Biomedical Engineering Reference
In-Depth Information
c.
Ingestion
is a less common route of expo-
sure. It can be the result of unintentional
hand to mouth contamination or swal-
lowing of saliva with trapped airborne
particles. Or it may also be intentional,
such as an oral ingestion for a suicide
attempt.
D. In addition to the route of exposure, the
amount of compound absorbed by the body
depends upon the:
a. Duration of exposure
b. Concentration of contaminant
c. Time of exposure
d. Environmental factors
E. Response to toxic chemicals radiological
agents and pathogens may differ among indi-
viduals because of the physiological vari-
ability present in the population.
a. Age
b. Pre-existing medical conditions
c. Prior exposure
d. Medications
e. Concurrent injury
f. Pregnancy
Background
The potential for hazardous materials exposure
requires specific procedures for the protection of
the patient, staff, and the environment. It differs
from the other emergency situations because of that
added risk of contamination to staff and facility.
Worker safety and training are key factors in the
management of these medical emergencies. Often
these patients may arrive at the hospital unan-
nounced. Patients being transported by EMS may
not have been fully decontaminated prior to their
arrival to the hospital.
Toxicological principles
A. Exposure to hazardous materials may produce
a wide range of adverse health effects. The
likelihood of an adverse health effect occur-
ring, and the severity of the effects, are depen-
dent upon:
a. The toxicity of the agent or pathogen;
b. Route of exposure;
c. The nature and extent of exposure to that
substance.
B. Toxic chemical effects may be localized at the
site of exposure, or may result in systemic
symptomatology after absorption into the
blood stream.
C. The three main routes of exposure are:
a.
Inhalation
resulting in the introduction
of toxic chemicals, radioisotopes, or
pathogens via the respiratory tract. Most of
the compounds that are inhaled are gases
or vapors of volatile liquids. However,
solids and liquids can be inhaled as dusts
or aerosols. Inhalation of chemical agents
generally result in a rapid absorption
into the bloodstream because of the large
surface and vascularity of the lungs. The
signs and symptoms of pathologic expo-
sure will usually occur 1-10 days after
exposure.
b.
Skin contact
or absorption via mucous
membranes is usually not as rapid as
inhalation. Exposure can be through the
mucus membranes (including conjunctiva)
and open wounds.
Notification
A.
Unannounced Arrival
refers to a patient
that presents to the ED Triage Nurse or
other healthcare provider. Once the health-
care provider determines a hazardous mate-
rials incident has occurred and contamination
may be present he/she should:
a. Direct the patient outside the ED lobby
entrance and proceed to the entryway of
the decon room. Confine the patient in this
location and remain with them.
b. Notify the charge nurse.
c. Notify security at Triage to secure the area.
d. Any persons the victim came in contact
with, including the initial healthcare
provider contact, should also be directed to
the decon room until the extent of contact
and the need for care can be determined.
e.
If there are multiple patients affected,
prepare to implement the mass decon-
tamination procedure utilizing identified
