# Presentation: 346625

## RESPONSE

**RESPONSE**
**    ****PHASE**
**DECONTAMINATION****©**

**© 1997 Lockheed Martin Energy Research Corporation**

## Decontamination

**• ****Reduction of contamination**
**• ****Eliminating, or reducing, harmful effects**

**DECON2©**

## Any Method Based On Principles

**• ****Destroy agent through chemical change**
**• ****Remove agent**
**• ****Physically shield agent**

**DECON3©**

## Need for Decon

**•  ****Except for decon of people, extensive decon not required for most chemical agent release scenarios**
**  **
**•  ****Only liquid releases (including droplets and aerosols) pose risk of significant environmental contamination**
**•  ****Because agent in liquid form settles out of air relatively quickly, contamination generally confined to short distance from point of release**
**  **
**•  ****Off-post contamination presents significant risk to public only in event of very large liquid release in air—low probability of occurrence**

**DECON4©**

## Appendix L, CSEPP Planning Guidance

**•**** ****Provides standards on how to plan for decon in**
**   ****event of significant chemical agent release**
**•**** ****Addresses priorities and procedures for decon planning**

**DECON5©**

## Appendix L, CSEPP Planning Guidance

**DECON6©**

** ****Does not provide policy on specific identification of sites or areas that may require decon capability or provision of resources to those that do**
**•**** ****Those policies and guidelines may be affected by results of ongoing studies regarding liquid agent deposition**

## • Do it fast

**• **_**Do it fast**_
**• **_**Do it right**_

**DECON7©**

**With chemical agents ...**
**... must remove victim from **
**    ****the agent source**
**... must remove agent from **
**    ****contaminated personnel**

## How To Decon

***How To Decon***

**        ****CAUTION:  Do not use bleach solution in, or **
**        ****around, the eyes;  use plain water instead**

**DECON8©**

**Agent toxicity destroyed by contact with undiluted household bleach (neutralizes agent)**
**1 gallon of bleach needed per person, on average**
**Rinse person with clean water**

## When and Where To Decon

**DECON9©**

**• ****Primarily at location**
**   ****where exposure occurred **
**   ****(Self and Buddy Decon)**
**Also**
** **
**• ****At established Decon Stations**
**• ****When Emergency Medical Personnel**
**   ****treat exposed persons**

## Priorities for Decontaminationof People

**DECON10©**

**1.  Known or suspected of being contaminated and **
**requiring prompt medical attention **
**	****	****	****	****	**
**2.  Exhibiting signs/symptoms of agent exposure**
**3.  Known to be contaminated but not exhibiting **
**     ****signs/symptoms and not urgently in need of**
**     ****medical attention**
**4.  Suspected of being contaminated but showing**
**     ****no signs of agent toxicity**

***Priorities for Decontamination******of People***

## Handling Contaminated Articles

**• ****Must handle safely to avoid further contamination**
**• ****Must provide means to store and dispose **
**   ****of contaminated materials**
**• ****Bag and seal personal belongings, label with **
**   ****person’s name and other identification and store **
**   ****for later disposition**

**DECON11©**

## Key Points

**• ****Decontamination must be done immediately **
**   ****and must be done right**
**• ****Most likely place to perform decon of people **
**   ****is at location where exposure occurred—**
**   ****often self and buddy decon**
**• ****Household bleach is recommended solution for **
**   ****removing and neutralizing nerve/blister agent**
**• ****Blot, don't wipe; get crevices well; rinse with water **
**   ****afterwards**
**• ****Don't use bleach in and around eyes**

**DECON12©**

## SELF AND BUDDY

** **
**DECONTAMINATION**

**DECON15©**

## Self And Buddy Decon

**Objectives:**
**Define decontaminationstorage of personal belongings and items such as wigs, toupees, hearing aids, eyeglasses and artificial limbs**

**DECON16©**

## Why Self and Buddy Decon

**Person decons him/herself or teams up with another and the two decon each other**
**Buddy Decon is best—easier and allows for more thorough rinsing of places that are difficult to reach (back, buttocks, back of legs)**
** **
**Don’t wait to be “officially” decontaminated by special decon personnel**
**  **

