
  under certain circumstances, special precautions
  to protect caregivers and others who may come
  into contact with the victim are necessary.

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INTRODUCTION

• Sometimes hospitals may not know in advance
  they are receiving victims who were exposed to
  haz mat, so ...

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INTRODUCTION

• As a hospital employee or volunteer, you may
  unintentionally come into contact with a patient
  who has been exposed to or contaminated by
  hazardous materials.

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INTRODUCTION

• Your safety is a priority. Therefore, this
  training has been developed to protect you by
  teaching you to
• understand haz mat materials and risks
• recognize haz mat events/victims
• protect yourself from haz mat exposure
• identify your role in responding to haz mat
  events

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INTRODUCTION

• THIS TRAINING ALONE DOES NOT
• QUALIFY YOU TO HANDLE
• HAZARDOUS MATERIALS!

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INTRODUCTION

• The training includes information on
• NUCLEAR HAZARDS
• CHEMICAL HAZARDS
• BIOLOGICAL HAZARDS
• SUMMARY

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NUCLEAR/RADIATION
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NUCLEAR OBJECTIVES

• UNDERSTAND
• what is radiation
• types of radiological hazards
• effects of radiation contamination and exposure
• self-protection and management of radiation
  casualties

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WHAT IS RADIATION?
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RADIATION BASICS

• RADIATION IS...
• invisible particles of energy that travel through
  air and other substances.
• You cant see, taste, or smell radiation
• But it can be inhaled, swallowed, or absorbed
  through skin

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RADIATION BASICS

• There are 4 types of radiation
• ALPHA Shielded by clothing or paper
• BETA Shielded by thick clothing or aluminum
• GAMMA Shielded by lead, steel or thick cement
• NEUTRON Goes through anything, but is rare

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RADIATION BASICS
This is the universal symbol for radioactive
materials
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WHAT TYPES OF RADIOLOGICAL HAZARDS EXIST?
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NUCLEAR HAZARDS

• ACCIDENTAL -- (Industries)
• Nuclear reactor accidents
• Medical or laboratory errors
• Nuclear fuel spills/releases
• INTENTIONAL -- (Nations or Terrorists)
• Nuclear bombs triggering nuclear reactions
• Explosive devices w/ radioactive materials
• Radioactive isotopes planted to spread radiation

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NUCLEAR HAZARDS

• HISTORICALLY
• Reactor Incidents
• Laboratory or Medical Accidents
• Nuclear Waste Accidents
• Thermonuclear War Nationally Sponsored

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NUCLEAR PREPAREDNESS

• HISTORICALLY
• Bomb Shelters
• Public Siren Systems
• Public Education

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NUCLEAR HAZARDS

• NUCLEAR INCIDENT EXAMPLES
• Three Mile Island Middleton, PA (1979)Nuclear
  power plant meltdown. 100,000 residents flee. No
  injuries.
• Chernobyl, Ukraine (1986)Nuclear power plant
  incident contaminated 100,000 square miles, and
  killed 125,000.
• Springfield, MA (1991)Truck carrying nuclear
  fuel to a power plant collided with car. No one
  contaminated.
• 1999 reportable incidents 13 10 medical, 2
  occupational, and 1 fire at a plant.

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WHAT IS THE EFFECT OF RADIATION CONTAMINATION OR
EXPOSURE?
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RADIATION EFFECTS

• RADIATION SICKNESS Large amounts of radiation.
  Day of exposure symptoms may include vomiting,
  diarrhea, hemorrhage.
• RADIATION INJURY Usually large amount of Beta
  radiation. Local injuries, such as skin burns
  and lesions, usually to hands from handling.
• RADIATION POISONING Dangerous amounts of
  internal radiation. Causes delayed injuries like
  anemia or cancer.

