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Awareness Level Hazardous Materials Training. HOSPITAL’S NAME HERE. INTRODUCTION. Hospitals are sometimes called upon to treat patients who were accidentally or intentionally exposed to (contaminated by) haz ardous mat erials (haz mat). INTRODUCTION.

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introduction
INTRODUCTION

Hospitals are sometimes called upon to treat patients who were accidentally or intentionally exposed to (contaminated by) hazardous materials (haz mat).

introduction3
INTRODUCTION

Haz mat includes three main categories of substances -- nuclear, chemical and biological -- that could pose risks to health or safety.

introduction4
INTRODUCTION

Because haz mat substances can be harmful under certain circumstances, special precautions to protect caregivers and others who may come into contact with the victim are necessary.

introduction5
INTRODUCTION

Sometimes hospitals may not know in advance they are receiving victims who were exposed to haz mat, so ...

introduction6
INTRODUCTION

… As a hospital employee or volunteer, you may unintentionally come into contact with a patient who has been exposed to or contaminated by hazardous materials.

introduction7
INTRODUCTION

Your safety is a priority. Therefore, this training has been developed to protect you by teaching you to:

  • understand haz mat materials and risks
  • recognize haz mat events/victims
  • protect yourself from haz mat exposure
  • identify your role in responding to haz mat events
introduction8
INTRODUCTION

THIS TRAINING ALONE DOES NOT

QUALIFY YOU TO HANDLE

HAZARDOUS MATERIALS!

introduction9
INTRODUCTION

The training includes information on:

NUCLEAR HAZARDS

CHEMICAL HAZARDS

BIOLOGICAL HAZARDS

SUMMARY

nuclear objectives
NUCLEAR OBJECTIVES

UNDERSTAND:

  • what is radiation
  • types of radiological hazards
  • effects of radiation contamination and exposure
  • self-protection and management of radiation casualties
radiation basics
RADIATION BASICS

RADIATION IS...

  • invisible particles of energy that travel through air and other substances.
  • You can’t see, taste, or smell radiation…
  • But it can be inhaled, swallowed, or absorbed through skin
radiation basics14
RADIATION BASICS
  • There are 4 types of radiation:
  • ALPHA:Shielded by clothing or paper
  • BETA:Shielded by thick clothing or aluminum
  • GAMMA:Shielded by lead, steel or thick cement
  • NEUTRON:Goes through anything, but is rare
radiation basics15
RADIATION BASICS

This is the universal symbol for

radioactive materials:

nuclear hazards
NUCLEAR HAZARDS
  • ACCIDENTAL -- (Industries)
    • Nuclear reactor accidents
    • Medical or laboratory errors
    • Nuclear fuel spills/releases
  • INTENTIONAL -- (Nations or Terrorists)
    • Nuclear bombs triggering nuclear reactions
    • Explosive devices w/ radioactive materials
    • Radioactive isotopes planted to spread radiation
nuclear hazards18
HISTORICALLY

Reactor Incidents

Laboratory or Medical Accidents

Nuclear Waste Accidents

Thermonuclear War Nationally Sponsored

NOW

THE SAME THREATS EXIST

Terrorists and

Rogue Nations

NUCLEAR HAZARDS
nuclear preparedness
HISTORICALLY

Bomb Shelters

Public Siren Systems

Public Education

  • NOW
  • First Responders
  • Governmental Planning
  • Hospital Planning
NUCLEAR PREPAREDNESS
nuclear hazards20
NUCLEAR HAZARDS

NUCLEAR INCIDENT EXAMPLES

  • Three Mile IslandMiddleton, PA (1979)Nuclear power plant meltdown. 100,000 residents flee. No injuries.
  • Chernobyl, Ukraine (1986)Nuclear power plant incident contaminated 100,000 square miles, and killed 125,000.
  • Springfield, MA(1991)Truck carrying nuclear fuel to a power plant collided with car. No one contaminated.
  • 1999 reportable incidents: 1310 medical, 2 occupational, and 1 fire at a plant.
radiation effects
RADIATION EFFECTS
  • RADIATION SICKNESS:Large amounts of radiation. Day of exposure symptoms may include vomiting, diarrhea, hemorrhage.
  • RADIATION INJURY:Usually large amount of Beta radiation. Local injuries, such as skin burns and lesions, usually to hands from handling.
  • RADIATION POISONING:Dangerous amounts of internal radiation. Causes delayed injuries like anemia or cancer.
radiation effects23
RADIATION EFFECTS

Radiation sickness, injury and poisoning are NOT contagious or infectious.Treating or helping victims who were exposed to radiation, but are no longer near the source, will not expose you.

