Biomedical Engineering Reference
In-Depth Information
12. Decon team personnel should be decontam-
inated prior to entering the ED as described
in Personnel (Technical) Decon section.
13. Soap should be changed out every five
patients or whenever needed.
for turning the patient on the backboard and
one who will be responsible for maintaining
cervical spine precautions.
3. If the patient has not had a primary gross
decon in the field (defined as the removal of
clothing and first wash), visible particulate
matter should be removed by gently brushing
or dusting, and clothing should be cut and
rolled away from the center of body, in order
to contain the contaminants on the clothing.
4. Follow procedure for removal and bagging of
personal valuables.
5. Follow procedure for head-to-toe decontami-
nation wash cycle.
6. Irrigate open wounds with irrigation syringe
and copious amounts of saline and cover with
occlusive dressings. Any existing dressing
must be removed and placed in a biohazard
trash container.
7. Eye irrigation may be done with Morgans
lens and NS and/or IV tubing alone, if
gross contaminants on the face are suspected.
Otherwise, perform manual
C. Non-Ambulatory Patients
In a mass exposure to chemical agents, non-
ambulatory patients will most likely arrive after
the initial arrival of ambulatory patients exposed
in the same geographic location. Because of the
trimodal distribution of injuries, non-ambulatory
patients are likely to be more significantly exposed
to the contaminating agent. Those who are most
severely affected will be in the expectant cate-
gory at the incident scene, and those who are least
affected or only “potentially exposed” will arrive
as ambulatory patients.
The non-ambulatory patient decontamination
should be performed simultaneously with patient
stabilization. Basic life support (ABC's) will be
maintained, but definitive intervention should be
delayed until the patient is decontaminated, to a
degree that ensures staff safety and that invasive
procedures will not increase the patient's risk of
systemic toxic absorption. If large numbers of non-
ambulatory patients are delivered for decontamina-
tion and treatment simultaneously, the ED Charge
Physician will be required to make urgent triage
decisions.
irrigation with
copious fluids.
8. Gentle ear and nasal irrigation with frequent
suctioning from portable suction may be done
if such contamination is suspected.
9. C-collars as well as backboards must be
washed or changed if they are still required
for patient immobilization.
10. Patient should be transferred to a clean
stretcher for entry into the ED.
1. Patient should be received on a backboard and
stretcher by EMS staff. If incident involves
a single non-ambulatory patient, utilization
of the Emergency Department Decon Room
may be considered. If multiple patients are
expected, set up of the non-ambulatory mass
decontamination corridor should commence.
a. Placement of sawhorses with available C-
clamps in order to secure backboards to
the sawhorses.
b. Availability of water source for adequate
decontamination, including use of back-
pack sprayers.
2. The Decon team for non-ambulatory patients
must include a minimum of four (4)
providers, two of whom will be responsible
D. Personnel (Technical) Decon
Prior to leaving the decon room the decontamina-
tion team must undergo decontamination.
1. All equipment used by the decon staff must
be placed in appropriate receptacles or in bins
designated for equipment which can be cleaned
and reused. Refer to clean-up and recovery
protocol for direction on rehabilitation of used
equipment.
