Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Paramedic Care:Principles & Practice
Volume 5Special Considerations/
Operations
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Chapter 11Hazardous Materials Incidents
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
TopicsRole of the ParamedicIncident Size-UpSpecialized TerminologyContamination and Toxicology ReviewApproaches to Decontamination Hazmat Protection EquipmentMedical Monitoring and RehabilitationImportance of Practice
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Introduction
Hazardous materials are shipped throughout the United States by truck, pipeline, railroad, and tankers
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous Material
“Any substance which may pose an unreasonable risk to health and safety of operating or
emergency personnel, the public, and/or the environment if not properly controlled during handling, storage, manufacture, processing, packaging, use, disposal, or transportation.”
United States Department of Transportation
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Role of the Paramedic
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Role of the Paramedic
EMS agencies should train all of their personnel in how to respond to hazmat incidents
Responsibilities include:– Size-up the incident, assess the toxicological
risk, and activate the incident management system
– Evaluate decontamination methods, to treat and transport exposed patients, and to perform medical monitoring of hazmat teams
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazmat Standards
OSHA publication CFR 1910.120– Hazardous Waste Operations and Emergency
Response Standard (2004)
EPA regulation 40 CFR 311– Mirror regulation of CFR 1910.120
NFPA standard 473– Standard Competencies for EMS Personnel
Responding to Hazardous Materials Incidents
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Levels of Training
Awareness level– Recognition
EMS Level I (operations level)– Patient care in cold zone
EMS Level II (technician level)– Patient care in warm zone
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Incident Size-Up
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Incident Size-Up
IMS and Hazmat situations– Priorities for a hazmat incident are the same as
for any other major incidentLife safety
Incident stabilization
Property conservation
– Quickly determine if open incident or a closed incident
– Basic IMS at a hazmat incident
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Incident Awareness
Every emergency site has the potential to be a hazmat incident
Inspect the scene from a distance
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Transportation
Maintain suspicion of the presence of hazardous materials at any vehicle accident
Railroad accidents– Volume– Number of cars
involved
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Fixed Facilities
Facilities where dangerous substances are produced or stored – Chemical plants – Other facilities– Rural areas
Many communities have some kind of fixed pipelines
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Terrorism
The terrorist may use any variety of chemical, biological, or nuclear devices– Weapons of mass destruction
Lack of predictability about when or where an attack might take place
Look for potential clues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Recognition of Hazards
Placard Classifications– Absence of a
placard does not mean the absence of a hazmat threat
– Regulations vary
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Placard Classifications
Diamond shape
Indicates hazmat classifications – Color code– Hazard class
number
UN number
Use of symbols
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazard Classes and Placard Colors
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Placard Classifications
Several shortcomings of placards– Quantity may not be sufficient to require placard– “Dangerous” placard
Does not indicate substance present
– Lack of placard
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
NFPA 704 System
Identifies hazardous materials at a fixed siteUses diamond-shaped figures divided into four sections:– Red
Flammability
– BlueHealth hazard
– YellowReactivity
– WhiteSpecific information
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Identification of Substance
Emergency Response Guidebook
Shipping papers
Material safety data sheets (MSDS)
Databases
Hazmat telephone lines (CHEMTREC, CHEMTEL, Inc.)
