EMS and Hazmat: Routine Alarms?

Routes of Exposure• Contact• Absorption• Inhalation• Ingestion

EMS Precautions and Hazmat

• Has the patient exposed others onscene?

• Use any and all PPE (SCBA?)

• Avoid cross contamination

• RESCUE Options-

Remotely or emergency?

EMS Precautions and Hazmat

• Notify receiving hospitals early!

• Gather product information and pass it on to ground transportation teams.

• Assess exposure and injury/illness levels-

Prioritize the problems for treatment and decontamination.

EMS precautions and Hazmat

• Use existing decon equipment- for victims or yourself!

• Avoid victim contact while treating

• Decon invasive sites carefully

• Protect and prep equipment and MICUs

• Package victims- Three Blanket Drill

Exposure, hazard, or contamination?

A person may be exposed to large quantities of a hazmatin concentrations that do not present a hazard or to small amounts of a hazmat that present a very high hazard.

Exposure- someone inhaled toxic levels of ammonia gas...

Contaminated- someone has radioactive particles or some otherhazardous matter on their skin or clothing.

Required medical monitoring duties:

AFD, operations-trained, personnel may be assigned duties to assist the MICU unit on proper medical monitoring procedures.

•Obtain product info from site safety planProduct ID, Exposure routes, Exposure signs & symptoms•Observe, or treat, all personnel for heat or cold stress•Prep MICU for patient transport and treatment•Prep themselves and MICU units with proper PPE for patient treatment •Notify Medical Control and/or receiving hospital of incident

COA does not require Rural Metro to be hazmat trained above the “awareness” level ...

Required medical monitoring duties (CONT):

Screen and approve entry personnel for readiness-

•Verify entrant’s knowledge of product safety information•Verify general state of health•Insure pre-hydration•Record vital signs, ECG, skin condition for baseline and incident termination•Verify and screen for no exposures and heat stress

Note: some entrants vitals may be elevated due to anxietyor other factors...

Emergency Decontamination

•Use any and all PPE•Make rescue- emergency or remotely•Prompt enroute units, Medical Control, and MICU•Remove helmet, if worn, and wash with copious amounts of water•Remove SCBA, leave face mask in place & remove regulator onlyif air supply exhausted•Remove clothing while continuing to wash

Personnel can carry contaminates from a hot zoneon themselves or their PPE. Decon procedures must beimplemented to minimize secondary contamination.Not to mention the potential for a contaminated victim!

Emergency Decon (CONT)

•Move victim to clean area, administer EMS care, and package•Handoff or fax labels/MSDS copies to MICU and hospital•Consider remote decon, if necessary•Water is “first line decon solution” until ruled out…•Use lots of water!•Every engine/quint company has their own emergency/mass decon capability!•Clean yourselves while waiting for help if contaminated.

Emergency decon can be implemented without a formal CRZ. However, it only provides gross decon, so the victim may still be contaminated and pose a threat of secondary contamination.

• Control run-off...• Minimize exposure to

others and preventing contamination of clean areas by establishing control zones early in the incident!

Mass decon:

Low-pressure master streams

Control Zones

First-on units should establish the control zones.

•Size-up the problem and assess the incident priorities•Consult the ERG for guidance•Allocate resources to set-up the zones and control entrance, egress, isolation, evacuation, rescue, etc

HOTDECON

WARM

COLD

AREA OF SAFEREFUGE

DOWNWINDISOLATIONOR EVACUATION

Think three dimensionally...

Wind >

Public Protection Action Options

• Evacuation • Protect-in-place

Levels of Hazmat Incidents

• Level One

Operations

• Level Two

Technician and/or Specialist

• Level Three

Everybody in the world...

Command Post Location

• In the Cold Zone

• Designated

• Radio- and phone-equipped vehicle

• Scene observable

• Noise and interruptions controlled

• Expandable