For example: An x-ray will expose you to radiation, but you are not contaminated by an x-ray.

radiation effects24
RADIATION EFFECTS

However, if a victim arrives covered in radioactive dust or debris, the radioactive material can contaminate you.

radiation effects25
RADIATION EFFECTS

SEVERITY OF RADIATION’S EFFECTS

=

AMOUNTandTYPE of radiation

+ DISTANCEfrom radiation

+ type ofSHIELDING

+ TIMEexposed

protecting yourself from radiation
PROTECTING YOURSELF FROM RADIATION

The first step to protecting yourself is recognizing the risk of exposure.

CLUES MAY INCLUDE:

  • The location a victim came from (i.e., laboratory or radiation oncology clinic)
  • The victim’s occupation (i.e., truck driver, lab technician, power plant employee)
  • An explosion of unknown origin
  • History of an unknown substance
  • Patients from one area with similar symptoms
protecting yourself from radiation28
PROTECTING YOURSELF FROM RADIATION

If you suspect you, or someone in the near proximity to you, were potentially contaminated with radioactive material, here is what to do…

protecting yourself from radiation29
PROTECTING YOURSELF FROM RADIATION

DO NOT SPREAD THE CONTAMINATION!

  • To the extent possible, do not move; avoid touching yourself, objects, or people; and do not leave the room
  • Inform others in the areawho may have had contact to remain calm and to stay still too
  • Call out or telephone for assistance. Make it clear that a hazardous substance may be involved
awareness level staff roles
AWARENESS LEVEL STAFF ROLES
  • Know who to contactif you are the first to recognize a potential nuclear contamination event/victim
  • Know to whom to report for response instructions, and follow his/her directions carefully
  • You may be asked to:
    • assist in securing the containment area
    • directing the flow of patients and staff
    • appropriate tasks outside the contaminated area
    • HOSPITAL ADD APPROPRIATE FUNCTIONS HERE
awareness level staff roles32
AWARENESS LEVEL STAFF ROLES

But, NEVERwork inside the containment area or handle contaminated items.

You are not trained to wear special protective equipment or to handle nuclear hazardous materials.

chemical objectives
CHEMICAL OBJECTIVES

UNDERSTAND:

  • what is a chemical hazard
  • types of chemical hazards
  • effects of chemical contamination and exposure
  • self-protection and management of chemical casualties
chemical hazard basics
CHEMICAL HAZARD BASICS

CHEMICAL HAZARDS ARE...

  • Liquids, gases or solids that can cause injury by reacting with the body’s tissues.
  • You may be able to see, taste, or smell chemicals, but this is not always true.
  • Chemicals can be inhaled, swallowed, injected or absorbed through skin.
chemical hazard basics37
CHEMICAL HAZARD BASICS

CHEMICAL EXAMPLES:

  • Explosive: dynamite
  • Flammable: gasoline
  • Thermal: dry ice
  • Toxic/Poisonous: arsenic
  • Corrosive: acids
  • Anesthetic: chloroform
  • Asphyxiating: carbon monoxide
  • Noxious: tar gas
  • Blistering: mustard gas
  • Nerve agent: sarin
chemical basics
CHEMICAL BASICS

These are some of the chemical hazard symbols:

Flammable

Poison

chemical hazards
CHEMICAL HAZARDS
  • ACCIDENTAL -- (Industry and Home)
    • Manufacturing, shipping, or storage accidents
    • User error-- failed safety precautions
    • Combining harmless chemicals to create a dangerous reaction
  • INTENTIONAL -- (Terrorists and Warfare)
    • release of agents using bombs, aerosols, or other disbursement mechanisms
chemical hazards41
CHEMICAL HAZARDS

CHEMICAL HAZARD EXAMPLES

  • Union CarbideIndia (1984) Tank leaked extremely reactive chemical -- over 100,000 treated, 50,000 hospitalized, and 2,500 dead
  • CultJapan (1995) Released sarin gas in subway system -- 12 killed, thousands sought care
  • Refinery explosion Arkansas (1999) Killed 3; sent 3 to burn unit. Released smoke plume.
  • Rail yard spill California (2000) Mixed hydrochloric acid and jet fuel -- 1,000 evacuated, 2 hospitalized
chemical effects
CHEMICAL EFFECTS
  • The effect of a chemical exposure depends on the type of chemical(s)
  • Some are harmless; others are deadly
  • Symptoms and severity of the reaction vary depending upon the amount and/or duration of exposure and the form -- solid, liquid or gas.
chemical effects44
CHEMICAL EFFECTS