**DECON17©**

## Self and Buddy Decon Procedures

**    ****Cut off clothing normally removed over head**
** ****Remove eyeglasses or contact lenses**
** ****If eyeglasses needed to evacuate, soak in bleach**
**    ****5 minutes, rinse thoroughly with plain water**

***Self and Buddy Decon Procedures***

**DECON18©**

## Remove Extraneous Items

**DECON18A©**

**Remove extraneous items **
**    ****from contact with **
**    ****skin (wigs, toupees, hearing **
**    ****aids, artificial limbs)**
**If artificial limb required to safely evacuate,**
**    ****remove it, wipe it down with bleach, allow**
**    ****to air for 5 minutes or longer, rinse with**
**    ****clean water, and reattach**
** ****Bag artificial limbs not needed for evacuation**
** ****Carry those bagged to decon station**

## Flush eyes with lots of plain water

Wash face and hair with warm soapy water;
    rinse with plain lukewarm water

After washing with bleach, rinse with lots of water

**Flush eyes with lots of plain water**
**Wash face and hair with warm soapy water;**
**    ****rinse with plain lukewarm water**
**After washing with bleach, rinse with lots of water**

**Self and Buddy Decon****Procedures**

**DECON19©**

## Self and Buddy Decon Procedures

**Self and Buddy Decon Procedures**

** ****Put on fresh clothing**
** **
** ****Bag contaminated articles. Bring bag with**
**    ****critical items such as eyeglasses or artificial**
**    ****limbs to decon station**
** ****Proceed to nearest decon station**

## Materials And Supplies

** ****Liquid household bleach (undiluted)**
** ****Water**
** ****Scissors**
** ****Cloths**
** ****Plastic buckets**
** ****Polyvinylchloride bags**
** ****Clean clothes **
**Optional**
** ****Contact lens removers**

**DECON21©**

## Decontamination Station Operations

**DECON25©**

## Decontamination Station Operations

**Objectives:**
**Define decontamination**

**DECON26©**

## Decontamination Station Operations

**DECON27©**

**Decontamination Station Operations**

**Objectives:**
**Demonstrate collection and storage of personal belongings and external items such as wigs, toupees, hearing aids, eyeglasses and artificial limbs**
**Demonstrate collection and disposal of contaminated waste including**
**used decon solutions**
**rinse water**

## Must provide 
Visual screening without restricting flow of fresh air
Adequate showers
Adequate water supply
Adequate electricity supply
Adequate collection and containment of used decon solutions, rinse water, and other contaminated wastes

**Visual screening without restricting flow of fresh air**
**Adequate showers**
**Adequate water supply**
**Adequate electricity supply**
**Adequate collection and containment of used decon solutions, rinse water, and other contaminated wastes**

**DECON28©**

***Decon Facility***

## Decon Station Personnel

**DECON29©**

**Decon station personnel should be trained, equipped, and clothed to safely decon any person suspected of being contaminated before assisting in the decon facility   **
**Protective clothing and equipment should be approved for use with chemical agents**

## Decon Station Procedures

**Persons should go through decon station even if they have performed self or buddy decon   **
**Most can go through decon sequence with minimal assistance from Attendants**
**  **
**Those impaired by agent exposure, injury, poor health, or other handicaps may require assistance or special equipment (mesh stretcher for injured, boatswain’s chair for wheelchair users)**

**DECON30©**

## Males and females should enter separate decon     facilities, if possible

Young children should be permitted to
    accompany parent of either sex

 Decontamination should be performed according
    to priorities listed

**Young children should be permitted to**
**    ****accompany parent of either sex**
**	****	**
** ****Decontamination should be performed according**
**    ****to priorities listed**

**DECON31©**

**Decon Station Procedures**

**1.**

## Collect personal property such as billfolds and 
	 items such as wigs, hearing aids, and artificial
     limbs  

Remove all clothing.  Any clothing normally        removed over the head should be cut off

 Attendants should bag and seal items in
    agent-impermeable bag, label with 
    person’s name and identification, and 
    place in secure storage for later 
    disposition

