Bonus: Decon Tips for First Responders


 
 

Mark A. Kirk, MD | From the Disaster & Terrorism Preparedness Issue


After taking the steps in "Chemicalhttp://www.jems.com/sites/all/modules/fckeditor/fckeditor/editor/skins/d...); background-position: 0px -144px; " class="TB_Button_Image" alt="" /> Release," responders should then quickly proceed with a more comprehensive decon process.

Call for backup. If you’re among the first responders to arrive at the site of a chemical catastrophe, you’ll need help.

Alert the hospitals. Hospitals need advanced notice to prepare for the arrival of patients transported from the scene and of potentially contaminated, self-evacuated patients.

Protect yourself. Before entering any potentially contaminated area or handling any contaminated patients, don appropriate PPE. Remember to keep your distance from the source of the release and stay clear of chemical puddles.

Move patients to a designated area. Direct patients away from the contaminated area to protect them from further exposure but keep them in a designated area to prevent the spread of the contaminant. If people disperse without decon, chances are good that they will contaminate others when they show up at home or hospitals.

Triage. Initially carry out only simple triage, sorting patients based on whether they can walk and into groups of those who need critical attention and those with less serious injuries. Record similar signs and symptoms, and communicate these to the receiving hospitals.

Instruct patients to remove clothing. Separate patients by sex, lead them to a designated decon area and have them remove their clothing, particularly any articles known to have absorbed a contaminant. Assist the severely injured in clothing removal.

Decontaminate patients with water. Use what you have at your disposal. Once firefighters arrive, they can help make use of hazmat equipment.

Practice effective crisis communication. Victims are anxious and frightened. Most people in disasters don’t panic but are stunned and bewildered. They will respond to direct, clear instructions. Take charge, explain your actions and be patient.

Communicate with receiving hospitals. Provide information about the extent of decon performed at the scene. In a large-scale incident, thorough decon at the scene should preclude the need for repeating the procedure at the hospital. Clear communication during the hand-off will improve the overall response to these large incidents.

Train and rehearse the process. Training and drills are essential for preparedness. First responders and first receivers should train and drill together. Agencies that train jointly will better understand one another’s capabilities, develop mutual trust and confidence in the system, and strengthen their ability to overcome communication breakdowns.



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Related Topics: Major Incidents, WMD and Terrorism

Mark A. Kirk, MDMark A. Kirk, MD, is currently medical director of Medical Simulation Center and associate professor of emergency medicine at the University of Virginia.

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