Self-care Decontamination within a Chemical Exposure Mass-casualty Incident

Monteith, Raymond G.; Pearce, Laurie D. R.

doi:10.1017/s1049023x15004677

Cited by 12 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A custom-built, enclosed dosing chamber (1.2 m × 1.2 m × 1.8 m, total volume 2.592 m 3 ) was constructed to expose a seated volunteer to a metered, aerosolized spray of simulant delivered from a spray gun fitted with a circular nozzle cap (Cobra 1, DeVilbiss UK). The simulant was contained in a kettle pressurized by an air compressor.…”

Section: Dosing Chambermentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Larner

Durrant

Hughes

et al. 2019

Prehospital Emergency Care

View full text Add to dashboard Cite

Prompt disrobing and minimization of time to casualty decontamination are key to the effective treatment of individuals exposed to toxic chemicals. Established procedures for mass casualty decontamination that involve the deployment of equipment for showering with water (such as the ladder pipe system [LPS] and technical decontamination) necessarily introduce a short, but critical delay. The purpose of this study was to investigate the effectiveness of dry and wet decontamination approaches (individually and in combination) for removing a chemical warfare agent simulant from the hair and skin of human volunteers. A secondary aim was to quantify potential hazards arising from the decontamination processes. Volunteers were exposed to the simulant (mixture of methyl salicylate, fluorophore [curcumin] and mineral oil) as an aerosol within a custom-built dosing chamber. Three decontamination protocols (dry, LPS and technical decontamination) were applied in various sequences. The efficacy of the protocols was evaluated by whole-body fluorescent imaging and measurement of residual simulant recovered from the hair, skin, decontamination materials and air samples using liquid chromatography and thermal desorption gas chromatography. Dry decontamination before LPS or technical decontamination produced significant reductions in methyl salicylate skin contamination. The greatest reductions were seen with the Triple Protocol (dry, then LPS, then technical decontamination). Secondary sources of contamination (e.g. off-gassing of vapor and residue on wash cloths/towels) decreased following dry decontamination. The introduction of dry decontamination prior to wet forms of decontamination offers a simple strategy to initiate treatment at a much earlier opportunity, with a corresponding improvement in clinical outcomes. Our results confirm the value of a "Triple Protocol" response strategy based on the integration of dry and wet decontamination procedures. 3 Importantly, we highlight how these combined protocols may reduce toxicological risks downstream in the operational process.

show abstract

Section: Dosing Chambermentioning

confidence: 99%

“…The process of decontamination is known to be time-critical for mitigating the adverse health effects from chemical exposures (1)(2)(3)(4). Mass casualty decontamination by civilian emergency services has traditionally been based upon showering with water to dilute and remove noxious chemicals from the skin surface (5).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Larner

Durrant

Hughes

et al. 2019

Prehospital Emergency Care

View full text Add to dashboard Cite

show abstract

“…Furthermore, the results show that personal protective gear was unsuitable for protection against chemicals and was not easy to work in when performing standard work procedures. It is argued that standard EMS protective gear will provide little protection against chemical contamination (Monteith & Pearce, 2015). The legislation concerning workplace safety needs to be proactively reviewed to prevent any EMS personnel from getting injured or losing their health or lives due to inadequate equipment.…”

Section: Discussionmentioning

confidence: 99%

Chemical Incident Preparedness Among Emergency Medical Service Personnel

Gyllencreutz,

Karlsson,

Sjölander

et al. 2024

Intl J Paramedicine

View full text Add to dashboard Cite

Background: Hazardous chemicals are essential for modern society but the use and transportation of them bears the risk of major incidents. Past incidents have revealed the importance of preparation and training of emergency medical service (EMS) personnel when responding to these incidents. However, studies have shown the level of preparedness to be insufficient. There is a lack of knowledge as to how EMS personnel perceive their preparedness and response when facing chemical incidents. Aim: The aim of this study was to qualitative investigate working procedures regarding chemical incidents among a cohort of EMS personnel. Method: Seventeen ambulance nurses from rural and urban areas were individually interviewed using four different realistic scenarios (vignettes). The transcribed text from the interviews was analyzed using qualitative content analysis. Result: The results were derived into two categories with underlying sub-categories: a struggle to organize the onsite work situation (insufficient managerial support, limited resources, trust in rescue services, difficult decision making, stressful responsibilities); and decontamination—a demanding and risky situation (risk management, work in protective gear, aggravating circumstances). Participants often lack real life experience in facing a chemical incident and training that improves preparedness and the ability to respond adequately. Conclusion: Chemical incidents pose many challenges for EMS personnel, but with proper training efforts many of these challenges could be solved. This study has shown the need for more accessible chemical incident training targeting EMS personnel: especially focusing on risk assessment; managerial support; resource management; equipment; and decontamination, including stress management and decision-making. Research in the area of chemical incidents is sparse and there remains much to understand concerning work procedures during chemical incidents.

show abstract

“…This has introduced the concept of self-care decontamination and the mnemonic MADE: move and assist, disrobe and decontaminate, evaluate and evacuate. 86 All health care professionals who assist in decontamination must protect themselves by wearing appropriate PPE. 87 Currently, there are 4 levels of PPE, ranging from level A, which is the highest level of protection, to level D, which consists of a simple gown, gloves, and surgical mask.…”

Section: Decontaminationmentioning

confidence: 99%