**	**** ****items such as wigs, hearing aids, and artificial**
**     ****limbs  **
**Remove all clothing.  ****Any clothing normally        removed over the head should be cut off**
** **
** ****Attendants should bag and seal items in**
**    ****agent-impermeable bag, label with **
**    ****person’s name and identification, and **
**    ****place in secure storage for later **
**    ****disposition**

**DECON32©**

**Decon Station Procedures**

**2.**

## Remove potentially contaminated eyeglasses and
    contact lenses

Interview or evaluate wearer to determine if wearer has been in agent-contaminated area  

**    ****contact lenses**
** **
**Interview or evaluate wearer to determine if wearer has been in agent-contaminated area  **

**Decon Station Procedures**

**DECON33©**

**3.**

## Eyeglasses and contact lenses will be
   removed and handled according to following
   procedures:
Decon hands before removing contact lenses.  Use contact lens removers if available 
Collect contact lenses for later disposal.  Do not decon contact lenses
Expediently decon eyeglasses in metal frames by
   soaking for 5 min in undiluted household bleach
   and rinsing thoroughly
Eyeglasses in plastic/composite frames should be placed in gent-impermeable bag labeled with person’s name and id number for later disposition

**Eyeglasses and contact lenses will be**
**   ****removed and handled according to following**
**   ****procedures:**
**Decon hands before removing contact lenses.  Use contact lens removers if available **
**Collect contact lenses for later disposal.  Do not decon contact lenses**
**Expediently decon eyeglasses in metal frames by**
**   ****soaking for 5 min in undiluted household bleach**
**   ****and rinsing thoroughly**
**Eyeglasses in plastic/composite frames should be placed in gent-impermeable bag labeled with person’s name and id number for later disposition**

**Decon Station Procedures**

**DECON34©**

## 
NOTE:  If eyeglass wearers would be significantly impaired without corrective lenses,  remove lenses  from porous frames as time permits, decon lenses, remount in uncontaminated frames, and return to owners

   Time constraints and lack of new frames may preclude this option

**Decon Station Procedures**

**DECON35©**

**NOTE:  If eyeglass wearers would be significantly impaired without corrective lenses,  remove lenses  from porous frames as time permits, decon lenses, remount in uncontaminated frames, and return to owners**
**   ****Time constraints and lack of new frames may preclude this option**

##   Person should then blot skin areas 
     (excluding face) that may have been 
     exposed to agent with decon solution 
     (undiluted household bleach). Any 
      runoff should be collected

  Person should then step under shower 
     (lukewarm water recommended) and, following
     instructions of Attendant, first flush face and
     eyes with lots of water, then wash face and 
     rest of body with soapy water and rinse.

 All runoff should be collected

**     ****(excluding face) that may have been **
**     ****exposed to agent with decon solution **
**     ****(undiluted household bleach). Any **
**      ****runoff should be collected**
**  ****Person should then step under shower **
**     ****(lukewarm water recommended) and, following**
**     ****instructions of Attendant, first flush face and**
**     ****eyes with lots of water, then wash face and **
**     ****rest of body with soapy water and rinse.**
** **
** ****All runoff should be collected**

**Decon Station Procedures**

**DECON36©**

**4.**

**5.**

##  Following shower, attendants should check person for any signs or symptoms of agent exposure and follow medical screening guidelines for treatment

  Additional decontamination may be necessary      

**  ****Additional decontamination may be necessary      **

**Decon Station Procedures**

**DECON37©**

**6.**

## Complete decontamination of mustard victims is
    needed even if there are no immediate signs or symptoms, since onset of symptoms may be delayed for several hours  

Body crevices and warm, moist areas are very susceptible to effects of mustard—decon these carefully

**DECON38©**

**Complete decontamination of mustard victims is**
**    ****needed even if there are no immediate signs or symptoms, since onset of symptoms may be delayed for several hours  **
**Body crevices and warm, moist areas are very susceptible to effects of mustard—decon these carefully**

## Following confirmation of successful decon,
   person should proceed to area designated for first aid and re-dress.  Attendants will monitor or treat any injuries and provide replacement clothing (disposable paper garments and booties or clean used clothing obtained from Goodwill, Salvation Army, etc.)

