1. #1
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    Question Decon prior to EMS transport

    I'm curious...what kind of decontamination procedures do you follow prior to transporting a patient that has been exposed to Meth Lab materials? Do you perform an emergency decon, or a full decon? What do the ambulance personnel wear enroute to the hospital? What things do you require of the hospital prior to turning the patient over?

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    We have done some cross training with EMS. We have trained a few of their people as hazmat paramedics. They will come into the warm zone to administer meds if needed. If the situation dictated that the patient be transported immediately and a full decon could not be performed, the inside rear of the ambulance would be isolated with poly for the transport. The hospital would be notified so they could prepare an emergency bay in the same fashion. Usually by the time they arrive at the hospital, the patient will have been stabilized and a more thorough decon can be performed. Ideally this stabilization would happen in the decon corridor on scene and then a full decon performed prior to transport. This keeps the contaminants isolated to a much smaller area. But as we know, things don't always work as planned.
    Sometimes, in order to make an operation idiot proof, you must remove the idiot!

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    Winnipeg Fire department has such an incident about a year ago. The cook got the coldest shower of his life on the street during one of Winnipegs cool winter days - gotta love it!

    If your dealing with a hazmat incident you will likely have some sort of formal decon already set up (hopefully). Best plan is to decon your victim on scene prior to transporting him/her. Here in Manitoba some hospitals have good workable plans for handling contaminated patients. Other though, especially in rural areas have nothing.

    By the time your ambulance personnel have donned their PPE and draped the ambulance you probably could have deconed your victim instead. Or could we just stick the cook in a recovery drum?
    If at first you don't succeed; skydiving isn't for you!

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    Our hazmat paramedics will be dispatched to any event where fire department teams will be suiting up and making an entry. The idea is that they will be in place, ready to go before we enter. An emergency decon will be set up until the decon truck arrives and sets up a more thorough decon corridor.
    Sometimes, in order to make an operation idiot proof, you must remove the idiot!

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    Depends on patient status - if they are unstable, they get gross decon (which may be disrobed followed by a quick rinse with a fire hose) and enclosed in a body bag with the face exposed, and transported to the ED, which has a freestanding decon facility and the ability to bring treatment to the patient in the decon facility. If they are only contaminated they get full field decon and clean transport for eval.

    If PD knows they're going on a Meth lab, they generally have us standing by with decon available. Of course, they don't alway know what they're getting into.....

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