Mod 7 Hazardous Materials, Multiple-Casualty Incidents, and Incident Management Flashcards
Hazardous material
-Any substance or material in a form that poses an unreasonable risk to health, safety, and property when transported in commerce or kept in storage at a warehouse, port, depot or railroad facility.
The four levels of training that the regulations identify
- First responder awareness is where rescuers are likely to witness or discover hazardous substance release
- First responder operations is for those that initially respond to releases or potential releases of hazardous materials to protect people, property, and the environment
- Hazardous material technician is for rescuers who actually plug, patch, or stop the release of a hazardous material
- Hazardous materials specialist for rescuer who is expected to have advanced knowledge and skills and to command and support activities at the incident site.
Control the scene
- Establish safe zone: same level as and upwind from the incident site
- Call for the help you will need: firefighters, special rescue personnel, local or state hazmat experts, and law enforcement for crowd control.
- Implement agencies incident management system. Establish command and maintain role until relieved.
- Prevent the situation from getting worse. Evacuate people, establish perimeter.
- While help is on the way establish control zones
Hot zone
-The area of contamination or area of danger
Warm zone
-Area where patients will be decontaminated
Cold zone
-Equipment and other emergency rescuers to include myself should be staged.
Ways of obtaining information safely
- Use binoculars to look for identifying signs, labels, or placards from a safe distance.
- Do not approach scene to obtain this information
- Search for placards. Diamond shaped placards used in the transportation of dangerous good not only show hazard class, such as explosives, flammable gas, and poisons.
- Look for labels such as what is found on the beck of a truck carrying flammable liquids.
- Check invoices, bills of lading (trucks), and shipping manifests (trains)
- Review safety data sheets
- Interview workers or others leaving the hot zone.
Where to obtain information/advice on what initial actions should be taken at the scene of hazardous material
- Emergency response guidebook
- Chemical transportation emergency center (CHEMTREC)
- CHEM-TEL, Inc.
- Current list of state and federal radiation authorities
- Regional poison control centers
The characteristics of a rehab center
- Located in the cold zone
- Protected from weather
- Large enough to accommodate multiple rescue crews
- Easily accessible to EMS units
- Free from exhaust fumes
- Allows for rapid reentry into the emergency operation
Decontamination
-A chemical and/or physical process that reduces or prevents the spread of contamination from persons or equipment; the removal of hazardous substances from employees and their equipment to the extent necessary to preclude forseeable health effects
Important points for treating and transporting hazmat patients
- Field decontamination patients are not fully clean. Chemicals may settle in patients hair, groin armpits ect.
- PPE is needed to prevent secondary contamination of rescuers.
- Protect vehicles from contamination. During decon process they are soaked in water. Water could runoff and could contaminate the vehicle
- Consider used equipment as disposable. For example spine boards, stethoscopes, ect. may not be decontaminated and may need to be disposed.
- Structural firefighting clothing is not designed or recommended for use when working in hazardous material environments.
The four types of patients likely to be encountered by EMT’s
- Uninjured and not contaminated
- Injured and not contaminated
- Uninjured and contaminated
- Injured and contaminated
If confronted with contaminated patients prior to the arrival of the hazmat team
- Take precautions appropriate to the substance
- Follow the first aid measures
- Manage the patients critical needs. Do not forget to manage the ABC’s
- If treatment calls for irrigation with water, remember that water only dilutes most substances. If cannot neutralize remove clothing and irrigate body.
- After treating the patient, decontaminate yourself. Clothing may need to be disposed of.
Phases of decontamination
- Gross decontamination is the removal or chemical alteration of the majority of the contaminant.
- Secondary contamination is the alteration or removal of most of the residual product contamination. It provides a more thorough decontamination than the gross effort.
Mechanisms of decontamination
- Emulsification is the production of unmixable/insoluble materials using an emulsifying agent such as soap or detergent.
- Chemical reaction is a process that neutralizes, degrades, or otherwise chemically alters the contaminate. not recommended for use on living tissue
- Disinfection is the process that removes the biological contamination hazards as the disinfectant destroys microorganisms and their toxins
- Dilution is the process that simply reduces the concentration of the contaminant.
- Absorption and adsorption is the penetration of a liquid or gas into another substance.
- Removal is the physical process of removing contaminants by pressure or vacuum.
- Disposal is the aseptic removal of a contaminated object from a host, after which the object is disposed of
Decontamination procedures
- Determine appropriate level of protective equipment based on materials and associated hazards
- Properly wear and operate in PPE
- Establish operating time log
- Set up and operate the decontamination line
- Prioritize the decontamination of patients according to triage system
- Perform triage in PPE
- Be able to communicate while in PPE
Decontamination for patients wearing PPE
- Rinse, starting at head and working down
- Scrub the suit with a brush, starting at the head and working down. Pay special attention to heavily contaminated areas
- Rinse again starting at head and working down
- Assist the responder in removing the PPE
- Contain the runoff of hazardous wastewater.
Decontamination for patients not wearing PPE
- Have patient remove any materials trapping materials to skin.
- Double bag their clothing for disposal or decontamination later
- Patient should receive a a 2 to 5 min water rinse.
- Solids or particulate contaminants should brushed off lightly.
- Rinsing should start at head to reduce spreading to eyes nose or mouth.
Multiple casualty incident
- Any medical or trauma incident involving multiple patients
- Most common is an automobile crash involving 3 or more patients.
Disaster plan
-A predefined set of instructions that tells a community’s various emergency responders what to do in specific emergencies.
List of what the disaster plan should be
- Written to address the events that are conceivable for a particular location
- Well publicized
- Realistic
- Rehearsed
National incident management system
-The management system used by federal, state, and local governments to manage emergencies in the U.S.
Incident command system
-A subset of the NIMS designed specifically for management of multiple casualty incidents
Command
-The first on scene to establish order and initiate the incident command system
Single incident command
- Command organization in which a single agency controls all resources and operations
- Often used at fire and rescue incidents
Unified command
-Command organization in which several agencies work independently but cooperatively
Incident command
- The person or persons who assume overall direction of a large scale incident
- Best way to manage resources in most communities
Scene size up
- Arrive at the scene and establish incident command
- Do a quick walk through of the scene and assess number of patients, hazards, and degree of entrapment
- Get as calm and composed as possible to radio an initial scene report and call for additional resources.
