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Caring for the Chemically Contaminated Patient

Part 1:  Care Within a Context

 

Author/Presenter:             

 

Length of Program:          120 Minutes

 

Course Description:    This course is a discussion of the issues and techniques related to care for a contaminated patient.  Providing care within the necessary context, decontamination procedures and decontamination for nuclear, chemical and biological agents will be discussed.

 

Content for the program will include the following:

I.                     Introduction and Background

 

II.                   Definition of Contamination

A.     Threat of contamination

1.     Chemical and physical effects

2.     Cross-contamination and contamination spread

B.     How contamination occurs

1.     Substance release

2.     Vulnerable exposure routes

3.     Inadequate controls

C.    Sources of contamination

1.     Identifying possible sources within the workplace

a.      Chemical inventories

b.      Material safety data sheets

c.      Purchasing

d.      Substances used, handled, stored or manufactured onsite

2.     Community sources

a.      Commodity flow analysis

b.      Local business and industry data

i.        EPCRA

ii.      RMP

iii.    RTK

iv.     Local fire or other inspection or permitting effort

c.      Illegal activity

3.     Other surveillance systems (HSEES)

4.     The critical need to preplan

a.      Identify hazards

b.      Pre-select personal protective equipment (PPE)

c.      Evaluate adequacy of decon facilities

d.      Assess need for community emergency incident support

 

III.                  Whose Duty to Decon?

A.     The Logical Approach

1.     What a victim needs most

2.     The potential for cross-contamination in a care facility

3.     An ER off-line

4.     The optimum arrangement

B.     A Community Approach?

 

IV.               Who Can Decon?

A.     Regulatory Constraints and Their Intent

B.     Superfund Amendments Reauthorization Act of 1986 (SARA 1986)

1.     The driving force

2.     A multifaceted intent

3.     The genesis of OSHA HAZWOPER

a.      HAZWOPER levels of responder

i.        Awareness

ii.      Operations

iii.    Technician

iv.     Specialist

v.       Incident commander

vi.     Focus on operations level

 

V.                 Why You Need a Plan

A.     Sometimes challenges arrive in an unplanned unannounced manner

1.     Walk-ins/self referrals/POV arrivals

2.     Terrorism events

B.     Remember what the patient needs most from you?

C.    Other community emergency services may not be compliant, willing or prepared

D.    When you dont have a plan care is delayed

E.     Without a plan, staff will be unaware of contamination threat and need for control

F.     Its not the document!

 

VI.               Required HAZWOPER Planning Elements and Procedures

A.     Pre-emergency planning and coordination with outside parties

B.     Personnel roles, lines of authority, training and communication

C.    Emergency recognition and prevention

D.    Safe distances and places of refuge

E.     Site security and control

F.     Evacuation routes and procedures

G.    Decontamination

H.     Emergency medical treatment procedures

I.         Emergency alerting and response procedures

J.      Critiques of responses and follow-up

PPE and emergency equipment

 

Target Audience:   Hospital emergency room staff, emergency medical responders, healthcare security professionals, emergency managers and responders

 

At the conclusion of this program, participants will be able to:

 

1.         Understand the potential for exposure and cross-contamination that patient decontamination poses to healthcare providers and their facilities

2.         Explain OSHA requirements for employees performing patient decontamination

3.         Understand the importance of pre-emergency planning for contaminated patient events

4.         Identify local resources that can aid in planning activities

5.         Identify the optimum approach for patient decon as well as safe and effective alternatives

6.         List and explain the elements of OSHA HAZWOPER required plans  

 

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