1. Operational Level Lesson 6 Presentation
Hazardous Materials for First Responders, 3rd Ed.

2. Contamination Terms
Contamination — The process of transferring a hazardous material from its source to people, animals, the environment, or equipment
Decontamination
The process of removing hazardous materials to prevent the spread of contaminants beyond a specific area and reduce the level of contamination to levels that are no longer harmful
Is performed when a victim, responder, animal, or equipment leaves the hot zone
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Operational Level

3. Contamination Terms
Secondary contamination — The contamination of people, equipment, or the environment outside of the hot zone
Exposure — The process by which people, animals, the environment, and equipment are subjected to or actually come in contact with a hazardous material
Hazard — The harm that can be done by a material
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Operational Level

4. Types of Contamination
Primary
The direct transfer of a hazardous material to persons, equipment, and the environment
Occurs in the hot zone because of direct contact with a hazardous material
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Operational Level

5. Types of Contamination
Secondary
The contamination of people, of equipment, or the environment outside the hot zone
The contaminant is carried from the hot zone by personnel’s clothing or tools, air currents, and runoff water.
If personnel are not decontaminated before leaving the hot zone, they can contaminate whomever and whatever they touch thereafter.
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Operational Level

6. Types of Contamination
Surface
The contamination of the surface of a material
Does not penetrate, permeate, or soak into materials
Permeation
The penetration of a contaminant below the surface of a material
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Operational Level

7. Categories of Decontamination
Gross decontamination
Quickly removing the worst surface contamination, usually by rinsing with water from handheld hoselines, emergency showers, or other water sources
Performed on the following people in the following situations:
Entry team personnel before technical decontamination
Victims during emergency decontamination
Persons requiring mass decontamination
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Operational Level

8. Categories of Decontamination
Emergency decontamination
Removing contamination on individuals in potentially life-threatening situations with or without the formal establishment of a decontamination corridor
A type of gross decontamination
Technical (formal) decontamination
Using chemical or physical methods to thoroughly remove contaminants from responders (primarily entry team personnel) and their equipment
Conducted within a formal decontamination line or corridor following a gross decontamination
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Operational Level

9. Categories of Decontamination
Mass decontamination — Conducting gross decontamination of multiple people at one time
Secondary decontamination — Taking a shower after having completed a technical decontamination
Definitive decontamination — Decontaminating further after technical decontamination
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Operational Level

10. Categories of Decontamination
Patient decontamination — Decontaminating injured patients or victims
Buddy decontamination — Performing decontamination between entry team personnel (or others), making it easier to rinse difficult-to-reach areas such as the back and backs of legs and knees
Self decontamination — Conducting emergency decontamination on oneself, usually by rinsing with water or using a blotting/ absorption method
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Operational Level

11. Importance of Scene Control Procedures
First responders must direct victims to a safe location to await decontamination and prevent victims from leaving the scene.
Decontamination prevents secondary contamination to others.
All first responders must be sure to also know the department’s plan for evacuation of uncontaminated persons from the hazard area.
Operational Level

12. Decontamination Methods
Wet
Washing the contaminated surface with solutions or flushing with a hose stream or safety shower
Usually necessitates the collection of runoff water in wading pools or other liquid-retaining devices
Dry
Scraping, brushing, and absorption
May be as simple as removing contaminated clothing and putting into a 55-gallon (208 L) storage bag
Does not create large amounts of contaminated runoff
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Operational Level

13. Decontamination Methods
Physical
Removes the contaminant from a contaminated person without changing the material chemically
The contaminant is contained for disposal
Chemical
To make the contaminant less harmful by changing it through some kind of chemical process
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Operational Level

14. Gross Decontamination
Flushing with water from a hose stream, safety shower, or other water source
Operational Level

15. Emergency Decontamination
When it is needed:
Failure of protective clothing
Accidental contamination of first responders
Heat illness or other injury suffered by emergency workers in the hot zone
Immediate medical attention required for other victims
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Operational Level

16. Emergency Decontamination
Advantages
Requires minimal equipment
Reduces contamination quickly
Does not require a formal contamination reduction corridor or decontamination process
Limitations
Does not always totally decontaminate the victim
Creates contaminated runoff that can harm the environment and other exposures
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Operational Level

17. Steps in Emergency Decontamination
Remove the victim from the contaminated area.
Wash immediately any exposed body parts with flooding quantities of water.
Remove victim’s clothing and/or PPE rapidly – if possible, cutting from the top down in a matter that minimizes the spread of contaminants.
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Operational Level

