Mass Decon for WMD or MCIs
Presented by the
San Mateo County
Hazmat Response Team
San Mateo County Hazmat – January, 2004
Planning & Training
• First Responders will make a difference in
how many lives are saved.
• We need to pre-plan as much as possible.
• Training using the plan is important.
• Understanding our system and your role in
it can make a chaotic incident become more
organized and well-managed.
San Mateo County Hazmat – January, 2004
What Is Your Role?
• First responding fire companies -
• Size up the situation.
• Relay vital information & call for help.
• Do not become part of the problem.
• Isolate the incident & deny entry. (Zones)
• Identify, decontaminate, & treat the victims.
San Mateo County Hazmat – January, 2004
How Do You Do That?
• Approach the scene slowly, & keep a safe
distance.
• Back in & stay uphill, upwind, upstream if
possible.
• Don appropriate PPE.
• Separate victims according to level of exposure &
signs & symptoms.
• Start decon immediately. Don’t wait for the
hazmat team.
San Mateo County Hazmat – January, 2004
Importance Of Decon
• The faster you get water on the victims, the
better their chance for survival !!!
• Problem - the more victims you have, the
longer it takes.
• The longer it takes, the longer more people
will stay contaminated.
• The longer they are contaminated, the less
chance they have to survive.
San Mateo County Hazmat – January, 2004
Patient Separation For Decon
• Immediate decon - severely symptomatic,
but saveable. (Non-ambulatory)
• Next - decon those that are moderately
symptomatic. (Ambulatory)
• Last - decon those exposed but not
symptomatic. (Ambulatory)
• No decon needed - people not in the
immediate area & not symptomatic.
San Mateo County Hazmat – January, 2004
Gross Decon With Hoselines
• Have patients remove outer clothing first.
Assist patients as needed.
• Use low pressures, but large gpms.
• Try to bag outer clothing & valuables.
• Give patients triage tags. (ID piece of tag
goes into valuables bag.)
• Cover with blankets ASAP.
San Mateo County Hazmat – January, 2004
WMD - Hot Zone Setup (Showing Patient Separation for Decon)
Key
Hydrant
Non-Symptomatic Patients
Symptomatic Ambulatory Patients
Symptomatic Non-Ambulatory Patients
Dead or Non-Salvageable Patients
1st Engine
Wind
Hot Decon Warm
Undress
Zone Streams Zone
2ndEngine
Safe Distance
San Mateo County Hazmat – January, 2004
Mass Decon With Master Streams
• Setup master streams ASAP.
• 2 1/2” discharges w/nozzles, ladder pipes,
etc. with fog streams.
• Master streams are for ambulatory patients,
after they go through hose streams.
• Do not use master streams on non-
ambulatory patients.
• Cover with blankets ASAP.
San Mateo County Hazmat – January, 2004
WMD – Mass Emergency Decon
Note: This decon = F/F locations
Hydrant
performed before 8 F/Fs as shown
Hazmat arrives
Wind
1st Engine
Medical
Undress Decon Triage
Streams Area
2ndEngine
Warm Cold
Zone Zone
San Mateo County Hazmat – January, 2004
WMD – Mass Emergency Decon (Simultaneous Areas)
Note: This decon
performed before
Hydrant Hazmat arrives
Mild
Patients
= F/F locations
15 F/Fs as shown
Wind
1st Engine
Moderate Medical
Decon Triage
Patients Undress Area
Streams
2ndEngine
Hot Warm Cold
Zone Zone Zone
Severe
Patients
Undress
San Mateo County Hazmat – January, 2004
Technical Decon
• More time consuming process.
• Involves more hands on, and careful
washing with soap or bleach & water.
• May start if you have time, & few patients.
• Hazmat trailer carries many tools,
equipment, & PPE needed for mass
technical decon.
San Mateo County Hazmat – January, 2004
What Happens When
Hazmat Arrives?
• Hazmat team arrives with van & trailer.
• Hazmat will assign a Decon Group Leader,
make group assignments for decon, etc.
• Groups will take racks from trailer and
setup their areas with equipment on racks.
• Basic instructions for groups are on racks.
• Support teams needed to set up generators
& lighting, additional decon hoselines, etc.
San Mateo County Hazmat – January, 2004
Hazmat Trailer Layout
Generator
Rack #3 Rack #5 Rack #7 Shelf
Decon Tent Privacy Tent Support
Closet
Big Rear Door
Floor
Rack #2
Rack #1 Storage
Emergency
Closet
Decon Triage Well
Decon
(Trailer Tools)
Closet
Rack #4 Rack #6 Rack #8 Side Door
Decon Tent Privacy Tent Extra PPE
San Mateo County Hazmat – January, 2004
Hazmat Trailer Rack Layout
• Racks are arranged in the trailer in order of
desired deployment.
• Rack cards are color-coded. Some match
triage tag color system.
• Each rack has laminated cards attached with
important information: rack #, inventory,
setup instructions, & pictographs. Check
front & back of cards.
• Group #s will match the rack #s.
• Each rack is mostly self-contained.
San Mateo County Hazmat – January, 2004
General Group Procedures
• Deploy racks to desired area.
• Set up equipment on rack.
• Additional equipment may be set up by
support teams.
• Return to trailer for PPE.
• Use trailer or tents to dress in for privacy.
• Return to areas and prepare to receive
patients for decon.
