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  1. #1
    Robert Burke
    Firehouse.com Guest

    Lightbulb Turnouts and SCBA for Nerve Agents

    What do hazmat/firefighters think about the SBCCOM guidelines concerning responses to nerve agents where turnouts and SCBA's can be used to rescue victims in these environments:


  2. #2
    Petie
    Firehouse.com Guest

    Post

    The SBCCOM guidelines came out in August, 1999 after extensive testing with several fire departments across the country. Many refer to this guideline, which is designed to aid incident commanders and their decision making at terrorism incidents involving nerve agents or mustard gas, as the "3-30 Rule" because it states that firefighters will have adequate protection from nerve agents if they use their structural gear, scba's, and duct tape around the sleeves and pant legs. The guidelines are specifically for rescue of live victims and are not designed for entry into these areas to do other things. Many feel these guidelines at least provide some empirical evidence that these environments are survivable by responders in efforts to rescue victims. Still other people feel these guidelines go way beyond safe responses and may have the effect of causing more firefighter injuries and deaths. After all, just a few drops of nerve agent on the skin of a firefighter can kill and how many jurisdictions are stocked with adequate amounts of antidotes like atropine and 2-PAM chloride to treat not only nerve agent victims but also firefighter victims. In the absence of a hazmat team with Level A clothing many fire departments will do the best they can though at these incidents-and that is rescue attempts in turnout gear and scba's.
    Some other thoughts to throw out with these guidelines are;
    1. Turnout gear was not designed to provide safety from chemical, biological, or radiological materials so why are we allowing responses to nerve agents (which are nothing more than pesticides) with this clothing.
    2. OSHA would view responses to nerve agent atmospheres in turnout gear and scba's by firefighters to be severe violation of the Hazwoper law (29 CFR 1910.120(q)). Firefighters are not trained to the level that is required and the clothing is clearly not designed for these chemicals.
    3. From a legal perspective, are you as the incident commander willing to risk the health and safety of your personnel by sending them into nerve agent atmospheres in turnout gear? What if one of our own gets hurt or killed? Could you be held responsible for their death? Could it be negligence if you knew better, or malfeasonce, and how would things settle out in civil court? Some things to think about.
    4. How come pesticide incidents of the past were always thought to be Level A incidents with moon suits but now turnout gear and scba's are ok? Isn't there something wrong with this thinking? Aren't we going backwards?
    5. The International Association of Fire Fighters is against these guidelines for many of the above reasons. Does it make sense to increase the number of victims at a scene by adding firefighters? Clearly, a good risk vs. benefit analyis needs to be done. Is our involvement really worth what we can save? Hard questions that need to be asked.
    6. Why are we thinking of using gear that was not designed for chemicals when chemical gear, in concert with proper training and procedures, exist?
    7. While these guidlines remain controversial some fire departments have adopted them. Chicago and Houston have trained their personnel to utilize the guidelines while FDNY has not. LAFD does not allow firefighters in hot zones with turnout gear but they do issue Mark I injectors for nerve agent exposures.
    8. Perhaps the bottom line is do you feel comfortable ordering your personnel in to nerve agent atmospheres in turnout gear and scba to rescue victims?
    Lastly, before you can really decide you need to read the guidelines in their entirity, discuss them with others, and then decide if they apply to your jurisdiction before an incident occurs. Good luck!

  3. #3
    cwood1969
    Firehouse.com Guest

    Post

    The key to responding to these incidents in turn-outs is knowing what you are dealing with- as it is with all haz-mat incidents. I don't think we are moving backwards, but I do think we are getting smarter with how we respond to WMD. First responders must be trained to identify nerve agents by color, area odor, and effects on victims. Stations should keep MSDS on these agents, and firefighters should become familiar with them. The main hazards depend on the agent, but agents such as sarin (Tokyo subway) are mostly an inhalation hazard and dissipate quickly, so the SCBA provides the primary protection. The key here is a little taste of smoke due to a poorly sealed mask is ok, but a little taste of sarin is not. Firefighters are going to come across this stuff sooner or later, and if they are trained to handle the incident they stand a much better chance of surviving to save victims. Big cities with haz-mat teams and zoot suits is one thing, but a small department far away from these teams must know how to handle these incidents with what they have got. Turn-outs.