18. Steps in Emergency Decontamination
Perform a quick cycle of head-to-toe rinse, wash, and rinse.
Transfer the victim to treatment personnel for assessment, first aid, and medical treatment.
Ensure that ambulance and hospital personnel are told about the contaminant involved.
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Operational Level

19. Technical (Formal) Decontamination
Absorption
Picking up liquid contaminants with absorbents
Advantage — Absorbents are inexpensive and readily available
Limitations
Absorbents do not alter the hazardous material
Absorbents have limited use on protective clothing and vertical surfaces
Absorbent disposal may be a problem
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Operational Level

20. Technical (Formal) Decontamination
Adsorption
Process in which a hazardous liquid interacts with (or is bound to) the surface of a sorbent material
Brushing or scraping
Removing large particles of contaminant or contaminated materials such as mud from boots or other PPE
Is not sufficient decontamination
Is used before other types of decontamination
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Operational Level

21. Technical (Formal) Decontamination
Chemical degradation
Using another material to change the chemical structure of a hazardous material
Commonly used materials
Household bleach
Isopropyl alcohol
Hydrated lime
Household drain cleaner
Baking soda
Liquid detergents
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Operational Level

22. Technical (Formal) Decontamination
Chemical degradation
Advantage — Can reduce cleanup costs and the risk posed to the first responder
Limitations
Takes time to determine the right chemical to use and set up the process
Can be harmful to first responders if the process creates heat and toxic vapors
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Operational Level

23. Technical (Formal) Decontamination
Dilution
Using water to flush contaminants from contaminated victims or objects and diluting water-soluble hazardous materials to safe levels
Advantage — The accessibility, speed, and economy of using water
Limitations
Water may cause a reaction and create even more serious problems.
Runoff water from the process is still contaminated and must be confined and then disposed of properly.
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Operational Level

24. Technical (Formal) Decontamination
Neutralization
Changing the pH of a corrosive, raising, or lowering, it towards 7 (neutral) on the pH scale
Sanitization, disinfection, or sterilization
Sanitization — Reduces the number of microorganisms to a safe level (such as by washing hands with soap and water)
Disinfection — Kills most of the organisms present
Sterilization — Kills all microorganisms present, with chemicals, steam, heat, or radiation
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Operational Level

25. Technical (Formal) Decontamination
Solidification — Process that treats a hazardous liquid chemically so that it turns into a solid
Vacuuming — Process using high efficiency particulate air (HEPA) filter vacuum cleaners to vacuum solid materials such as fibers, dusts, powders, and particulates from surfaces
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Operational Level

26. Technical (Formal) Decontamination
Washing
Process similar to dilution, but also involves using prepared solutions such as solvents, soap, and/or detergents mixed with water in order to make the contaminant more water-soluble before rinsing with plain water
Evaporation
Can be accomplished by simply waiting long enough for hazardous materials to evaporate
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Operational Level

27. Technical (Formal) Decontamination
Isolation and disposal
Isolating the contaminated items by collecting them in some fashion and then disposing of them in accordance with applicable regulations and laws
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Operational Level

28. Mass Decontamination
The process of conducting gross decontamination of multiple people at one time in emergency situations
Is initiated where the number of victims and time constraints do not allow the establishment of an in-depth decontamination process
Uses large volumes of low-pressure water to reduce the level of contamination
Check with LERP or SOPs for exact procedures
Operational Level

29. Patient Decontamination
Is necessary whenever victims have been contaminated yet need medical attention
Uses the same techniques as other types of decontamination, but gives special consideration to the injuries and medical conditions of the victims
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Operational Level

30. Patient Decontamination
Ambulatory patients
Victims who are able to understand directions, talk, and walk unassisted
Most are triaged as minimal
Factors for determining priority
Casualties closest to the point of release
Casualties reporting exposure to the hazardous material
Casualties with evidence of contamination on their clothing or skin
Casualties with serious medical symptoms
Casualties with conventional injuries
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Operational Level

31. Decontamination Steps for Ambulatory Patients
Direct patients by voice, PA system amplification, and/or hand signals to the gross decontamination area inside the hot zone but away from the high-risk areas.
Direct patients to remove their clothing down to their underwear.
Place the patient's clothing in trash barrels whenever possible, separating valuable personal effects into clear plastic bags, and placing the patient’s name or a unique identifying number on the bags whenever possible.
(1 of 2)
Operational Level

