Scene Mitigation - Decontamination

Decontamination is the process of removing or deactivating harmful contaminants from surfaces and is a primary objective of initial patient care reducing further harm and exposure to patients and responders/rescuers. Initial methods involve removal from the contaminated environment and then removal of clothing, which is estimated to decrease exposure by 80-90%.

Principles:

  • The process of removing or deactivating harmful contaminants from surfaces
    • Physical measures (remove clothing, wash off with water removing gross contaminant)
    • Deactivation may include soap and water cleansing, or chemical agent which deactivates or reverses/stops the chemical process or exposure.
  • This is a primary objective of initial patient care. This reduces ongoing deleterious exposure for the patient as well as secondary contamination of scene/healthcare providers and treatment facilities.
  • Reduces exposure

Types:

  • Gross decontamination
    • Initial high volume rinse decontamination
    • Ambulatory versus non-ambulatory
  • Technical decontamination
    • Secondary fine thorough washing of all body locations
    • Ambulatory versus non-ambulatory
    • Ambulatory capable patients can be instructed and guided through disrobing and self decontamination showering and washing. Non-ambulatory patients will likely require assistance and disrobing and decontamination by available trained and appropriately garbed responders.

The decision to decontaminate patients can be difficult if information is limited and the agent is unclear, law enforcement on scene may have additional information regarding signs/symptoms and scene factors which can be beneficial for decontamination decision-making. Ultimately, if the decision is made to decontaminate then decontaminating those on scene can decrease public panic and exposure at secondary sites (i.e. hospitals, clinics, urgent care facilities and businesses or family).

Decision to decontaminate or not :

  • Other factors that may influence decision
    • Unusual clouds, mists, fogs, odors, residues
    • Dead animals
    • Dispersion devices
    • Atmospheric conditions
    • Victim proximity to dispersion
    • Clothing and skin
    • Signs and symptoms of exposed individuals
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