Poison control centers
Toxicologists
References
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Emergency Response Guidebook
Should be carried on every emergency vehicle
Lists more than a thousand hazardous materials
Specific emergency procedures
Shortcomings
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Shipping Papers
Contains the most accurate information about a transported substance – Bill of Lading
May not be with driver if they have left vehicle
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Material Safety Data Sheets
Present at fixed facilities
Data
Should be posted in easily accessible location
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Monitors and Testing
Air and gas monitors– Determines the percentage of oxygen in the air – Measures the presence of explosive gases,
carbon monoxide, and toxic gases
Litmus paper – Measures the approximate pH of a liquid
Colormetric tubes – Suction the air and search for specific chemicals
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Other Sources of Information
Textbooks, handbooks, or technical specialists
Computerized database – CAMEO®—Computer-Aided Management of
Emergency Operations
Local or regional poison control center
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Other Sources of Information
CHEMTREC– Maintains a 24-hour, toll-free hotline
800-424-9300
CHEMTEL, Inc.– Maintains another 24-hour, toll-free emergency
response communications center 800-255-3024
– Supplies the names of state and federal authorities that deal with radioactive incidents
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous Materials Zones
Your main priority at a hazmat incident is safety
Request help right away and establish command
Evacuate people from the area around the incident
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous Materials Zones
Establish zones– Hot (Red) – Warm (Yellow)– Cold (Green)
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Specialized Terminology
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Specialized Terminology
Boiling point
Flammable/ explosive limits– LEL– UEL
Flash point
Ignition temperature
Specific gravity
Vapor density
Vapor pressure
Water solubility
Alpha radiation
Beta radiation
Gamma radiation
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Contamination and Toxicology Review
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Contamination and Toxicology Review
Threshold limit value/time weighted average (TLV/TWA)
Threshold limit value/short-term exposure limit (TLV/STEL)
Threshold limit value/ceiling level (TLV-CL)
Lethal concentration/lethal doses (LCt/LD)
Parts per million/parts per billion (ppm/ppb)
Immediately dangerous to life and health (IDLH)
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Types of Contamination
Primary– Direct contact
Secondary– A contaminated person or object comes in
contact with an uncontaminated person or object
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Routes of Exposure
Respiratory inhalation
Topical absorption
Parenteral injection
Gastrointestinal ingestion
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Routes of Exposure
Click here to view an animation on poisons.
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Cycles and Actions of Poisons
Acute effects
Delayed effects
Local effects
Systemic effects
Biotransformation
Synergism
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Treatment of Common Exposures
Treatment ranges from supportive care to specific antidotes
Before administering specific pharmacological treatment, at least two sources should agree on the medication
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Corrosives
Brush off dry particles
Flush liquid corrosives with large quantities of water
Tincture of green soap may help in decontamination
Irrigate eye injuries, possibly with proparacaine hydrochloride to assist
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Corrosives
If the corrosive has been ingested, do not induce vomiting
If the patient can swallow and is not drooling, give the person 5cc/kg water up to 200 cc
Support the ABCs
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Pulmonary Irritants
Cannot be decontaminated
Remove patient’s clothing
Flush exposed skin with large quantities of water
Irrigate eyes with water– Tetracaine to reduce eye discomfort
Treat pulmonary edema with furosemide and albuterol
Support the ABCs
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Pesticide Actions
S—Salivation
L—Lacrimation
U—Urination
D—Diarrhea
G—Gastrointestinal distress
E—Emesis
Involuntary muscle contraction
Pinpoint pupils
Blocks acetylcholinesterase (AChE) causing:
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Pesticide Treatment
Remove all clothing and jewelry
Maintain and support ABCs
Suction if needed
Administer atropine 2 mg IV push until SLUDGE symptoms resolve
If an adult has seizures, administer 5–10 mg of diazepam
If the patient can swallow, give 5cc/kg up to 200 cc of water
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Chemical Asphyxiants
The most common chemical asphyxiants include:– Carbon monoxide
Has a high affinity for hemoglobin and displaces oxygen in the red blood cells
– CyanidesInhibit cytochrome oxidase that enables oxygen to create adenosine triphosphate (ATP) required for muscle energy
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
General Treatment for Chemical Asphyxiants
Decontamination is usually not necessary
Remove from the toxic environment
Remove patient’s clothes to prevent trapped gases
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Treatment for CO Exposure
Oxygenate patient
Hyperbaric therapy is necessary in some cases– Increases the displacement of carbon monoxide
from hemoglobin molecules by oxygen
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Treatment for CyanidePasadena, Lilly, or Taylor kit
Administer amyl nitrate ampulesPrepare and administer sodium nitrite– 300 mg IV push over 5 minutes
Follow with an infusion of thiosulfate, – 12.5 g IV push over 5 minutes
Repeat at half doses if necessary
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Treatment for CyanideCyanokit
Hydroxocobalamin– Binds cyanide from
cytochrome oxidase
– Forms cyanocobalamin (Vitamin B12)
– Excreted by the kidneys © Courtesy Dey, L.P.