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RADIATION EFFECTS
Radiation sickness, injury and poisoning are NOT
contagious or infectious. Treating or helping
victims who were exposed to radiation, but are no
longer near the source, will not expose you. For
example An x-ray will expose you to radiation,
but you are not contaminated by an x-ray.
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RADIATION EFFECTS
However, if a victim arrives covered in
radioactive dust or debris, the radioactive
material can contaminate you.
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RADIATION EFFECTS
SEVERITY OF RADIATIONS EFFECTS AMOUNT and
TYPE of radiation DISTANCE from radiation
type of SHIELDING TIME exposed
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HOW DO YOU PROTECT YOURSELF FROM RADIOACTIVE
EXPOSURE?
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PROTECTING YOURSELF FROM RADIATION

• The first step to protecting yourself is
  recognizing the risk of exposure.
• CLUES MAY INCLUDE
• The location a victim came from (i.e., laboratory
  or radiation oncology clinic)
• The victims occupation (i.e., truck driver, lab
  technician, power plant employee)
• An explosion of unknown origin
• History of an unknown substance
• Patients from one area with similar symptoms

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PROTECTING YOURSELF FROM RADIATION

• If you suspect you, or someone in the near
  proximity to you, were potentially contaminated
  with radioactive material, here is what to do

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PROTECTING YOURSELF FROM RADIATION

• DO NOT SPREAD THE CONTAMINATION!
• To the extent possible, do not move avoid
  touching yourself, objects, or people and do not
  leave the room
• Inform others in the area who may have had
  contact to remain calm and to stay still too
• Call out or telephone for assistance. Make it
  clear that a hazardous substance may be involved

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WHAT IS EXPECTED FROM AN AWARENESS LEVEL
RESPONDER?
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AWARENESS LEVEL STAFF ROLES

• Know who to contact if you are the first to
  recognize a potential nuclear contamination
  event/victim
• Know to whom to report for response instructions,
  and follow his/her directions carefully
• You may be asked to
• assist in securing the containment area
• directing the flow of patients and staff
• appropriate tasks outside the contaminated area
• HOSPITAL ADD APPROPRIATE FUNCTIONS HERE

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AWARENESS LEVEL STAFF ROLES
But, NEVER work inside the containment area or
handle contaminated items. You are not
trained to wear special protective equipment or
to handle nuclear hazardous materials.
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CHEMICAL
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CHEMICAL OBJECTIVES

• UNDERSTAND
• what is a chemical hazard
• types of chemical hazards
• effects of chemical contamination and exposure
• self-protection and management of chemical
  casualties

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WHAT IS A CHEMICAL HAZARD?
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CHEMICAL HAZARD BASICS

• CHEMICAL HAZARDS ARE...
• Liquids, gases or solids that can cause injury by
  reacting with the bodys tissues.
• You may be able to see, taste, or smell
  chemicals, but this is not always true.
• Chemicals can be inhaled, swallowed, injected or
  absorbed through skin.

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CHEMICAL HAZARD BASICS
CHEMICAL EXAMPLES

• Explosive dynamite
• Flammable gasoline
• Thermal dry ice
• Toxic/Poisonous arsenic
• Corrosive acids
• Anesthetic chloroform
• Asphyxiating carbon monoxide
• Noxious tar gas
• Blistering mustard gas
• Nerve agent sarin

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CHEMICAL BASICS

• These are some of the chemical hazard symbols

Flammable
Poison
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WHAT TYPES OF CHEMICAL HAZARDS EXIST?
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CHEMICAL HAZARDS

• ACCIDENTAL -- (Industry and Home)
• Manufacturing, shipping, or storage accidents
• User error-- failed safety precautions
• Combining harmless chemicals to create a
  dangerous reaction
• INTENTIONAL -- (Terrorists and Warfare)
• release of agents using bombs, aerosols, or other
  disbursement mechanisms

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CHEMICAL HAZARDS

• CHEMICAL HAZARD EXAMPLES
• Union Carbide India (1984) Tank leaked extremely
  reactive chemical -- over 100,000 treated, 50,000
  hospitalized, and 2,500 dead
• Cult Japan (1995) Released sarin gas in subway
  system -- 12 killed, thousands sought care
• Refinery explosion Arkansas (1999) Killed 3
  sent 3 to burn unit. Released smoke plume.
• Rail yard spill California (2000) Mixed
  hydrochloric acid and jet fuel -- 1,000
  evacuated, 2 hospitalized

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WHAT IS THE EFFECT OF CHEMICAL CONTAMINATION OR
EXPOSURE?
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CHEMICAL EFFECTS

• The effect of a chemical exposure depends on the
  type of chemical(s)
• Some are harmless others are deadly
• Symptoms and severity of the reaction vary
  depending upon the amount and/or duration of
  exposure and the form -- solid, liquid or gas.