  4. #4
    Tcashel
    Firehouse.com Guest

    Post

    The use of structural firefighter turn-out gear for entry into nerve agents release is important. The intent of the SCBCOM data is imform responders that a very limited entry can be made for KNOWN VICTIMS. RECON time is less and upon concentration levels of agent. The use of taping prior to entry is an old method. I remember initial haz. Mat entry by engine crews using duct tape. This was even listed in the Fire Chief Mag. by two well respoected HM instructors from Maryland. The bottom line, is that we have some guideline that we assist in our assessment. Nothing is definitive. We always bring all of our tools with us. Legel concerns of acting is important, but legal issues of failung to act when data has been presented that can be used in the field. The IC make's the call. The action is contrary to known established Haz. Mat. response protocols. In WMD incidents are nothing more than Haz. Mat incidents with an attitute. They are guidelines use as such.
    Just some thoughts

  5. #5
    Bob Bailes
    Firehouse.com Guest

    Post

    I have been involved in the Hazmat field sence 1980 when i was an NBC NCO in the Army. In 1982 I took the Technical Escort class and was assigned to the CAICO(Chemical Accident/Incident Control Officer for the US Army. We had world wide responsibility to respond to any incident involving the US arcinal of chemical weapons(the very same weapons that are discussed in this forum).
    We did this work, due to security reasons I still today can not say how many incidents that I personnally responded to, but I will say this; I would have never concidered entering a contaminated area without impermiable garments on. As a mater of record the US Army did not us SCBA for responce to those types of spills, we used standard M-9 negitive pressure respirators with chemical cartridges, and butyl rubber suits with chemically impregnated undergarments, and yes our gloves and cuffs were wraped with duct tape.
    All this said, I don't believe that 'can firefighters wear turn out gear for entry' is the question. I beiieve the question should be how will these rapid intervention responders be decon'd. Will they be completely stripped on site or will they be alowed to go forth and contaminate others.
    Also remember the first rule of terrorism, fear, let them think they have it under control and then prove that they don't. (i.e. mixed chemicals, bio and chemicals, and the last but not the least secondary devices)

  6. #6
    dousaems
    Firehouse.com Guest

    Red face

    This is a controversial topic that depends upon the Incident Commander's comfort in responding to WMD incidents. I was involved in the SBCCOM report, and when one is discussing a vapor incident, this is a viable option. WITH A FEW OPTIONS:
    1. You know it is a vapor incident
    2. Your crews have been trained in WMD response
    3. They have adequate detection capability, which may invole M8 or M9 paper, M256 kits, and maybe even a CAM (FDNY has them).
    If you are dealing with a vapor incident, and you have to perform a life-saving rescue, I believe that this is a good option, with a minimal cost impact. If you have time, it is always good to wait for the glow-worms, but those of us who are cross-trained will go nuts in that time. So here are a few other things to think about:
    1. If your people have to make a rescue, when they come out, montior them closely. You will not send your crews into an unknown WMD incident without a clue. Therefore, your local facilities, not to mention your EMS support, should know how to treat what you are dealing with.
    2. You already carry atropine. Being from MD myself, I know your crews carry a good amount of atropine. It should be used for your responders first, then patients. I know it sounds bad, but self-preservation is #1.
    3. Bug your ED and find out how much 2-PAM they have. Don't forget that large animal vets have a bunch of the stuff. I would rather use it that wait for 4 hours for additional FDA approved 2-PAM. Gotta do what you gotta do.
    4. This is a treatable disease if someone is exposed. I have treated cholinesterase-inhibiting pesticide exposures, and we can treat them given enough atropine, and a competent medic. Not that I want anyone exposed, but the ones I have treated have turned out fine without any long-term effects that I have noted.
    5. Back to the beginning: If it doesn'tlook safe, don't risk your people. But turnout gear is as good as anything, if not better, until a HAZMAT team arrives. And that is 45 mintues for them to make entry. Remember, if it is a vapor, this risk is really limited. Only if you are dealing with liquid does it get seriously complicated.


    ------------------
    Todd Dousa
    NREMT-P, CCEMT-P

    [This message has been edited by dousaems (edited 11-17-2000).]

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