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hydrocarbon Solvents
Support the ABCs
Decontaminate the exposed area
Do not induce vomiting
If the patient can swallow and is not drooling, administer 5 cc/kg up to 200cc of water
Seizures– 5–10 mg diazepam
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Approaches to Decontamination
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Approaches to Decontamination
To reduce or remove hazardous substances from people and/or equipment
Can be accomplished by physical or chemical means
Serves several purposes: – Reduces the dosage of the material – Reduces secondary exposure
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Methods of Decontamination
Dilution – Application of large quantities of water to the
person– Water may be aided by soap
Absorption– Use of pads or towels to “blot” up the hazardous
material – Commonly used during environmental cleanup
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Neutralization– One substance reduces or eliminates the toxicity
of another – Rarely used by EMS
Isolation/Disposal– Separate the patient or equipment from the
hazardous substance – Establish zones– Items that might contain or trap a hazardous
substance should be removed – Destroy or store contaminated substances
Methods of Decontamination
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Decontamination Decision Making
Recall the priorities of incident management – Life safety, incident stabilization, and property
conservation
Environmental considerations form a major concern only in cases where there are no life threats
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Modes of Operation
Fast-break Decision Making– Conscious, contaminated victims will often self-
rescue May try to leave the scene entirely
– EMS units must be prepared for gross decontamination
Two-step process
– ImplementationCritical patients and unknown or life-threatening materials
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Modes of Operation
Long-Term Decision Making– Occurs when patients remain in the hot zone
and have not self-rescued – Advantages
Better opportunity for thorough decontamination Better PPE Less chance of secondary decontamination Greater consideration of the environment More detailed research of the actual hazardous substance
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Field Decontamination
Decontamination method and type of PPE depend on the substance involved – When dealing with unknowns, do not attempt to
neutralize
Brush off dry chemicals
Apply large quantities of water with green soap if available
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Two-Step Process
Step 1– Remove patient’s clothing and jewelry
Step 2– Wash and rinse the patient with water and soap– Repeat– Pay attention to difficult areas
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Eight-Step Process
1. Rescuers enter the decontamination area at hot end of corridor and mechanically remove contaminants
2. Rescuers drop equipment in a tool-drop area, and remove outer gloves
3. Decontamination personnel shower and scrub all victims and rescuers using gross decontamination. (Victims can be moved to step 6 or step 7)
4. Rescuers remove and isolate their SCBA (continued)
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
5. Rescuers remove all protective clothing (Victims who are still clothed have their clothes removed)
6. Rescuers remove all personal clothing
7. Rescuers and victims receive a full-body washing
8. Patients receive rapid assessment and stabilization before transport
Eight-Step Process
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Transportation Considerations
Field-decontaminated patients may still need to undergo a more invasive decon process at a medical facility – Transport to facilities capable of performing
more thorough decon procedures
Stretcher decon pool
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazmat Protection Equipment
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazmat Protection Equipment
Level A– Highest respiratory
and splash protection
– Fully encapsulating
Level B– Full respiratory
protection– Non-encapsulating,
but chemically resistant
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazmat Protection Equipment
Level C– Uses an air-purifying respirator– Nonpermeable suit, boots, and eye and hand
protection
Level D– Structural firefighting gear
The level of protection needed depends on the chemical or substance involved
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Medical Monitoring and Rehabilitation
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Medical Monitoring and Rehabilitation
Blood pressure
Pulse
Respiratory rate
Temperature
Body weight
ECG
Mental/ neurological status
Entry Readiness
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Post-Exit Rehab
Complete decontamination
Post-entry monitoring – Measure and
document the same parameters on the flow sheet
Fluid replacement
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Heat Stress Factors
Take into account:– Temperature and humidity– Prior hydration status– Duration and degree of activity– Level of protective suit used
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Importance of Practice
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Importance of Practice
Put on and take off Level B hazmat protective equipment
Set up and practice decon– Two-step process– Eight-step process
Identify a simulated chemical, determine the correct PPE, and establish the proper decontamination methods
Monitoring methods and flowsheets
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
SummaryRole of the ParamedicIncident Size-UpSpecialized TerminologyContamination and Toxicology ReviewApproaches to Decontamination Hazmat Protection EquipmentMedical Monitoring and RehabilitationImportance of Practice