San Mateo County Hazmat – January, 2004
Sample Rack # Card (Front)
Decon
Triage 3
person
group
San Mateo County Hazmat – January, 2004
Sample Inventory Card (Back)
Rack #1 Inventory
Shelf #1 Shelf #4
4 - Boxes of space blankets 20 – Nylon stretchers
1 – Clear plastic tarp
Shelf #2 Shelf #5
2 - Boxes of zip-lock bags 5 – Wheeled stretchers
6 – Collapsible hampers
1 - Box of 600 triage tags
Shelf #3
1 - Box of 60 mark-1 kits
2 – Boxes of drum liners
1 – Box w/ megaphone, marking
pens, & trauma shears
San Mateo County Hazmat – January, 2004
Sample Group Assignment Card (Front)
Decon Triage Area Setup & Group #1 Assignments
Assign 3 F/Fs to this task, designate as Group #1, & assign a Group #1 Leader.
Remove Rack #1 from trailer and roll to designated Decon Triage Area.
Group #1 return to trailer, dress in appropriate PPE, and return to Decon
Triage Area.
Position F/Fs in appropriate positions, and prepare to guide patients through
the Mass Decon process.
Note: Some patients may be severely symptomatic and/or non-ambulatory and will
need additional F/Fs to physically help them through the process.
(See next slide for more)
San Mateo County Hazmat – January, 2004
Sample Group Assignment Card (Back)
Decon Triage Area Setup & Group #1 Assignments
Group #1 Leader - takes position in designated Decon Triage Area, receives
patients after gross decon, coordinates all Decon Triage F/Fs & assigns
positions, rechecks triage tags after mass decon, tears off appropriate parts, &
directs patients to appropriate Tent or Decon Area. Reports to Decon Group
Leader.
1st F/F - takes position between hose streams & master streams areas, gives
patients whole triage tags, directs patients to remove outer clothes & valuables,
places valuables into small bags, clothes in large bags, places tag ID pieces into
small bag, & directs patients to go through Master Streams decon.
2nd F/F - takes position in Decon Triage Area, gives wet patients blankets, assists
Group #1 Leader as needed. (May be utilized like 1st F/F.)
Group #1 responsible for placing Rack #1 back in service.
(End)
San Mateo County Hazmat – January, 2004
Sample Patient Instruction Card
(These cards located in each Group Leader Vest pocket)
Patient Instructions for Mass Decon Process
Note: Firefighters will assist patients through this process as needed.
Step #1 - Undress Area Step #3 - Master Stream Shower
Remove outer clothes, put in large bag. Follow F/F instructions. Go
Remove valuables & put in small bag. slowly through master streams. (About
Go to Hose Streams Shower. 1 minute to complete) Exit master
Step #2 - Hose Streams Shower streams at other side. Go to Decon
Go slowly through hose streams. Triage Area as directed.
Get triage tag from F/F. Step #4 - Decon Triage Area
Go to Step #3 (Master Streams Shower)
or Emergency Decon Area as directed. Get blanket from F/F and put it on.
Show triage tag to F/F. Go
to Tent or Decon Area as directed.
(End)
San Mateo County Hazmat – January, 2004
Sample Pictograph Cards (animated)
Decon Triage Area Layout
Bags Hampers Triage Tags Blankets
F/F F/F
Decon
Undress Master Streams F/F
Triage
Area
San Mateo County Hazmat – January, 2004
Emergency Decon Area Layout
Bags Hampers Sponges Bucket Nozzle Blankets
F/F F/F F/F
Exit to
Enter Undress Wash & Rinse Blanket Medical
F/F F/F F/F
San Mateo County Hazmat – January, 2004
Decon Tent Layout
Bags Hampers Soaps Suits Towels Booties Blankets
1 2 3 4
Exit to
Men Enter Medical
Undress Shower Drying Dressing
F/F F/F
F/F Center Corridor F/F
1 2 3 4
Exit to
Medical
Undress Shower Drying Dressing
Women
Enter
San Mateo County Hazmat – January, 2004
Privacy Changing Tent Layout
Bags Hampers Suits Towels Booties Blankets
Exit to
Enter Medical
Undress Drying Dressing
F/F F/F
San Mateo County Hazmat – January, 2004
WMD – Mass Decon Area (Full Setup)
= F/F locations
Hydrant Decon Pools –
38 F/Fs as shown (Hazmat Entry Team)
Non-Symptomatic
Wind Privacy Changing Tent
(Men)
1st Engine Non-Symptomatic
Privacy Changing Tent
(Women)
Medical
Decon Decon Triage
Undress
Streams Triage Area
Area Decon Tent
2ndEngine
Decon Tent
Warm Cold
Zone Zone
Emergency Decon Area
(Symptomatic Non-Ambulatory)
San Mateo County Hazmat – January, 2004
What About After Decon?
• Patients will need to be medically triaged,
treated, & transported.
• Hospitals will not accept exposed patients
without decon.
• Minor, delayed, & immediate transported
accordingly as ambulances arrive.
• Dead - Coroner to transport after decon.
San Mateo County Hazmat – January, 2004
Medical Triage Treatment & Transport Setup
Minor
Wind Delayed
Medical
Warm Zone Triage Cold Zone
Area Immediate
Medical
Treatment
Area
Dead
San Mateo County Hazmat – January, 2004
WMD – Decon Algorithm
WMD Exposure or Contamination
Undress & Gross Decon
Decon Triage
Symptomatic Non-Ambulatory Symptomatic Ambulatory Non-Symptomatic
Emergency Decon Area Decon Tent Privacy Changing Tent
Medical Triage
Medical Treatment
Transport (Symptomatic) Released (Non-symptomatic)
San Mateo County Hazmat – January, 2004
The End
San Mateo County Hazmat – January, 2004