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CHEMICAL EFFECTS
Examples of symptoms include
Unconsciousness
Confusion
Drooling and tearing eyes
Light-headedness or dizziness
Blurred or double vision
Coughing or painful respiration
Change in skin color or blushing
Anxiety
Tingling or numbness of extremities
Nausea, vomiting, abdominal cramping and diarrhea
Changes in behavior or mannerisms
Loss of coordination
Burns or burning sensation
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CHEMICAL EFFECTS
Chemical exposures are not contagious or
infectious. Treating or helping victims who were
exposed to chemicals, but are no longer exposed
to the source, will not expose you.
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CHEMICAL EFFECTS

• However, if a victim arrives with chemicals on
  his/her clothing, shoes, or body, the chemicals
  can contaminate you.
• You may not know a victim has been contaminated
  because not all chemicals can be detected easily
  by sight or smell.

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HOW DO YOU PROTECT YOURSELF FROM CHEMICAL
EXPOSURE?
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HOW DO YOU PROTECT YOURSELF FROM CHEMICAL
EXPOSURE?

• The first step to protecting yourself is
  recognizing the risk of exposure.
• CLUES MAY INCLUDE
• The location a victim was near (i.e., hardware
  store, industrial park, truck accident, gas
  station)
• The victims occupation (i.e., garbage removal,
  lawn care, construction, transportation,
  medicine)
• An explosion or gas cloud of unknown origin
• An unknown liquid, oil, gas or powder
• Patients from one area with similar symptoms
• Unidentified smells or tastes

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PROTECTING YOURSELF FROM CHEMICALS

• If you suspect you, or someone in the near
  proximity to you, were potentially contaminated
  with a chemical, here is what to do...

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PROTECTING YOURSELF FROM CHEMICALS

• DO NOT SPREAD THE CONTAMINATION!
• Avoid touching the suspected liquid or solid, or
  breathing fumes. If you may have touched a
  chemical, do not touch yourself, objects or
  people.
• Remove yourself from immediate risk like fumes or
  additional contamination, but stay as near to the
  source as possible.
• Inform others in the area to minimize all contact
  and to stay calm.
• Call out or telephone for assistance, making it
  clear that a hazardous substance may be involved.
• Immediately, report all routes taken by the
  victim or anyone with secondary contamination.

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WHAT IS EXPECTED OF AN AWARENESS LEVEL RESPONDER?
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AWARENESS LEVEL STAFF ROLES

• Know who to contact if you are the first to
  recognize a potential chemical contamination
  event/victim
• Know to whom to report for response instructions,
  and follow his/her directions carefully
• You may be asked to
• assist in securing the containment area
• directing the flow of patients and staff
• appropriate tasks outside the contaminated area
• HOSPITAL ADD APPROPRIATE FUNCTIONS HERE

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AWARENESS LEVEL STAFF ROLES

• But, NEVER work inside the containment area or
  handle contaminated items.
• You are not trained to wear special protective
  equipment or to handle chemical hazardous
  materials.

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BIOLOGICAL
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BIOLOGICAL OBJECTIVES

• UNDERSTAND
• what is a biological hazard
• types of biological hazards
• effects of biological contamination and exposure
• self-protection and management of biological
  casualties

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WHAT IS A BIOLOGICAL CONTAMINANT?
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BIOLOGY BASICS

• BIOLOGICAL HAZARDS ARE...
• Harmful, invisible, living micro-organisms that
  travel through air, by surface to skin, or by
  skin to skin contact
• You cant always see, taste, or smell biological
  contamination
• But it can be inhaled, swallowed, or absorbed
  through skin

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BIOLOGY BASICS
Biological hazards come in three forms. Examples
include Bacteria Pneumonia, Meningitis,
Tuberculosis, Anthrax Virus Flu, Chicken Pox,
Hepatitis, Small Pox, Ebola Toxin Botulism,
Ricin
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BIOLOGY BASICS
This is the universal symbol for BIOLOGICAL
HAZARDS
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WHAT TYPES OF BIOLOGICAL HAZARDS EXIST?
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BIOLOGICAL HAZARDS

• ACCIDENTAL -- (Natural)
• Contagious/infectious diseases
• Food poisoning
• Diseases from insects, animals or pets
• INTENTIONAL -- (Nations or Terrorists)
• Contamination of food or water
• Aerosolized biological agents
• Explosive devices deploying biological agents
• Suspicious containers with accompanying threats

