DECON TEAM REQUIREMENTS/ SITE CONSIDERATIONS

1. DECON TEAM REQUIREMENTS/SITE CONSIDERATIONS

2. Objectives • Who should be on the Decon team? • Discuss OSHA First Receivers standard. • Roles of various team members. • Discuss decontamination site selection. Decontamination Team

3. Hospital Decontamination Teams • Core Trained Group • Originally only ER staff • Now core includes many more than ER staff • Members available 24/7 • Pager • Stipend for responding and training • Accountability for equipment and access Decontamination Team

4. Who will do Decon?Who should not do DECON? • Administrators • ED Clinicians • Firefighters/EMS • Housekeeping • Facilities • Military • Techs and non-medical support • Security Decontamination Team

5. OSHA First Receivers Guidelines • Created in January 2005 • It is an extension of the standards for personnel involved in responding to hazardous chemical spills • Specifically addresses hospital providers • Available at www.osha.org Decontamination Team

6. Security Team • Control all access to hospital entrance/exits. • May have to recruit non-security staff. • PPE requirements risk/benefit analysis. • Might be the first person to “greet” a contaminated patient. Decontamination Team

7. Decontamination Team • Patient transport – entry and exit (does not enter tent) • To the tent (guide/non-ambulatory) • Cut clothes if non-ambulatory • Triage - pre and/or post decontamination (does not normally enter tent) • Decontamination personnel • Ambulatory (1 per side – post DECON) • Non-ambulatory (minimum of 4 (?) per patient) • Agent specific monitoring for success (another person?) Decontamination Team

8. Decontamination Clinical Team Decides if immediate treatment is needed prior to decontamination • MARK 1 kits • Amyl nitrate • Decide what type of decontamination is needed • Deceased/expectant patients assessment Decontamination Team

9. Perfect World • Decon zone personnel = 9 people • Safety Monitor - 1 • Security - 1 • Clinical/Triage - 1 • Litter bearers/escorts – 2 • Decontaminators – 4 • Decon zone personnel = 30 people • Safety Monitor - 1 • Security – 1 to 4 • Clinicians – 2 to 5 • Litter bearers/escorts – 14 • Decontaminators – 8 Decontamination Team

10. Decontamination Site • Large outdoor area • Fixed lines vs. deployable shelters • Control run off (EPA) • Non-permeable surface if possible • Utilities & Water • Hot & cold • No tears soap • Down wind of the facility • Controlled access to the DECON site and the healthcare facility!!!!!!!!! Decontamination Team

11. DecontaminationEquipment • Ownership • Accessible • Mobile as site may change • Maintained and Inspected regularly Decontamination Team

12. Hospital Secure Entry Control Point DecontaminationSite Triage Station Immediate Treatment ? Wet Decon Dry Decon Litter Decon Secondary Facility ? Decontamination Team

13. Dry Decon Litter Decon Wet Decon Decontamination Team

14. Summary • Personnel need to … • Understand the decontamination plan • Understand the difference in requirements between the RELEASE SITE (HAZMAT) and HOSPITAL ENTRY DECON zones • Be trained and medically cleared for their specific roles • Equipped with Level C PPE if working in the decon zone • Scale response to the size of the event • Establish a decontamination site Decontamination Team

15. Thank you! Questions?