China
Africa
Explore chapters and articles related to this topic
CBRN and the Trauma Victim
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Removing the outer layer of clothing has been demonstrated to reduce contamination load by around 90% and is therefore recommended as an initial step. Beyond this, the pragmatic approach suggested by the international Optimisation through Research of Chemical Incident Decontamination Systems (‘ORCHIDS’) project1 offers an evidence-based approach. This includes: Dry decontamination. Using absorbent material, such as ‘blue roll’ towelling paper, to carefully dab or brush off liquid or solid contaminant;Wet decontamination (rinsing). Using copious amounts of water at 35°C for up to 90 seconds if showering and to rinse wounds and thereby remove and dilute any potential contamination;Surgical debridement. Removal of devitalised tissue from wounds to reduce bacterial load and residual hazard, as well as healing. More specific therapies and interventions are discussed later.
Neurotoxicology
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Sean D. McCann, Trevonne M. Thompson
Assessment of the poisoned patient should always include consideration of decontamination, as this represents a chance to prevent the development of, or worsening of, toxicity. Decontamination includes any procedure intended to prevent or reduce absorption of a toxin. Decontamination may include dermal (i.e. irrigation with soap and water or “dry decontamination” by blotting with paper towels) or one of several methods of gastrointestinal decontamination.
Medical Management of Chemical Warfare Agents
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Since emergency endotracheal intubation could be performed in a contaminated area, certain measures must be followed to prevent further contamination of the patient.1.The operator should decontaminate his or her gloves immediately prior to performing intubation.2.Prior to intubation, do not lay the endotracheal tube (ETT) on the patient’s chest, on the ground, or in any other potentially contaminated area. The ETT should be kept in its wrapper and the wrapper ideally kept inside a butyl rubber glove (as a protective cocoon) for as long as possible and then removed from the opened wrapper by the individual performing the intubation.3.Do not touch the patient’s face, lips, and so on, with the ETT unless you know that this area has been decontaminated.4.Prior to securing the tube with tape or a tube holder, be sure that this area of the skin has been decontaminated. A M291 dry decontamination kit (NSN 6850-01-357-8456) is excellent for this purpose, as its dry black decontamination material will dramatically show what skin has been decontaminated.5.Do not kneel on the ground while performing intubation, as liquid chemical agent could be on the ground and permeate through your PPE suit.
Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders
Published in Prehospital Emergency Care, 2020
Joanne Larner, Adam Durrant, Philip Hughes, Devanya Mahalingam, Samantha Rivers, Hazem Matar, Elliot Thomas, Mark Barrett, Andreia Pinhal, Nevine Amer, Charlotte Hall, Toni Jackson, Valeria Catalani, Robert P. Chilcott
These findings further document the importance of a combined decontamination strategy utilizing an initial dry decontamination step prior to the deployment and application of wet decontamination procedures. Our findings showed that initial dry decontamination, performed promptly after exposure and in conjunction with subsequent wet decontamination, had a significant and positive effect on the overall success of the decontamination process. This confirms the findings from a large-scale exercise, “Operation Downpour,” which used both ambulant and non-ambulant volunteers to evaluate the operational and clinical effect of incorporating dry decontamination into the US emergency response (13). Areas of fluorescent contamination on towels used for technical decontamination were smaller when individuals had already undergone other decontamination procedures, suggesting that opportunities for earlier decontamination are important to reduce casualty exposure.
Decontamination efficacy of soapy water and water washing following exposure of toxic chemicals on human skin
Published in Cutaneous and Ocular Toxicology, 2020
Emma Forsberg, Linda Öberg, Elisabet Artursson, Elisabeth Wigenstam, Anders Bucht, Lina Thors
In response to exposures to toxic chemicals, disrobing will remove the majority of contamination from the casualties10. However, when exposed to liquid or solid compounds, decontamination is normally required to remove the toxic chemical from skin, hair and eyes11,12. In guidelines for immediate operational decontamination, procedures generally consist of disrobing and wet decontamination by showering, washing with soap and water or water only12. Lately, dry decontamination has been recommended for promptly initiated response following exposures for all non-corrosive liquid contaminants10,13 Dry decontamination can be performed using any available absorbing material and has been emphasized to increase decontamination efficacy and minimize the risk of enhanced dermal penetration by wash-in effects. Evaluation of wet decontamination following exposure to industrial chemical have shown that differences in dermal absorption between chemicals and the choice of detergent may have an impact on the decontamination efficacy14,15.
Novichok: a murderous nerve agent attack in the UK
Published in Clinical Toxicology, 2018
J. Allister Vale, Timothy C. Marrs, Robert L. Maynard
In principle, after resuscitation and stabilization of the casualty, if exposure is dermal, thorough skin decontamination should be carried out. Traditionally, this has been done by removing all contaminated clothing and washing affected skin thoroughly with soap and cold water, including exposed areas (e.g., hands, arms, face, neck and hair) [20], though early removal of contaminated clothing and dry decontamination may be just as effective [21]. Decontamination should be done without “care-givers” themselves being contaminated and casualties becoming hypothermic. However, given the circumstances of likely exposure, and particularly if there are a large number of casualties, even dry decontamination may be difficult to achieve in practice. The removal and appropriate storage of contaminated clothing may be all that can be done. It is essential that decontamination does not lead to delays in the administration of antidotes to those who are severely poisoned. If exposure is by inhalation, skin decontamination is unnecessary.