32. Decontamination Steps for Ambulatory Patients
Vacuum, brush, or wipe all particulate matter off the contaminated patients.
Have patients close their mouth and eyes.
Using handheld sprayers containing tepid water and/or diluted bleach solution, rinse the patient from head to toe for 1 minute.
Direct patients to proceed to the cold zone.
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Operational Level

33. Patient Decontamination
Nonambulatory patients
Victims who are unconscious, unresponsive, or unable to move unassisted
Operational Level

34. Decontamination Steps for Nonambulatory Patients
Remove the person from the high-risk area in the quickest way possible and carry the patient to the edge of the hot zone bordering the warm zone.
Remove the patient’s clothing, cutting it off as necessary, down to the underwear.
Place the patient’s clothes in a trash barrel, separating personal effects into clear plastic bags, and placing the patient’s name or a unique identifying number on the bags whenever possible.
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Operational Level

35. Decontamination Steps for Nonambulatory Patients
Vacuum, brush, or wipe off all particulate matter from the patient.
Close the patient’s mouth and pinch the nose shut if the patient cannot do so.
Using the handheld sprayer or hoseline, rinse the patient with tepid water for 1 minute, beginning with the face and airway and proceeding to open wounds.
Ensure that the armpits, genitalia, and the back are rinsed.
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Operational Level

36. Decontamination Steps for Nonambulatory Patients
Rinse the backboard before transferring the patient to the cold zone, unless switching to clean basin.
Apply a C-collar as soon as possible if a C-spine injury is suspected and a collar is available.
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Operational Level

37. Decontamination Steps for Nonambulatory Patients
Determine whether secondary decontamination will be done. If not, carry the patient into a decontamination alley to be quickly dried, covered, wrapped in an enclosing blanket, and then carried to the cold zone on a backboard.
Scan the patient with detection equipment and report the results to the treatment team if a radiological agent is involved.
Transfer the patient to properly protected cold-zone personnel who will perform indicated patient care.
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Operational Level

38. Factors to Consider when Choosing a Decontamination Site
Accessibility
Must be away from hazards, but adjacent to the hot zone
Crucial time periods to consider
Travel time in the hot zone
Time allotted to work in the hot zone
Travel time back to the decontamination site
Decontamination time
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Operational Level

39. Factors to Consider when Choosing a Decontamination Site
Terrain and surface material
The decontamination site ideally slopes toward the hot zone.
Diking around the site prevents accidental contamination escaping.
It is best if the site has a hard, nonporous surface to prevent ground contamination.
When a hard-surface driveway, parking lot, or street is not accessible, some type of impervious covering may be used to cover the ground.
Use covers or sheeting to form the decontamination corridor regardless of whether the surface is porous.
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Operational Level

40. Factors to Consider when Choosing a Decontamination Site
Lighting (and electrical supply)
A site illuminated by streetlights, floodlights, or other type of permanent lighting reduces the need for portable lighting
Drains and waterways
Avoid locating a site near storm or sewer drains, ponds, ditches, and other waterways.
Water supply
Water (and sometimes detergent) must be available.
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Operational Level

41. Factors to Consider when Choosing a Decontamination Site
Weather
Set up the site upwind in order to prevent the spread of contaminants into clean areas.
Make every attempt to shield victims from cold winds while they are removing protective clothing.
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Operational Level

42. Setting up a Decontamination Corridor
Ensure privacy.
Provide a private, restricted area in which to conduct decontamination.
Use female responders to assist whenever possible when decontaminating women.
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Operational Level

43. Setting up a Decontamination Corridor
Bag and tag contaminated clothing/effects carefully.
Label bags whenever possible.
Separate personal effects into clear plastic bags clearly marked with the person’s name.
Mark all personal effects so that they can be returned to their proper ownders after the incident without confusion.
Make the corridor visually recognizable – with barrier tape, safety cones, etc.
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Operational Level

44. Decontamination Corridor
Operational Level

45. Collecting Evidence at Crime Scenes
Minimize disturbance to possible crime-scene evidence, while still making life safety the top priority.
Take notes or pictures documenting where victims were located and how the scene looked upon arrival.
Dead victims at crime scenes must go through a decontamination process before transport to the medical examiner.
Operational Level

46. Terminating an Incident
Hold a debriefing for those involved in the incident as soon as possible.
Provide exposed persons with as much information as possible about the delayed health effects of the materials involved in the incident.
Schedule follow-up examinations with medical personnel if necessary.
Operational Level

47. Operational Level Lesson 6 Presentation
Hazardous Materials for First Responders, 3rd Ed.