Mass Casualty Decontamination

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DEFINITION OF DECONTAMINATION

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DECON IS THE PROCESS OF REMOVING CONTAMINATES FROM PEOPLE,EQUIPMENT,STRUCTURES, THE ENVIRONMENT OR ANYTHING THAT MAY BE CONTAMINATED. DECONTAMINATION IS PRIMARILY DESIGNED TO MINIMIZE EXPOSURE TO HAZARDOUS SUBSTANCES AND LIMIT THE SPREAD OF CONTAMINATION

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TWO QUESTIONS THAT MUST BE ASKED OF POSSIBLY EXPOSED OR CONTAMINATED PATIENTS

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-DID YOU GET ANY CHEMICAL ON YOU? IN OTHER WORDS, ARE YOU CONTAMINATED? IF THE ANSWER IS YES, THIS PERSON MAY REQUIRE DECONTAMINATION. DIRECT THIS PERSON TO THE WARM ZONE FOR FURTHER ASSESMENT.
-ARE YOU FEELING ANY OF THE EFFECTS OF THE CHEMICALS? IN OTHER WORDS, HAVE YOU BEEN EXPOSED? AT VERY LEAST THIS PERSON WILL REQUIRE MEDICAL ASSESSMENT

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WHAT ARE THE 3 MOST IMPORTANT REASONS FOR DECONTAMINATING EXPOSED CASUALTIES

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1-REMOVING THE AGENT FROM THE PATIENT'S SKIN AND CLOTHING, THUS REDUCING FURTHER AGENT EXPOSURE AND PHYSICAL EFFECTS.
2- PROTECTING EMERGENCY RESPONDERS, MEDICAL PERSONNEL AND OTHERS FROM SECONDARY TRANSFER EXPOSURES.
3- PREVENTING PERSONS FROM SPREADING CONTAMINATION OVER ADDITIONAL AREAS.

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WHAT ARE THE 3 BASIC METHODS OF DECONTAMINATION

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DISCARDING, DILUTION, AND ABSORBTION.

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DISCARDING

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THE PROCESS OF REMOVING AND DISPOSING OF CONTAMINATED CLOTHING AND EQUIPMENT. THE ACT OF REMOVING CONTAMINATED CLOTHING WILL TYPICALLY REDUCE THE AMOUNT OF CONTAMINANT ON A PATIENTBY 80-90% AND IN SOME CIRCUMSTANCES MAY BE ALL THAT IS NEEDED.

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DILUTION

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THE USE OF COPIOUS AMOUNTS OF WATER ALONE, SOAP AND WATER OR A SPECIFIC DECONTAMINATION SOLUTION TO FLUSH OFF OR DILUTE THE THE CONTAMINENTS

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ABSORPTION

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THE USE OF AN ABSORBING MATERIAL TO TRAP AND HOLD CONTAMINANTS. THIS TECHNIQUE REDUCES RUN-OFF WASTE AND IS OFTEN USED IN COLD WEATHER AND RADIOLOGICAL CONTAMINATION.

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BEFORE DECONTAMINTAION WE MUST ASK SERVERAL QUESTIONS ABOUT THE NEED TO DECON

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IS DECONTAMINATION NECESSARY? IS A FULL BODY DECON NECESSARY? IS PRIVACY AN ISSUE? IS COLD WEATHER AN ISSUE?

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DECON IN EXTREME COLD WEATHER NOTE:

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DURING DECONTAMINATION IN EXTREME COLD, THE DECONTAMINATION WATER COULD CREATE A GREATER HAZARD AND RESULT IN MORE COLD WEATHER VICTIMS THAN THE CONTAMINATION HAZARD.

