1. EMS and Hazmat: Routine Alarms? Routes of Exposure Contact Absorption Inhalation Ingestion

2. EMS Precautions and Hazmat Has the patient exposed others onscene? Use any and all PPE (SCBA?) Avoid cross contamination RESCUE Options- Remotely or emergency?

3. EMS Precautions and Hazmat Notify receiving hospitals early! Gather product information and pass it on to ground transportation teams. Assess exposure and injury/illness levels- Prioritize the problems for treatment and decontamination.

4. EMS precautions and Hazmat Use existing decon equipment- for victims or yourself! Avoid victim contact while treating Decon invasive sites carefully Protect and prep equipment and MICUs Package victims- Three Blanket Drill

5. Exposure, hazard, or contamination? A person may be exposed to large quantities of a hazmat in concentrations that do not present a hazard or to small amounts of a hazmat that present a very high hazard. Exposure- someone inhaled toxic levels of ammonia gas... Contaminated- someone has radioactive particles or some other hazardous matter on their skin or clothing.

6. Required medical monitoring duties: AFD, operations-trained, personnel may be assigned duties to assist the MICU unit on proper medical monitoring procedures. Obtain product info from site safety plan Product ID, Exposure routes, Exposure signs & symptoms Observe, or treat, all personnel for heat or cold stress Prep MICU for patient transport and treatment Prep themselves and MICU units with proper PPE for patient treatment Notify Medical Control and/or receiving hospital of incident COA does not require Rural Metro to be hazmat trained above the “awareness” level...

7. Required medical monitoring duties (CONT): Screen and approve entry personnel for readiness- Verify entrant’s knowledge of product safety information Verify general state of health Insure pre-hydration Record vital signs, ECG, skin condition for baseline and incident termination Verify and screen for no exposures and heat stress Note: some entrants vitals may be elevated due to anxiety or other factors...

8. Emergency Decontamination Use any and all PPE Make rescue- emergency or remotely Prompt enroute units, Medical Control, and MICU Remove helmet, if worn, and wash with copious amounts of water Remove SCBA, leave face mask in place & remove regulator only if air supply exhausted Remove clothing while continuing to wash Personnel can carry contaminates from a hot zone on themselves or their PPE. Decon procedures must be implemented to minimize secondary contamination. Not to mention the potential for a contaminated victim!

9. Emergency Decon (CONT) Move victim to clean area, administer EMS care, and package Handoff or fax labels/MSDS copies to MICU and hospital Consider remote decon, if necessary Water is “first line decon solution” until ruled out… Use lots of water! Every engine/quint company has their own emergency/ mass decon capability! Clean yourselves while waiting for help if contaminated.

10. Emergency decon can be implemented without a formal CRZ. However, it only provides gross decon, so the victim may still be contaminated and pose a threat of secondary contamination. Control run-off... Minimize exposure to others and preventing contamination of clean areas by establishing control zones early in the incident! Mass decon: Low-pressure master streams

11. Control Zones First-on units should establish the control zones. Size-up the problem and assess the incident priorities Consult the ERG for guidance Allocate resources to set-up the zones and control entrance, egress, isolation, evacuation, rescue, etc

12. HOT DECON WARM COLD AREA OF SAFE REFUGE DOWNWIND ISOLATION OR EVACUATION Think three dimensionally... Wind >

13. Public Protection Action Options Evacuation Protect-in-place

14. Levels of Hazmat Incidents Level One Operations Level Two Technician and/or Specialist Level Three Everybody in the world...

15. Command Post Location In the Cold Zone Designated Radio- and phone-equipped vehicle Scene observable Noise and interruptions controlled Expandable