**   ****person should proceed to area designated for first aid and re-dress.  Attendants will monitor or treat any injuries and provide replacement clothing (disposable paper garments and booties or clean used clothing obtained from Goodwill, Salvation Army, etc.)**

**Decon Station Procedures**

**DECON39©**

**7.**

## Person should be directed to holding area for
    observation of any agent exposure symptoms
Observe nerve agent victims for at least 30 min and mustard victims for 4 to 6 hr before releasing from observation area

 Decontaminated persons should generally be kept separate from uncontaminated ones 
In some cases it may be prudent to allow uncontaminated persons such as parents to join decontaminated dependents

**DECON40©**

**8.**

**Person should be directed to holding area for**
**    ****observation of any agent exposure symptoms**
**Observe nerve agent victims for at least 30 min and mustard victims for 4 to 6 hr before releasing from observation area**
** ****Decontaminated persons should generally be kept separate from uncontaminated ones **
**In some cases it may be prudent to allow uncontaminated persons such as parents to join decontaminated dependents**

## Each person undergoing decon at station should 
   be marked (e.g., by casualty tag, hospital
   bracelet, or by writing directly on chest or  forehead with indelible marker) with indication of      specific treatment, decon, and completion time

**   ****be marked (e.g., by casualty tag, hospital**
**   ****bracelet, or by writing directly on chest or  forehead with indelible marker) with indication of      specific treatment, decon, and completion time**

**Decon Station Procedures**

**DECON41©**

**9.**

## Each person processed through station
      should be provided with certificate
      indicating
	Description of decon actions taken
	Time decon completed
	Time the individual released from
           observation area 
	Description of any medical treatment
           administered in conjunction with decon

Decon station personnel should also retain copy of certificate

**      ****should be provided with certificate**
**      ****indicating**
**	****Description of decon actions taken**
**	****Time decon completed**
**	****Time the individual released from**
**           ****observation area**** **
**	****Description of any medical treatment**
**           ****administered in conjunction with decon**
**Decon station personnel should also retain copy of certificate**

**Decon Station Procedures**

**DECON42©**

**10. **

## Protective clothing for care provider
Liquid household bleach (undiluted)
Water
Scissors
Cloths
Plastic buckets
Agent-impermeable bags
Tags for bags, casualty tags
Indelible markers

**Liquid household bleach (undiluted)**
**Water**
**Scissors**
**Cloths**
**Plastic buckets**
**Agent-impermeable bags**
**Tags for bags, casualty tags**
**Indelible markers**

**Materials And Supplies**

**DECON43©**

## Materials And Supplies

** ****Clean clothing/disposable paper **
**    ****garments and booties**
** ****Clean bandages, etc.**
** ****Wire stretcher/stretcher with **
**     ****non-absorbent surface**
** ****Certificates**
**Optional**
** ****Contact lens removers**
** ****Spare eyeglass frames**
** ****Reagents from Army skin decon kits**

**DECON44©**

## DECONTAMINATION

** **
**PROCEDURES**
**FOR**
** **
**EMERGENCY MEDICAL **
**PERSONNEL**

**DECON50©**

## Objectives:

Define decontamination personal belongings and external items such as wigs, toupees, hearing aids, eyeglasses and artificial limbs

**Personnel**

**Objectives:**
**Define decontamination personal belongings and external items such as wigs, toupees, hearing aids, eyeglasses and artificial limbs**

**DECON51©**

## Emergency Medical Personnel

**Emergency medical personnel should be  trained, equipped, and clothed to safely decontaminate any injured person suspected of being contaminated before placing person in transport to care facility**
**Protective clothing and equipment should be approved for use with chemical agents**

**DECON52©**

## Why Decon Twice

**Presence of chemical agent on person’s skin, hair, or clothing is not readily apparent  **
**Self and buddy decon is expedient to quickly reduce amount of agent contamination on body  **
** **
**Emergency medical personnel should decon   injured persons even if persons have already performed self or buddy decon **