Examples of symptoms include:

Unconsciousness

Confusion

Drooling and tearing eyes

Light-headedness

or dizziness

Blurred or double vision

Coughing or painful respiration

Change in skin color or blushing

Anxiety

Tingling or numbness of extremities

Nausea, vomiting, abdominal cramping and diarrhea

Changes in behavior or mannerisms

Loss of coordination

Burns or burning sensation

chemical effects45
CHEMICAL EFFECTS

Chemical exposures are not contagious or infectious.Treating or helping victims who were exposed to chemicals, but are no longer exposed to the source, will not expose you.

chemical effects46
CHEMICAL EFFECTS

However, if a victim arrives with chemicals on his/her clothing, shoes, or body, the chemicals can contaminate you.

You may not know a victim has been contaminated because not all chemicals can be detected easily by sight or smell.

how do you protect yourself from chemical exposure48
HOW DO YOU PROTECT YOURSELF FROM CHEMICAL EXPOSURE?

The first step to protecting yourself is recognizing the risk of exposure.

CLUES MAY INCLUDE:

  • The location a victim was near (i.e., hardware store, industrial park, truck accident, gas station)
  • The victim’s occupation (i.e., garbage removal, lawn care, construction, transportation, medicine)
  • An explosion or gas cloud of unknown origin
  • An unknown liquid, oil, gas or powder
  • Patients from one area with similar symptoms
  • Unidentified smells or tastes
protecting yourself from chemicals
PROTECTING YOURSELF FROM CHEMICALS

If you suspect you, or someone in the near proximity to you, were potentially contaminated with a chemical, here is what to do...

protecting yourself from chemicals50
PROTECTING YOURSELF FROM CHEMICALS

DO NOT SPREAD THE CONTAMINATION!

  • Avoid touching the suspected liquid or solid, or breathing fumes. If you may have touched a chemical, do not touch yourself, objects or people.
  • Remove yourself from immediate risklike fumes or additional contamination, but stay as near to the source as possible.
  • Inform others in the areato minimize all contact and to stay calm.
  • Call out or telephone for assistance, making it clear that a hazardous substance may be involved.
  • Immediately, report all routes takenby the victim or anyone with secondary contamination.
awareness level staff roles52
AWARENESS LEVEL STAFF ROLES
  • Know who to contactif you are the first to recognize a potential chemical contamination event/victim
  • Know to whom to report for response instructions, and follow his/her directions carefully
  • You may be asked to:
    • assist in securing the containment area
    • directing the flow of patients and staff
    • appropriate tasks outside the contaminated area
    • HOSPITAL ADD APPROPRIATE FUNCTIONS HERE
awareness level staff roles53
AWARENESS LEVEL STAFF ROLES

But, NEVERwork inside the containment area or handle contaminated items.

You are not trained to wear special protective equipment or to handle chemical hazardous materials.

biological objectives
BIOLOGICAL OBJECTIVES

UNDERSTAND:

  • what is a biological hazard
  • types of biological hazards
  • effects of biological contamination and exposure
  • self-protection and management of biological casualties
biology basics
BIOLOGY BASICS

BIOLOGICAL HAZARDS ARE...

  • Harmful, invisible, living micro-organisms that travel through air, by surface to skin, or by skin to skin contact
  • You can’t always see, taste, or smell biological contamination…
  • But it can be inhaled, swallowed, or absorbed through skin
biology basics58
BIOLOGY BASICS

Biological hazards come in three forms. Examples include:

Bacteria: Pneumonia, Meningitis, Tuberculosis, Anthrax

Virus: Flu, Chicken Pox, Hepatitis, Small Pox, Ebola

Toxin: Botulism, Ricin

biology basics59
BIOLOGY BASICS

This is the universal symbol for

BIOLOGICAL HAZARDS:

biological hazards
BIOLOGICAL HAZARDS
  • ACCIDENTAL -- (Natural)
    • Contagious/infectious diseases
    • Food poisoning
    • Diseases from insects, animals or pets
  • INTENTIONAL -- (Nations or Terrorists)
    • Contamination of food or water
    • Aerosolized biological agents
    • Explosive devices deploying biological agents
    • Suspicious containers with accompanying threats
biological hazards62
BIOLOGICAL HAZARDS

