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. 2015 Jun;30(3):288-96.
doi: 10.1017/S1049023X15004677. Epub 2015 Apr 27.

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

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

Raymond G Monteith et al. Prehosp Disaster Med. .

Abstract

Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.

Keywords: CBRN chemical; DPS disaster psychosocial; Disrobe/Decontaminate; EMS Emergency Medical Services; Evaluate/Evacuate; HazMat hazardous materials; HazMat/CBRN; IOR Initial Operational Response; MADE Move/Assist; MCI mass-casualty incident; NFPA National Fire Protection Association; PPE personal protective equipment; SCBA self-contained breathing apparatus; SFPC structural firefighting protective clothing; and nuclear; biological; buddy system; chemical exposure; decontamination; decontamination response algorithm; hazardous materials; mass-casualty incident; radiological; self-care decontamination protocol.

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