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Decontamination, Isolation and Radiation Protection Decontamination is a very simple concept. However, the logistics of decontamination are far more complex. It is important to understand what circumstance would prompt the need for decontamination. Decontamination is used for Hazardous Materials exposure when the contact is on the skin surfaces. Ingested Agents can be purged, but there is no need for decontamination. Inhaled agents do no requires decontamination.

The key to proper decontamination is early recognition of the contaminant and early decontamination procedures. In many past events, the need to decontaminate was not recognized early and the contamination was spread to other areas at the scene, in emergency response vehicles, and the worst case scenario spreading to the hospital. Once these mishaps occur, the event expands and complicates exponentially.

In the event of a mass exposure to a disease caused by a biological agent, the potential exists to produce a global pandemic. An important consideration in such a disease scenario, to control the spread of the illness and to treat the afflicted victims is the mass isolation area. Creation of such a unit is costly and requires routine maintenance. However, in the event of such a disease, it can be the only thing standing between containment of the disease and the rampant spread. Biological terrorism has been popular methodology because the ingredients are present in nature, and therefore, relatively readily available.

The key to survival from ionizing radiation is to limit the time spent in proximity to the source and to provide as much as distance between the source and the victim. We will discuss the three types of ionizing radiation. The alpha wave is the weakest of the three types and can be stopped b a sheet of paper. The beta wave is slightly stronger, requiring more shielding. However, water will prevent penetration. The gamma wave is the strongest and most deadly. It penetrates all substance except lead or thick concrete. However, the more barriers placed between the source of emission and the victim, the less potential for toxicity.

COVID-19 taught us many lessons related to isolation of patients. While stressful, these lessons can be replicated during a mass casualty event that may involve a contagious substance or disease.

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DEPARTMENT OF HEALTH SERVICES COUNTY OF LOS ANGELES

(EMT, PARAMEDIC, MICN) SUBJECT: MCI FIELD DECONTAMINATION GUIDELINES REFERENCE NO. 519.5

PRINCIPLES:

1. The need for decontamination should not delay the provision of time critical medication and treatment (i.e., Mark 1 antidote).

2. Patients shall not be transported to the receiving facility if hazardous chemical contamination is present.

3. Do not delay treatment or transport of patients contaminated with radiation, who also have a life-threatening injury or medical condition. Contamination mitigation efforts and decontamination should be done, only if they do not delay treatment or transport.

4. If incident involves chemical contamination and treatment is required, provider shall contact the base hospital or Medical Alert Center. Treatment should be based on the appropriate treatment protocol.

Effective Date: 1-1-07 Reviewed 06-01-14

HAZARDOUS MATERIAL CONTAMINATION

Radioactive Contamination

Assess for Life

No

Yes

Chemical Contamination

ADMINISTER Life Saving Treatment and/or

Medications

Threatening Condition

Decontamination Triage, determine the priority for

decontamination

Yes

CONSIDER Life Saving Treatment and/or

Medications in Conjunction with Decontamination

T R A N S P O R T T O T H E A P P R O P R I A T E T R E A T M E N T A R E A

Remove Clothing

Collect Belongings & Preserves Evidence

Decontaminate Patient

Triage Patient according to Ref. No. 519.2

Use Appropriate Personal Protective Equipment (PPE) Contact Hazmat Resources

Secure Area Establish Incident Site According To Provider Agency Protocol

Implement Rapid Extraction Consider Gross Decontamination

Triage Patient as Immediate Triage Patient as Immediate

Remove Clothing

Collect Belongings & Preserve Evidence

Determine Priority

Remove Clothing

Collect Belongings & Preserves Evidence

Decontaminate Patient

Triage patient according to Ref. No. 519.2