HAZMAT DECONTAMINATION PROCEDURES ( For divers and first responders) Motorcops and Squad Jockey's included!!!

INTRODUCTION TO DECONTAMINATION

This article is an introduction to procedures for the decontamination of both divers and tenders exposed to contaminated water in the course of rescue operations. While it is not designed to establish protocols for local and regional teams, it is designed to supply an overview to assist in the establishment of local and regional Standard Operating Procedures (SOPs).

In the course of rescuing both civilian and public safety personnel during in-water operations, divers and their tenders may be exposed to unknown and unseen hazards and dangers. The author therefore recommends that records be maintained on dive time, in-water time, hazards known to exist, and medical data.

Decontamination is the process of removing any and all contaminates from the exposed surface areas of dive and support personnel and their equipment. This article will introduce you to the various means of decontaminating personnel and the victims. It is further recommended that a Hazardous Material Decontamination course be taken by response personnel or that a properly trained HazMat Team be requested by the Incident Commander (IC) during contaminated water operations.

There are 6 recognized techniques for decontaminating equipment and personnel. They are:

Mechanical - physically wiping the contaminate away
Dilution - using water to mix with the contaminate to reduce it’s strength
Absorption - using other materials to soak up the contaminate
Degradation - adding a chemical to change the product
Isolation and Disposal - packing the product in containers
Disinfecting - washing with specified cleaners for the contaminate ( JAVEX, LAVASOAP,etc.)

We will discuss these techniques and how to make the best use of them in dive operations. The use of proper protective equipment will also be discussed in regards to safeguarding support and rescue personnel on the scene of a contaminated water operation.

SCENE SAFETY

During water operations it is imperative that ALL response personnel wear Personal Flotation Devices (PFDs) while operating within 25 feet of the water’s edge on normal ground and 50 feet on sloping or slippery surfaces. This is designed so that in the case of a sudden emergency, when a Public Safety (PS) personnel slips and falls in the water, they are guaranteed to remain afloat while rescue procedures are initiated. It is further recommended that the PFDs be supplied with either Cyalume lightsticks or strobes for night operations to aid in the locating of personnel.

On every PS operation a recognized Incident Command System should be established and maintained throughout the operation. This includes designating an Incident Commander (IC), rescue officer, dive officer, decon officer, safety officer and any and all other necessary sectors as needed or determined by the scope of the operation.

All divers MUST be attached to tender lines and be accompanied by a trained tender to the water’s edge, during the operation and returning from the water after being decontaminated. The author assumes that any PS dive teams using these procedures are properly trained, and if not that they will seek out training. It is up to the individual team to determine the level of dive gear and SOPs for operating in contaminated waters. The purpose of this article is decontamination after the diver and victim are removed from the contaminated water.

While most teams take into consideration how the contaminate affects the diver, it is suggested that the dive tenders be protected as well from the various contaminates. Most dive teams enforce their tenders to wear gloves while handling tender lines, but these are either leather work or fire gloves and have a tendency to absorb and hold water, thereby exposing the tender to the same contaminates as the in-water team. A good doubled up pair of medical latex gloves worn under the work glove can help in eliminating the exposure to the tender. It is also recommended that on-shore tending personnel be dressed in proper protective clothing for the known chemical, in most cases a vinyl or latex oversuit is all that will be required to protect them from splashing and wet, contaminated ropes.

It is suggested that the Safety Officer determine several levels of potential contamination. The first of these is the HOT zone and includes any area where actual contaminate may be contacted by PS personnel. The next zone is the WARM zone where all personnel must have some level of protective clothing, which can include chemical protective clothing depending on the hazardous material. The last area is the COLD zone and this is the area where it has been determined that no contaminate will be found. This is the area after the last phase of decontamination and no protective clothing is required to safeguard from the contaminate.

MEDICAL CHECKS

While ALL in-water PS members are checked medically before entering the dive suits for blood pressure (B/P), pulse rate, and respiratory rate, it is also suggested that on-shore PS personnel be monitored for the same whenever they are going to be placed into chemical protective clothing. These procedures should be followed on each and every operation including training drills, and records should be maintained for a set amount of time. An SOP must be established to determine when a PS member can be permitted to participate in an operation and when one cannot participate.

The Fire Department of the City of New York (FDNY) has established stringent medical limits for their HazMat team members. During the pre-operating phase if a member is found to have B/P with a systolic above 150 mm hg, a diastolic over 90 mm hg, and a pulse rate above 110 beats per minute they are determined unable to participate in the operation. They may be rechecked at 15-minute intervals for participation in the next phase of the operation, but 3 consecutive readings above the established limits preclude any in-suit operations for the day.

While these are not designed to be standards for all PS teams, they are a suggestion for you and your team to follow. It is recommended that your department and team establish their own limits and enforce them. It is also recommended that all dive team personnel have yearly physical exams including chest x-rays and EKGs, as well as a pulmonary function test.

DECONTAMINATION

As mentioned in the introduction to this article, there are several methods on decontaminating exposed personnel and equipment, but for the purpose of this article we will discuss only one. This is the Dilution method. This method can be set up and performed by most PS dive teams with the assistance of the local fire department, or handled on their own until a proper decon team is on-scene.

The equipment needed to properly perform a basic decontamination includes: several small pools (rigid side kiddy pools), scrub brushes with at least 2 foot handles, 5 gallon buckets, sponges, a hose with a spray nozzle or water fire extinguishers and a few water tight containers large enough to hold the divers equipment (including weight belt, fins, tank and BC, and their dive suit).