**DECON53©**

## Decon Procedures for  Emergency Medical Personnel

**DECON54©**

**1.**

** ****Procedures should incorporate standard medical **
** ****procedures for the injury involved.  Care provider**
** ****should also: **
**    ****Remove outer clothing by cutting clothing**
**      ****and lifting person free onto wire stretcher or one**
**      ****with non-absorbent surface**

## Remove rest of clothing, cutting it and pulling from underneath person and removing  personal belongings or items such as wigs, hearing aids and artificial limbs 

Remove items, bag and seal in agent-impermeable bag, and label with 
    person’s name, other identification

Place bag in secure storage for later disposition

** **
**Remove items, bag and seal in agent-impermeable bag, and label with **
**    ****person’s name, other identification**
** **
**Place bag in secure storage for later disposition**

**EMP Decon Procedures**

**2.**

**DECON55©**

## Remove any potentially contaminated bandage material, exercising extreme care when removing bandages that are used to control hemorrhages

**EMP Decon Procedures**

**4.**

**DECON56©**

**Remove eyeglasses and contact lenses and**
**    ****place in agent-impermeable bag labeled with person’s name & id number for later disposition**

**3.**

## Blot (not swab or wipe) potentially contaminated body surfaces with lots of 5% bleach solution or with reagents from Army’s skin decon kit, and wash face and eyes with clear water

**Blot (not swab or wipe) potentially contaminated body surfaces with lots of 5% bleach solution or with reagents from Army’s skin decon kit, and wash face and eyes with clear water**

**EMP Decon Procedures**

**DECON57©**

**5.**

## Lack of immediate symptoms does not mean that complete decontamination of mustard victims is
    not needed, since onset of symptoms may be delayed for several hours  

Body crevices and warm, moist areas are very susceptible to effects of mustard—decon these carefully

**Lack of immediate symptoms does not mean that complete decontamination of mustard victims is**
**    ****not needed, since onset of symptoms may be delayed for several hours  **
**Body crevices and warm, moist areas are very susceptible to effects of mustard—decon these carefully**

## 	
Decontaminate chemical protective clothing of care provider

Each person having undergone decon or   medical treatment should be marked (casualty tag, hospital bracelet, or by writing directly on chest or forehead with indelible marker) with indication of specific treatment and completion time

**Decontaminate chemical protective clothing of care provider**
**Each person having undergone decon or   medical treatment should be marked (casualty tag, hospital bracelet, or by writing directly on chest or forehead with indelible marker) with indication of specific treatment and completion time**
**    **

**EMP Decon Procedures**

**6.**

**7.**

**DECON59©**

## EMP Decon Procedures

**Apply fresh bandages where necessary to control bleeding, and place injured person in  transport vehicle**

**8.**

**DECON60©**

## Materials And Supplies

**  ****Protective clothing for care provider**
**  ****Liquid household bleach (undiluted)**
**  ****Water**
**  ****Scissors**
**  ****Cloths**
**  ****Plastic buckets**
**  ****Agent-impermeable bags**
**  ****Tags for bags, casualty tags**
**  ****Indelible markers**

**DECON61©**

## Clean clothing/disposable paper 
    garments and booties
Clean bandages
Wire stretcher/stretcher with 
     non-absorbent surface

Optional

Contact lens removers
Reagents from Army skin decon kits

**    ****garments and booties**
**Clean bandages**
**Wire stretcher/stretcher with **
**     ****non-absorbent surface**
**Optional**
**Contact lens removers**
**Reagents from Army skin decon kits**

**Materials And Supplies**

**DECON62©**

## DECONTAMINATION PLANNING

**DECON65©**

## Decontamination Planning

**Integral part of planning for emergency response **
**Will reduce potential for injury and save lives during emergency response phase following significant agent release  **
**Decon of people must begin immediately, **
**    ****with implementation of protective actions **

**DECON66©**

## Provides standards on how to plan for decon in
   event of significant chemical agent release

Addresses priorities and procedures for decon planning

**Provides standards on how to plan for decon in**
**   ****event of significant chemical agent release**
**Addresses priorities and procedures for decon planning**

