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Incidents involving weapons of mass destruction (WMD) require special consideration involving decontamination. Many responders believe that the standard wet decontamination as taught during our hazardous materials response classes is sufficient, but this is not necessarily the case. Moreover, many believe that a gross decontamination will suffice in an incident involving mass casualties and WMD, but in some cases this does not hold true itself.
Strategic guidelines must be in place for all departments that specifically state which forms of decontamination should be used for certain incidents. The determining factor is the type of agent involved. This article will provide information to formulate a guide in dealing with some of the potential agents.
Chemical warfare agents have been around since the early 1900s. Generally, these agents are broken down into four groups: nerve, blister, blood and choking. The groups are derived from the signs and symptoms produced by each. Each agent has a code associated with it for identification, often times these agents are referred to by their code such as sarin (GB), soman (GD) and VX by its code VX. Decontamination procedures for all of the chemical warfare agents should be accomplished as follows.
Often, we forget that removal of all clothing on the individual is a top priority and may remove as much as 80% of the contaminants. Clothing removal should be accomplished in a systematic manner, cutting along seams when possible and avoiding penetrations in the clothing that may have been made by the dispersion device. The penetrations may be helpful for law enforcement or forensics during the investigation portion of the event. In addition, at minimum, clothing should be double-bagged in plastic liners and kept separate for each individual involved.
The next step is to set up at least two pails, one with a 5% bleach solution and one with clean water. It is imperative that a tepid water solution be used; if not, a problem may occur at the skin level, since hot water tends to cause the pores of the skin to expand and can allow more contaminants into the body. In cold water, the skin pores tend to contract, which allows them to close, entrapping the agent inside.
At this point, several sponges should be available. The patient is then placed on a backboard onto a platform; the platform may be made from a ladder. A basin should be placed under the platform to catch the contaminated water. Start at the patient’s head, utilizing an imaginary line running up and down the nose from the head to the lower part of the trunk. Use a sponge with the bleach solution to sweep, beginning at the midline and swabbing outward, and then follow this immediately with a sponge utilizing the clean water. Repeat this technique from head to toe, including arms. Once the anterior side of the patient has been completed, log-roll the patient and perform the same procedure on the posterior side. At this point, the patient may be checked for further contamination by using M-8 paper or a monitor designed for use with these agents.
Certain agents can be produced with different viscosities. The reasoning behind this is so they may stick and last longer on items such as buildings and ships so that the effects will last much longer and not be dispersed by wind or affected by evaporation. The change in viscosity is relatively easy once the agent is obtained by adding certain materials.