Upon exiting the water, the diver must release his weight belt and leave it by the side of the water along with his dive fins. This is done so the diver can easily move about on dry land while reducing his risk of tripping and failing. The diver’s regulator must remain in his mouth from the minute he enters the water until he is cleared to remove it by the decon officer or the decon officer’s designee. There should be no time when the diver is in contact with the water either while actually in-water, or after exiting the water until decontamination is completed. It is important that PS teams practice non-verbal communications so the diver does not have the need to remove his regulator, barring an out-of-air emergency.

The first step in decontaminating the diver is for him to step into one of the small pools and be rinsed off with copious amounts of water to remove the contaminate. At the same time the decon team can begin to scrub the diver and his gear down using the scrub brushes and a 10% bleach solution diluted in water, or a standard degreasing solution of dishwashing detergent and water for petroleum-based contaminates. Once again, it is up to the team’s SOPs to decide the agent used to decontaminate personnel.

The next step is for the diver to remove his BC and tank while leaving his regulator in his mouth and his mask on so the back of his dive suit and tanks can be cleaned as well. The diver can now remove his mask and regulator and exit the poo1 leaving his tank and BC at the first stage pool. He should then remove his gloves and booties and step into a second pool for a quick rinse of any remaining cleaning agents. After this step, the diver should remove his dive suit and if he is wearing a wet suit, he should now enter a final poo1 for a complete wash down.

This pool should be protected from view, as the diver should remove any and all wet clothing including swim trunks worn under his suit. If the diver has been wearing a dry suit, this step can be skipped, unless there was failure of the seals and the diver finds he has been exposed to the contaminated water. The diver should then be given a clean dry towel to thy off and a clean change of clothing. The towel is to be disposed of after each and every use, and the bag used to hold the towels should be labeled hazardous material before disposed of.

If the tender has been exposed to the contaminated water, they too should go through the various steps of decontamination. The tender’s gloves are to be disposed of in the same bags as the towels and labeled in the same manner. While many teams have been decontaminating their divers, they fall to do the same for their support personnel. During the decon steps, any and all runoff should be contained by diking the areas to prevent the spread of the contaminates.

The final step for decontaminating PS personnel is to have a post-operation medical evaluation, the same as the pm-operation and the results recorded. At this time the PS personnel can be considered decontaminated. If the diver and tender are going to be needed to participate in a second or third evolution they can remain in their suits after removing their tanks during the first wash down. However they should not be allowed into a designated clean area, but rather remain in the warm zone of the incident.

VICTIMS

While it is not the intent of this article to discuss complete decontamination techniques for both rescuers and victims, it is important to basically cover care of the victim who brought the PS team out to do it’s job in the first place. Remember that the victim has been submerged or exposed to the very same contaminates that are concerning us, yet they have not been afforded any amount of protective clothing.

As mentioned earlier, the in-water response personnel must never remove their respiratory protection and that means delaying artificial respiration attempts until the person has reached the on-shore operation. This is done for two reasons; the first being to limit any exposure to in-water personnel and the second to prevent any contaminates in the victim’s mouth from being forced into their lungs. A properly trained and prepared team should be able to retrieve the victims to a shore or platform operation within a minute or two and then provide resuscitation efforts.

One of the primary concerns should be the protection and establishment of a secured airway for the victim, whether by endotracheal intubation by ALS crews or bag-valve-mask by BLS crews. Either way, a quick suctioning of the oro-pharynx can remove most, if not all of the contaminate from the airway and then resuscitation should be attempted. If the victim is covered in contaminate a quick wash down using Green soap and water mixture with the sponges in the decon kit can remove much of the product from the victim and then they can be transported to the appropriate medical facility.

Local emergency medical protocols will dictate proper pre-hospital decon methods. It is suggested by the author that the receiving medical facility be notified of the expected delivery of a contaminated patient so hospital decon can be set up prior to arrival. There are several methods of decontaminating victims in the field. The FDNY uses commercially available stretcher tubs that are one time use collapsible wash containers. These fit in the top of standard ambulance stretchers. The victim is placed on a plastic longboard, wooden ones absorb the contaminate, and is then placed in the stretcher tub and washed off by trained HazMat Medical Decontamination Teams. The teams are protected from any splashing of products and the patient, once cleaned, is transferred to transport crews.

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CONCLUSION

Remember that all the individuals in the Hot zone and Warm zone are to be considered potentially contaminated and must be decontaminated prior to leaving these areas. This includes in-water personnel, on-shore personnel, support personnel, and victims.

It is also recommended that a properly trained and equipped HazMat team be requested by the IC to respond to the scene of any potential HazMat incident. These specially trained teams can assist in the recognition, containment and decontamination of all involved. It is up to individual departments to decide when to utilize these teams and have these decisions listed in the department’s SOPs.

While most responders may not think they are responding to a HazMat in-water incident, any time a vehicle has entered the water there is always the consideration of fuel, diesel and gasoline, engine oil, transmission fluids, anti-freeze, etc. that are all potential contaminates. Dive teams should be operating in vulcanized rubber thy-suits and positive pressure full-face masks. While it is understood that these items may not be present and available to all teams, the IC must decide the risk factors of exposing PS personnel to any known hazards, or awaiting the arrival of a properly equipped team.

S/SGT. T. HANNA #36739
T/O URT "D" DIVISION

cc: To all URT Teams
via HQ OTTAWA