1. Decon v2.0 1 DECON TEAM REQUIREMENTS/ SITE CONSIDERATIONS

2. Decon v2.0Decontamination Team2 Objectives Who should be on the Decon team?Who should be on the Decon team? Discuss OSHA First Receivers standard.Discuss OSHA First Receivers standard. Roles of various team members.Roles of various team members. Discuss decontamination site selection.Discuss decontamination site selection.

3. Decon v2.0Decontamination Team3 Hospital Decontamination Teams Core Trained GroupCore Trained Group –Originally only ER staff –Now core includes many more than ER staff Members available 24/7Members available 24/7 –Pager –Stipend for responding and training Accountability for equipment and accessAccountability for equipment and access

4. Decon v2.0Decontamination Team4 Who will do Decon? Who should not do DECON? Administrators ED Clinicians Firefighters/EMS Housekeeping Facilities Military Techs and non-medical support Security

5. Decon v2.0Decontamination Team5 OSHA First Receivers Guidelines Created in January 2005Created in January 2005 It is an extension of the standards for personnel involved in responding to hazardous chemical spillsIt is an extension of the standards for personnel involved in responding to hazardous chemical spills Specifically addresses hospital providersSpecifically addresses hospital providers Available at www.osha.orgAvailable at www.osha.org

6. Decon v2.0Decontamination Team6 Security Team Control all access to hospital entrance/exits.Control all access to hospital entrance/exits. May have to recruit non-security staff.May have to recruit non-security staff. PPE requirements risk/benefit analysis.PPE requirements risk/benefit analysis. Might be the first person to “greet” a contaminated patient.Might be the first person to “greet” a contaminated patient.

7. Decon v2.0Decontamination Team7 Patient transport – entry and exit (does not enter tent)Patient transport – entry and exit (does not enter tent) –To the tent (guide/non-ambulatory) –Cut clothes if non-ambulatory Triage - pre and/or post decontamination (does not normally enter tent)Triage - pre and/or post decontamination (does not normally enter tent) Decontamination personnelDecontamination personnel –Ambulatory (1 per side – post DECON) –Non-ambulatory (minimum of 4 (?) per patient) –Agent specific monitoring for success (another person?) Decontamination Team

8. Decon v2.0Decontamination Team8 Decontamination Clinical Team Decides if immediate treatment is needed prior to decontamination –MARK 1 kits –Amyl nitrate Decide what type of decontamination is neededDecide what type of decontamination is needed Deceased/expectant patients assessmentDeceased/expectant patients assessment

9. Decon v2.0Decontamination Team9 Perfect World Decon zone personnel = 9 peopleDecon zone personnel = 9 people –Safety Monitor - 1 –Security - 1 –Clinical/Triage - 1 –Litter bearers/escorts – 2 –Decontaminators – 4 Decon zone personnel = 30 peopleDecon zone personnel = 30 people –Safety Monitor - 1 –Security – 1 to 4 –Clinicians – 2 to 5 –Litter bearers/escorts – 14 –Decontaminators – 8

10. Decon v2.0Decontamination Team10 Decontamination Site Large outdoor areaLarge outdoor area Fixed lines vs. deployable sheltersFixed lines vs. deployable shelters Control run off (EPA)Control run off (EPA) Non-permeable surface if possibleNon-permeable surface if possible Utilities & WaterUtilities & Water –Hot & cold –No tears soap Down wind of the facilityDown wind of the facility Controlled access to the DECON site and the healthcare facility!!!!!!!!!Controlled access to the DECON site and the healthcare facility!!!!!!!!!

11. Decon v2.0Decontamination Team11 Decontamination Equipment Ownership Accessible Mobile as site may change Maintained and Inspected regularly

12. Decon v2.0Decontamination Team12 Hospital Secure Entry Control Point Secondary Facility ? Wet DeconDry Decon Litter Decon Triage Station Immediate Treatment ? Decontamination Site

13. Decon v2.0Decontamination Team13 Wet Decon Litter Decon Dry Decon

14. Decon v2.0Decontamination Team14 Summary Personnel need to …Personnel need to … –Understand the decontamination plan –Understand the difference in requirements between the RELEASE SITE (HAZMAT) and HOSPITAL ENTRY DECON zones –Be trained and medically cleared for their specific roles –Equipped with Level C PPE if working in the decon zone –Scale response to the size of the event –Establish a decontamination site

15. Decon v2.0 15 Thank you! Questions?