BIOLOGICAL INCIDENT EXAMPLES

Flu Season (Annually) Average 20,000 deaths, and 100,000 hospitalizations in U.S.; person to person

West Nile Fever New York (1999)62 severe cases, including 7 deaths; mosquito-borne virus

CryptosporidiosisMilwaukee, WI (1993)Over 400,000 ill and 4,400 hospitalized; unintentionally contaminated drinking water

Accidental anthrax release Former USSR (1979)66 human deaths and animal deaths for 30 miles downwind; factory release

biological hazard effects
BIOLOGICAL HAZARD EFFECTS
  • The effect of a biological depends on the organism
  • Some are harmless; others are deadly
  • Often, symptoms change over time
  • The initial symptoms are usually vague and may include fever, cough, malaise, and fatigue
biological hazard effects65
BIOLOGICAL HAZARD EFFECTS

Over time, symptoms may progress.

Blurred or double vision

Delirium

Anxiety

Pink or red sputum

Unconsciousness

Painful/distressed respiration

Glandular swelling

Nausea, vomiting, abdominal cramping and diarrhea

Burning/blistered skin

Rash

Bleeding/hemorrhaging under the skin

Paralysis

biological effects
BIOLOGICAL EFFECTS

Biological exposure is often contagious from person to person.Sometimes breathing the same air or touching the same surfaces as a contaminated victim can expose you to the bacteria or virus they are carrying.

Symptoms are not instantaneous; they take time to develop (incubation period). Some infected people do not know they were exposed or are contagious.

biological effects67
BIOLOGICAL EFFECTS

Biological contaminant victims usually require medical care to kill the bacteria or control the virus. But, the body’s own immune system also fights to remove harmful infections.

People with weakened immune systems, like the elderly, children and people with chronic diseases, are at a greater risk from biological agents.

protecting yourself from biological hazards
PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS

On a daily basis, patients who are potentially infected with a bacteria or virus present to the hospital.

protecting yourself from biological hazards70
PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS

Luckily, there are many easy methods for reducing the likelihood of infection.

  • Hand washing
  • Universal (standard) precautions
  • Antibacterial cleaners
  • Gloves
  • Proper sharps disposal
  • Flu shots and other immunizations
  • Proper handling and disposal of bodily fluids
protecting yourself from biological hazards71
PROTECTING YOURSELF FROM BIOLOGICAL HAZARDS

Hospitals have many measures in place to protect employees, volunteers, visitors and the public from harmful bacteria and viruses.

HOSPITAL insert list of policies on: cleansing procedures, isolation (standard) precautions, sharps and disposal policies, others as necessary

awareness level staff roles73
AWARENESS LEVEL STAFF ROLES

Help identify a biological outbreak as soon as possible.

POSSIBLE CLUES INCLUDE:

  • Epidemic-like trends (many people with similar symptoms)
  • Victims were at common location or event at some point in the past
  • Respiratory complaints, rashes, fevers
  • Unusual animal deaths/illnesses
  • An explosion of unknown origin
awareness level staff roles74
AWARENESS LEVEL STAFF ROLES

HERE IS WHAT TO DO IF YOU EXPECT AN OUTBREAK!

HOSPITAL fill in policy on reporting suspected infectious disease patterns or events

summary76
SUMMARY
  • Hospitals often provide care to victims of radiation, chemicals and biological hazardous material events
  • Haz mat agents may affect one or many victims
  • Haz mat events may be accidental or intentional
summary77
SUMMARY
  • Hospitals may not know that patient(s) they received have been contaminated by haz mat
  • Senses, such as smell or sight, are not always sufficient to detect haz mat
  • Relying on clues such as patients with similar symptoms, or location and occupation can help detect haz mat
summary78
SUMMARY
  • Knowing how to report a suspected haz mat event and limiting the spread of haz mat contamination are key roles
  • Biological haz mat is common in hospital settings. Many policies and procedures to limit exposure are in place
summary79
SUMMARY
  • Radiation and chemicals do not pose a risk to caregivers once the haz mat source is removed
  • Only trained employees should handle hazardous materials or enter contaminated areas
  • This training alone is not sufficient for you to work in contaminated areas
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