1. Initial Operational Response (IOR) To a CBRN or HAZMat Incident

2. IOR Aimed at first responders (non specialists) Objective is to do something early on! Providing interim and improvised Decontamination at scene Reduced requirement for wet decontamination (for certain incidents)

3. IOR – essential info Saving Life - Priority for all responders Safety of responders – Joint Dynamic Hazard Assessment Evacuation – from source (within 15 mins) Disrobe – removal of outer clothing (within 25 mins) Decontamination – Improvised Dry or Wet (within 50 mins)

4. Identification of a CBRN incident Step 1: One person incapacitated with no obvious reason - Approach using standard protocols Step 2: Two people incapacitated with no obvious reason - Approach with caution using standard protocols Step 3: Three or more people incapacitated with no obvious reason - Use caution Plus: Follow the CBRN First Responder Flow Chart to consider what actions can be undertaken to save life. Evacuation – Disrobe - Decontamination

5. Joint Dynamic Hazard Assessment Considerations CBRN (or Chemical) release indications Casualty numbers (walking and non walking) Severity and type of signs and symptoms Weather conditions – in particular wind direction Hazards present or suspected The location of the incident – is it likely to be terrorism or a hazardous material incident Environment – building, open space, underground Presence of perpetrators JDHA – informs the individuals agencies Dynamic Risk assessment based on the tasks required.

6. Evacuation and Disrobe Move affected persons away from the area of release to relative safety FRS / HART to rescue non ambulant (PPE) Encourage persons to remove outer clothing to underwear. Provide disrobe packs if available (FRS) Communicate clearly and honestly with patients

7. Improvised Decontamination Two types Dry and Wet for first responders Dry Decon –Default choice –Dab and rub skin with absorbent paper / cloth Wet Decon –Only considered where chemical is Irritant e.g. acid –Uses any available water source + soapy water –Rinse – Wipe – Rinse method

8. Interim Decontamination Interim Decon is undertaken using Fire Service equipment e.g. Hose reel Other available showers could be used All decon considerations Modesty Hypothermia Waste water / materials Minimising spread of substances

9. What happens next ? On-going clinical assessment once Improvised / Interim Decon applied. Specialist Operational Response – HART / SORT teams Clinical / Mass Decon structures Need for further decontamination?? Hospital Decontamination??

10. Summary IORP is about first responders taking positive action to save lives Evacuation – Disrobe – Improvised Decon is key with materials available Doesn’t necessarily replace need for full Decon – buys time! Any questions?