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6 PRCEDURES FOR A FIRST ARRIVING CAPTAIN WITH A SMALL NUMBER OF PATIENTS

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1- THE CAPTAIN ON THE FIRST ARRIVING APPARATUS QUICKLY ASSESES THE SITUATION, ENSURING THE HE/SHE PROTECTS THE SAFETY OF HIS CREW
2-THE CAPTAIN SHALL ESTABLISH HAZARD ZONES, AND COMMUNICATES THIS OVER THE RADIO
3- IF THE CAPTAIN IS PRESENTED WITH POSSIBLE PATIENTS, HE MUST DIRECT THEM FROM AREAS OF DANGER (HOT ZONE)
4- ASK THE PATIENT IF THEY HAVE THE PRODUCT/HAZMAT ON THEM-ARE THEY CONTAMINATED? IF SO DIRECT THEM TOT HE WARM ZONE TO DETERMINE IF THEY REQUIRE DECONTAMINATION
5- IF THE PATIENT IS NOT CONTAMINATED, ASK THE PATIENT IF THEY HAVE BEEN EXPOSED TO THE HAZMAT AND ARE SUFFEREING EFFECTS DUE TO THE EXPOSURE? IF SO DIRECT THEM TO THE COLD ZONE FOR MEDICAL ASSESMENT
6- IF THE PATIENT IS CONTAMINATED, DETERMINE HOW DECONTAMINATION WILL BE ACCOMPLISHED.

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DUTIES OF FIRE FIGHTERS AT A DECONTAMINATION SCENE

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1- IF IMMEDIATE DECON IS REQUIRED, THE 2 FF FROM THE BACK IN FULL PPE SHALL PULL OFF A HANDLINE AND WAIT FOR THE CAPTAIN'S INSTRUCTIONS. THEY SHOULD CONSIDER WIND DIRECTION AND SLOPE FOR RUNOFF. THEY SHOULD DETERMINE THE BEST LOCATION TO LIMIT THE TRAVEL OF THE RUNOFF. THIS MAY BE ON SOIL OR GRASSED AREA, IF RUNOFF CANNOT BE OTHERWISE CONFINED.
2-THE DRIVER CHARGES THE HANDLINE AND AWAITS FURTHER INSTRUCTION FROM THE CAPTAIN, THE PRESSURE SHOULD BE BETWEEN 60-90 PSI
3-THE FIRST FIRE FIGHTER GUIDES AND INSTRUCTS THE CASUALTY ON HOW TO REMOVE CLOTHING AND THEN TO TURN IN THE WATER FOG FOR BEST CONTAMINANT REMOVAL
4-THE SECOND FF WITH THE HOSELINE WASHES THE CASUALTY FROM HEAD DOWN( HIGH VOLUME LOW PRESSURE)
5-PATIENTS ARE THEN DIRECTED TO A MEDICAL TREATMENT AREA IN THE COLD ZONE.

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MASS DECONTAMINATION DEFINITION

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MASS DECONTAMINATION IS THE COORDINATED AND RAPID REMOVAL OF CONTAMINATES FROM LARGE NUMBERS OF PEOPLE. IT IS PERFORMED WHEN THE SHEER NUMBER OF POTENTIALLY CONTAMINATED PEOPLE OVERWHELMS THE RESOURCES AVAILABLE TO DECONTAMINATE THEM. MASS DECON IS ACCOMPLISHED WITH COPIOUS AMOUNTS OF WATER

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6 BASIC STEPS FOR THE PROCESS OF MASS DECONTAMINATION

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1- SIZE UP
2- ESTABLISH ZONES
3- PATIENT CONTROL AND DECON TRIAGE
4- DECON SETUP
5-MASS DECON EXECUTION
6- POST DECONTAMINATION

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WHAT IS THE KEY TO A SUCCESSFUL MASS DECON

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IS TO USE THE FASTEST APPROACH THAT WILL CAUSETHE LEAST HARM AND DO THE MOST GOOD FOR THE MAJORITY OF THE PATIENTS. FIRST RESPONDERS WILL HAVE TO DETERMINE THE NEED FOR MASS DECON, THE EXTENT AND PRACTICALITY OF PERFORMING DECON TRIAGE, AND THE SCOPE OF THE RESOURCES NEEDED VS RESOURCES AVAILABLE