Hospital Emergency Response Team—Home Training Hospital Decontamination Procedures

Decontamination Methods for Hospital Operations Contamination— exposure to a hazardous substance. May be Liquid, Solid, or Vapor; and Biological, Chemical, or Radiological.

Decontamination The removal of hazardous substances from employees and their equipment to the extent necessary to preclude the occurrence of foreseeable adverse health effects”

Survey and Monitoring

Decontamination Methods Physical decontamination includes Clothing removal, wiping off, or briefly washing. Clothing removal reduces contaminant by 80– 90%. Wet decontamination, using soap and water. Wash for 20 minutes. Use mild liquid soap with good surfactant qualities.

Decontamination Methods (continued) Physical decontamination also includes Dry decontamination—Brush, vacuum, or absorb with powders. Chemical decontamination Can be wet or dry. Use agents to remove or deactivate contaminant.

Types of Decontamination—Gross Decontamination This type of decontamination Is performed at the incident site. Significantly reduces surface contaminant. Must be performed as quickly as possible. Uses low-pressure, high-volume water. Can use makeshift facilities (e.g., car washes)

Types of Decontamination—Secondary Decontamination This type of decontamination is Used after gross decontamination, outside hot zone. Used as needed by ETA. More thorough. May be single body part.

Types of Decontamination—Technical Decontamination This type of decontamination is Thorough, for responders and equipment. Performed using solvents and alkaline solutions. Separate from patients. Established first.

Decontamination Methods (continued) Physical decontamination also includes Dry decontamination—Brush, vacuum, or absorb with powders. Chemical decontamination Can be wet or dry. Use agents to remove or deactivate contaminant.

Decontamination Stations

Decontamination Stations Patients move between hot and cold zones as follows: Patient registration, Clothing removal, Rinse station, Wash station, Survey and inspection station, and Dressing station.

Ambulatory Decontamination Ambulatory patients progress as follows: Patient registry; Decontamination kit issued; and Holding area or decontamination corridor

Ambulatory Decontamination (continued) Ambulatory patients progress as follows: Clothing removal, including Patients’ items bagged and tagged. Triage tag placed around patients’ necks.

Ambulatory Decontamination (continued) Ambulatory patients progress as follows: Rinse station; Wash station, including 20 minutes warm water wash; Survey and monitoring station, including Designation as clean or needing rewash; and Dress station.

Nonambulatory Decontamination Hospital Emergency Response Team (HERT) members should Wear appropriate Personal Protective Equipment (PPE). Limit healthcare responders with patient contact. Restrain clothing from patient’s face during removal process.

Nonambulatory Decontamination (continued) Move patient to decontamination corridor with Placement on padless gurney or backboard. Four staff members to move patient. Three staff members, minimum, attending.

Nonambulatory Decontamination (continued) During this stage Clothing removed by two members, cutting as needed. One member maintains patient’s airway.

Nonambulatory Decontamination (continued) During this stage Do not straddle patient. Decontaminate scissors and gloves after each cut.

Nonambulatory Decontamination (continued) Use the following cutout procedures: Perform medical monitoring from head. First cut waist to head. Second cut up the sleeves.

Nonambulatory Decontamination (continued) Continue the following cutout procedures: Third cut up each pant leg. Fourth cut remove socks. Move to backboard. Bag clothing.

Nonambulatory Decontamination (continued) Rinse patient quickly, avoiding mouth, then clean as follows: Airway; Open wounds; All orifices; and Entire body. Decontaminate backboard and medical treatment supplies.

Special Needs Special considerations include Large-print signs, Translators, Walkers, Railings, and Pet line for service dogs.

Special Needs (continued) Children may require special decontamination, plus Infant baskets; Toys, friendly decals; and Families kept together through special lines. Other special needs include Law enforcement officers with weapons, and Technical decontamination corridor.

Conclusion Identify the methods of decontamination appropriate for hospital operations during a Mass Casualty Incident (MCI) involving patient contamination. Recognize the components in a decontamination corridor for use in a hospital’s Emergency Treatment Area (ETA) established in response to a Mass Casualty Incident (MCI) involving patient contamination.

Conclusion (continued) Describe the step-by-step procedures for ambulatory and nonambulatory decontamination performed in response to a Mass Casualty Incident (MCI) involving patient contamination.

Questions