**DECON67©**

## Appendix L, CSEPP Planning Guidance

**DECON68©**

**Does not provide policy on specific identification of sites or areas that may require decon capability or provision of resources to those that do**
**Those policies and guidelines will be determined by results of ongoing studies regarding liquid agent deposition**

## Decon Plan Required

***Decon Plan Required***

**Describe agencies to be responsible**
** **
**Describe resources to be available**
**Describe procedures to be followed to deal with agent-contaminated people and animals**
**    ****that provide critical support to humans**
**   **
**Plan should emphasize self and buddy decontamination ( Standard L-1)**

**DECON69©**

## Agencies Responsible

**DECON70©**

**Identify organization(s) responsible for decon of people and of animals that provide critical support to humans (e.g., Seeing Eye dogs) (Standard L-2) **

## Agencies Responsible

** ****Identify officials and agencies responsible for strict quarantine of all potentially contaminated materials and property not to be immediately deconned **
** **
**Strict quarantine will prohibit entry by unprotected public**
**    ****until safe to reenter**
**Criteria for this to be specified in Appendix M on Reentry/**
**    ****Restoration  (Standard L-9)**

**DECON71©**

## Resources

**DECON72©**

**Personnel decon station at **
**Each reception center **
**Each host hospital identified in evacuation plan **
**Other locations as needed **

## Each decon station will:

Have adequate supplies of water and electricity 
Contain/collect all used decon solutions/rinse water for later disposition  (Standard L-5)
Be adequately staffed and equipped to decon maximum number of contaminated persons 

**Have adequate supplies of water and electricity **
**Contain/collect all used decon solutions/rinse water for later disposition  (Standard L-5)**
**Be adequately staffed and equipped to decon maximum number of contaminated persons **

**Resources**

**DECON73©**

## Resources

**Be capable of being staffed quickly after public alerted **
**Be able to decon concurrently with life-saving first aid for people suffering from agent exposure or other injury**
**Be able to screen people for symptoms of chemical agent toxicity  (Standard L-5)**

**Resources**

**DECON74©**

## Procedures

** ****Establish guidelines for determining **
**When decon is needed**
**What decon resources are available**
**Which decon concerns must be addressed first through pre-event planning**
** ****Establish procedures at decon station for **
**Evaluating which people require decon**
**Immediately decontaminating people likely to have been exposed to chemical agent (Standard L-5)**

**DECON75©**

## Procedures

**Establish procedures for handling personal property of potentially contaminated persons (Standard L-5)**
**Include list of priorities for decon/treatment of affected materials to guide allocation of resources after chemical agent release  (Standard L-2)**

**DECON76©**

## Describe plans for educating public for self and buddy decon

Should apply to all people in areas at risk of exposure to agent 

** **
**Should apply to all people in areas at risk of exposure to agent **

**DECON77©**

**Procedures**

## Public education program may include
Instructions on self and buddy decon 
List of necessary supplies 
Guidance on other ways of expedient personal decon 	
Public information releases at time of emergency should clearly identify population segments that should perform self and buddy decon
Recommended for all people who are or have been within the chemical agent plume or have come in contact with people, animals, or objects (e.g., vehicles) that have been in plume 
   (Standard L-3)

**Procedures**

**Public education program may include**
**Instructions on self and buddy decon **
**List of necessary supplies **
**Guidance on other ways of expedient personal decon ****	**
**Public information releases at time of emergency should clearly identify population segments that should perform self and buddy decon**
**Recommended for all people who are or have been within the chemical agent plume or have come in contact with people, animals, or objects (e.g., vehicles) that have been in plume **
**   ****(Standard L-3)**

## Coordinate with all other emergency preparedness procedures and especially with those for reentry, monitoring, and medical services 

Incorporate requirements of federal/state laws that could, e.g., limit kinds and quantities of decon solutions that could be used in particular area or require containment and 
    treatment of decon runoffs

**Incorporate requirements of federal/state laws that could, e.g., limit kinds and quantities of decon solutions that could be used in particular area or require containment and **
**    ****treatment of decon runoffs**

**DECON79©**

**Procedures**