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BIOLOGICAL HAZARDS

• BIOLOGICAL INCIDENT EXAMPLES

Flu Season (Annually) Average 20,000 deaths, and
100,000 hospitalizations in U.S. person to
person West Nile Fever New York (1999) 62 severe
cases, including 7 deaths mosquito-borne virus
Cryptosporidiosis Milwaukee, WI (1993) Over
400,000 ill and 4,400 hospitalized
unintentionally contaminated drinking
water Accidental anthrax release Former USSR
(1979) 66 human deaths and animal deaths for 30
miles downwind factory release
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WHAT IS THE EFFECT OF BIOLOGICAL CONTAMINATION OR
EXPOSURE?
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BIOLOGICAL HAZARD EFFECTS

• The effect of a biological depends on the
  organism
• Some are harmless others are deadly
• Often, symptoms change over time
• The initial symptoms are usually vague and may
  include fever, cough, malaise, and fatigue

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BIOLOGICAL HAZARD EFFECTS
Over time, symptoms may progress.
Blurred or double vision
Delirium
Anxiety
Pink or red sputum
Unconsciousness
Painful/distressed respiration
Glandular swelling
Nausea, vomiting, abdominal cramping and diarrhea
Burning/blistered skin
Rash
Bleeding/hemorrhaging under the skin
Paralysis
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BIOLOGICAL EFFECTS

• Biological exposure is often contagious from
  person to person. Sometimes breathing the same
  air or touching the same surfaces as a
  contaminated victim can expose you to the
  bacteria or virus they are carrying.
• Symptoms are not instantaneous they take time
  to develop (incubation period). Some infected
  people do not know they were exposed or are
  contagious.

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BIOLOGICAL EFFECTS

• Biological contaminant victims usually require
  medical care to kill the bacteria or control the
  virus. But, the bodys own immune system also
  fights to remove harmful infections.
• People with weakened immune systems, like the
  elderly, children and people with chronic
  diseases, are at a greater risk from biological
  agents.

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HOW DO YOU PROTECT YOURSELF FROM BIOLOGICAL
EXPOSURE?
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PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS

• On a daily basis, patients who are potentially
  infected with a bacteria or virus present to the
  hospital.

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PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS
Luckily, there are many easy methods for reducing
the likelihood of infection.

• Hand washing
• Universal (standard) precautions
• Antibacterial cleaners
• Gloves
• Proper sharps disposal
• Flu shots and other immunizations
• Proper handling and disposal of bodily fluids

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PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS

• Hospitals have many measures in place to
  protect employees, volunteers, visitors and the
  public from harmful bacteria and viruses.
• HOSPITAL insert list of policies on cleansing
  procedures, isolation (standard) precautions,
  sharps and disposal policies, others as necessary

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WHAT IS EXPECTED FROM AN AWARENESS LEVEL
RESPONDER?
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AWARENESS LEVEL STAFF ROLES

• Help identify a biological outbreak as soon as
  possible.
• POSSIBLE CLUES INCLUDE
• Epidemic-like trends (many people with similar
  symptoms)
• Victims were at common location or event at some
  point in the past
• Respiratory complaints, rashes, fevers
• Unusual animal deaths/illnesses
• An explosion of unknown origin

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AWARENESS LEVEL STAFF ROLES

• HERE IS WHAT TO DO IF YOU EXPECT AN OUTBREAK!
• HOSPITAL fill in policy on reporting suspected
  infectious disease patterns or events

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SUMMARY
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SUMMARY

• Hospitals often provide care to victims of
  radiation, chemicals and biological hazardous
  material events
• Haz mat agents may affect one or many victims
• Haz mat events may be accidental or intentional

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SUMMARY

• Hospitals may not know that patient(s) they
  received have been contaminated by haz mat
• Senses, such as smell or sight, are not always
  sufficient to detect haz mat
• Relying on clues such as patients with similar
  symptoms, or location and occupation can help
  detect haz mat

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SUMMARY

• Knowing how to report a suspected haz mat event
  and limiting the spread of haz mat contamination
  are key roles
• Biological haz mat is common in hospital
  settings. Many policies and procedures to limit
  exposure are in place

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SUMMARY

• Radiation and chemicals do not pose a risk to
  caregivers once the haz mat source is removed
• Only trained employees should handle hazardous
  materials or enter contaminated areas
• This training alone is not sufficient for you to
  work in contaminated areas