SIN: The Correct Awareness Level Response to Internal Spills and Contaminated Patients

1. SIN AFETY SIN: The Correct Awareness Level Response to Internal Spills and Contaminated Patients SOLATION OTIFICATION

2. SAFETY (First, last, and always) Don’t be a Dead Hero! • Get the big picture. • Can you handle it? • What are the risks? • What do you know? • What don’t you know?

3. ISOLATE • Isolate the scene and deny entry. • (if someone has something on them don’t let them go away. If others haven’t been exposed don’t let them have contact with the chemicals.)

4. NOTIFY • Call the hospital operator to announce a Code Orange (or site specific name) • Call your Supervisor • Call your Hazmat Coordinator • Have the operator call 911

5. Definitions - FRA • First Receiver “Awareness” • Likely to witness/discover a release • Notify proper authorities • Take no further action

6. First Operational Thought • First operational thought is safety • Safety starts with first receiver on-scene • All must have positive safety attitude

7. Conduct Safe Assessment • Conduct size-up! • Don’t get close enough for positive ID • Slow down, shut-off A/C, observe area • Don’t touch suspected contaminated patients

8. IsolationFirst Operational Priority • FROs — usually isolate and deny entry by establishing a “Perimeter” • How do you set up perimeters in the Hospital ? • Use ERG recommendations ERG

9. IsolationFirst Operational Priority • Dilemma • Safe distance vs. control of Perimeter • If too large will require more resources.

10. Perimeters & Control Zones • Purpose of Perimeter & Control Zones • Ensure safety and isolation • Control the scene • Limit spread of contamination • Allow for safe working area

11. Control Access to Perimeter • Deny entry to all • Stage receivers not assigned • Establish emergency exit procedures • Establish control zones • If outside watch for wind shifts

12. Field Control Zones Contamination Reduction Zone Exclusion Zone Support Zone

13. Hospital Zones • Hospital Decontamination Zone • Post Decontamination Zone

14. Pre-Decon Zone (Exclusion / Hot / Red) Decon Zone (Contamination Reduction / Warm / Yellow) Post-Decon Zone (Support / Cold / Green)

15. Decontamination Control Zones Pre-Decon = Staging of “dirty” People Decon = Removing Contamination Post-Decon = Medical Care

17. Types of Notifications • Mandatory notifications • Resource requests • Report of conditions

18. Notification Requirements • Mandatory Notifications • Local 911 (Local Dispatch) • CUPA/Administering Agency • State Warning Center (800-852-7550) • National Response Center (800-424-8802)

19. Notification Requirements • Receivers — make same notifications as back-up • RP must make “mandatory” notifications • Possible civil/criminal penalties for non–notification!

20. SIN • Call the hospital operator to announce a Code Orange (or site specific name) • Call your Supervisor • Call your Haz Mat Coordinator • Have the operator call 911, if necessary OTIFICATION

21. What are your first concerns? Directed Self Decontamination • Is this patient contaminated with a hazardous material? • How can contamination of the ED and its occupants (patients and staff) be minimized? • How can the patient be managed so that he can receive medical care?

22. S SAFETY: Do not touch the patient or allow anyone else to have patient contact. I ISOLATION: Get the patient out of the ED to a predesignated location!!! N NOTIFICATION: Activate your facility’s protocol for a haz mat incident. Directed Self Decontamination(continued) What are your first ACTIONS?

24. Trash Bag Decon • directed self-decon without modesty screens using a large(!) opaque plastic bag • placing potentially contaminated clothing in double clear plastic bags • placing valuables in a separate sealable clear plastic bag • tracking of patients • clothing a decontaminated patient A kit intended to allow for:

25. How Soap (Surfactants)Works. OIL Molecules Soap breaks the surface tension of the water and makes the “water wetter.” Soap attracts the water soluble contaminants to one end of the molecule and oil soluble contaminants to the other end and carries them away. SOAP WATER Molecules

26. Step A • Open this package and find the clear bag. • Remove your over garments, and shoes. • Place these items in the clear bag. Thanks to Anna Valdez, RN for use of these slides

27. Step B • Remove your personal items such as your watch, jewelry, and valuables and place them in the small Ziploc bag.

28. Step C • With the pen, write your name on the label on the clear bag. • Attach the label to the large clear bag.

29. Step D • Find the black plastic bag and place it on you over your clothing like a poncho. There are holes for your head and arms.

30. Step E • Now bring your arms inside of the poncho type plastic bag you are wearing and undress. • Remove all clothing, including underwear and socks. • Place all clothing in the clear bag.

31. Step F • Use the sponge and soap that is inside of this bag to wash any residue from your body. • Await further decontamination instructions.

32. NOW..... . . . . w h o w a n t s t o v o l u n t e e r ?

33. Review • Questions • Post Assessment • must have name on top • Module Evaluation • name optional