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HazMat for Healthcare 2013/2014
Transcript of HazMat for Healthcare 2013/2014
Personal Protective Equipment (PPE)
NER & HERT
National Emergency Response
Hospital Emergency Response Team
Hospital Incident Command System
Emergency Treatment Area
of CBRNE Events
Who we are
During a HazMat release first responder & receiver operations (FRO) protect people, environment, and/or property in a
action without trying to actually stop the release.
What we do.
First Receiver Operations (FRO)
Apply fundamental concepts required to establish a Hospital Emergency Response Team (HERT) that can respond operationally to a Mass Casualty Incident (MCI).
Protect This House!
Why do we need a HERT?
How do we roll out HICS in an MCI?
What is the appropriate level of Personal Protective Equipment (PPE) when receiving contaminated patients?
What is the Emergency Treatment Area (ETA) and where is it located during an MCI?
How do you triage patients during an MCI involving contamination?
...and we'll compare decon methods & procedures.
DONNING & DOFFING
of Medical personnel (ems & hospital)
are injured at hazmat emergencies.
#1 Exposure =
Employee must pass fit test
Known concentration of hazmat
Gradually acclimate to working in PPE
Maintain good physical condition
Take rest breaks from working PPE
Recognize early symptoms
Limited field of vision
No evaporative cooling
Sweat mechanism failure
PHYSICAL & PSYCHOLOGICAL
WITH LEVEL C SUITS
Heat Stress is the primary risk when wearing PPE.
Response System (NERS)
Management System (NIMS)
OSHA regulations require responders to know their local/employer (hazardous materials) emergency plan, including the responder's role, responsibilities, and scene management system.
Health hazard data
is it feasible to evacuate this?
protect this house!
Incident Commander via Security Control Center
NOTIFIES HERT AND INITIATES CALL-OUT
HERT MEMBERS REPORT TO
MC PHYSICIAN'S LOT
SECURITY/PARKING SECURES HOSPITAL
& RESTRICTS ACCESS
EH&S MOBILIZES & DISTRIBUTES
State Warning Center
National Response Center
& Hazard Assessment
You Are Here!
Incident Action Plan (IAP)
Consists of 5 primary phases
Enables completion of incident objectives in specified time
Provides clear strategic direction
Lists tactical objectives, resources, reserves, & support
Coordinates sequence of events to achieve multiple incident objectives
Putting HICS into Operation
Contamination Reduction Zone
Emergency Response Equipment
First Operational Thought
(at a distance)
(Don't touch, taste, smell)
This is a 2-Day Initial Class
Annual 1-Day Refresher Class REQUIRED
Code ORANGE Drills
Video Recording, Interviews
Slogan: "Protect This House"
HERT's Primary Responsibility:
Protecting the hospital by decontaminating patients for entry into the facility for medical treatment.
the level of PPE worn by the Decon Team?
A: The Incident Commander (IC)
Responsible for tactical execution of
incident goals and objectives.
Always activated in the event of a MCI.
Also, the person on-scene in charge until relieved by pre-determined or more qualified individual.
Burning sensation in the eyes
Nausea & vomiting
Shortness of breath
Soft tissue damage
Why discuss CBRNE Events?
Generally, they cause MCI's and often
require the setup of the ETA.
What conditions must be met for Level C to be used?
A: Known type & concentration of substance & APR criteria
OUTSIDE THE ETA
Temporary Morgue Section
Victims of MCI Arrive at the ETA...
prior to entering the patient reception area they must be assessed & filtered as...
they have not been decontaminated...
Types of Decon:
Directed Self Decon
Pediatric patients have key physiological differences not recognized by adult-based triage tools.
A patient who is able to walk when directed is classified as:
An unconscious patient with no visible wounds, spontaneous respiration after opening the airway, and a capillary refill time of > 2 seconds is classified as:
Establish incident objectives & strategies
Develop the Plan
Prepare & Disseminate the Plan
Evaluate & Revise
FEMA Center for Domestic Preparedness (CDP)
Passing Score: 70%
Passing Score: 70%
Student ID #
T-Shirts - Team Pride!
1. Sign up for a SID.
2. Write your SID on
a sticky note.
3. Complete Indirect
Form & include SID.
Survey & Monitoring (S&M)
M8 Paper Procedures
Remove 1 sheet
Blot (DO NOT RUB) on liquid
Observe for color change
Determine if clean or dirty
LEL % (combustible gases)
CO (carbon monoxide)
H2S (hydrogen sulfide)
Pancake Ludlum Detector
4 Gas Monitor Alarms
The Technical Specialist is part of the victim decon team.
Employers must keep exposure
Highly toxic material by inhalation and skin absorption requires level A PPE.
We must know oxygen level before donning our PAPR's.
If you don't have PPE for protection, you may only employ defensive containment
First Receiver Awareness
(FRA) is trained only in recognizing
the presence of hazmat.
take no action in clean up or
response. Only ID and notification.
OSHA regs require employers to have SDS available for all chemicals in the work place.
SHElter in place is the protective action employed during a hazmat incident.
In addition, initial actions are to deny entry to contaminated patients
Directed self decon first task is to isolate the contaminated patient
Poison Control is also a useful resource
for emergency department staff.
Many nerve agents fall into a class of organophosphates including the warfare agent Sarin.
Their properties mirror that of pesticides.
Specific gravity will tell you
weather a chemical will sink
of float in water.
Treshold limit value (TLV)
refers to long term exposure
to a chemical.