Browse the corpus

Contending with a mass casualty incident involving a chemical exposure seems daunting; fortunately, these are rare events. Acute care clinicians may encounter single patients or possibly several individuals presenting for care following hazardous chemical exposure. Emergency medical services (EMS) have protocols and employ providers who are well versed in responding to hazardous chemical exposures, but these specialized response teams take time to mobilize. It is likely that injured patients, including those exposed to a dangerous chemical, will arrive at a healthcare facility before undergoing decontamination. Some hazardous materials will produce toxicity even after removing an individual from the hot zone or source of exposure. This activity describes the process of decontamination and highlights the role of the interprofessional team in the management of providing care for contaminated patients while preventing the spread of toxic chemicals. Objectives: Identify the equipment used for chemical decontamination. Describe the techniques involved in chemical decontamination. Explain the clinical relevance of chemical decontamination. Review some interprofessional team strategies for enhancing care coordination and communication to educate the interprofessional team about the proper management of chemically contaminated patients to prevent the potentially devastating spread of toxic chemicals within a healthcare facility. Access free multiple choice questions on this topic.

Contending with a mass casualty incident involving a chemical exposure seems daunting; fortunately, these are rare events.  Acute care clinicians may encounter single patients or possibly several individuals presenting for care following hazardous chemical exposure. Emergency medical services (EMS) have protocols and employ providers who are well versed in responding to hazardous chemical exposures, but these specialized response teams take time to mobilize.  It is likely that injured patients, including those exposed to a dangerous chemical, will arrive at a healthcare facility before undergoing decontamination. Chemical exposure and subsequent tissue injury or organ-system dysfunction are both dose and time-dependent.  Some hazardous materials will produce toxicity even after removing an individual from the “hot zone” or source of exposure. Chemical exposures, in general, will cause injury more rapidly than radiological or biological agents. Given the relationship between exposure time and degree of injury, immediate decontamination is essential to limit further absorption as well as reduce potential hazardous exposures to treating healthcare providers.[1] In the case of noxious or highly toxic substances, contamination can render a healthcare treatment site inoperable; thus, decontamination initiation outside the patient treatment area is essential. Decontamination is best initiated before arrival at the medical treatment facility, but this not always feasible. This review will focus on decontamination at the site of a medical treatment facility. Most medical treatment facilities do not possess extensive equipment and expertise compared to highly trained hazardous materials emergency medical services (HAZMAT) teams; however, review of personal protective equipment (PPE) options, even if unavailable to the provider, is relevant.

Providing care for injured patients from hazardous chemical exposure is an uncommon scenario but can be very disruptive to normal clinical operations. The entire interprofessional team of acute care providers needs to be familiar with the principles of decontamination. Institutional protocols and scheduled practical exercises are helpful to ensure readiness to care for individuals exposed to hazardous chemicals. Pre-positioned supplies should be readily available in patient receiving areas of the healthcare facility, and additional stocks of supplies should remain on hand in the facility for replenishment.