Chemical injuries
Jan de Boer, Marcel Dubouloz in Handbook of Disaster Medicine, 2020
Decontamination is the physical process of removing harmful substances from personnel, equipment, and supplies. It is a fastidious and time-consuming procedure which should only be performed whenever there is a risk of secondary exposure from a hazardous substance18. A person or equipment may become contaminated by contacting vapors, gases, mists, solids, or liquids from the source of contaminant or from others who are already contaminated18. Decontamination protects the victims from continuous exposure to the toxic materials, makes easier the treatment and the evacuation of the casualties and is a very important factor in the containment of the toxic hazard3. Although the victim, injured or not, must in principle be decontaminated before being transported to the medical facilities to protect EMS and emergency department staff, a variety of factors, such as adverse weather conditions, technologic constraints, and lack of pre-hospital training and equipment, may complicate this procedure57. Liquid remaining on the skin or clothing may vaporise and contaminate EMS and transporting personnel, ambulances and emergency departments. Large areas of medical facilities might be unusable for hours if non-decontaminated casualties are brought into the hospital12,13,23,30,40. The decontamination procedures should be carried out as soon as possible.
Hygiene
Barbara Smith, Linda Field in Nursing Care, 2019
Decontamination is the combination of cleaning, disinfection and sterilisation, the processes that make equipment safe for re-use by destroying or removing microorganisms (Royal College of Nursing, 2017). This combination is used to ensure that medical equipment is safe and reusable, decontamination destroys and /or removes microorganisms, inadequate decontamination can result in healthcare-associated infections (Royal College of Nursing, 2017). Reusable equipment must be decontaminated thoroughly after use on a patient, however only reusable equipment can be decontaminated. Safe decontamination is essential if the effective control of infection is to be achieved. Nurses are duty bound to ensure medical devices are maintained and decontaminated in accordance with local and national guidelines (for example the 2017b National Institute for Health and Care Excellence guideline for Infection prevention and control and organisational policies) (Nursing and Midwifery Council, 2015). Equipment that is deemed as single use is only ever used once.
Medical Management of Chemical Warfare Agents
Brian J. Lukey, James A. Romano, Salem Harry in Chemical Warfare Agents, 2019
Remember that decontamination is a physical process whose purpose is to remove contaminant from the patient in the shortest possible time and thus, reduce the concentration of any toxic material to below toxic threshold levels. Two old-time nursing principles are true of decontamination. First, “separate the puddle from the patient.” Second, “the solution to pollution is dilution.” Multiple different protocols can accomplish this goal, each having its own advantages and disadvantages. The important thing is for everyone to be familiar with their particular protocol and then execute that protocol flawlessly. A particular order of decontamination is appropriate:1.Critically ill patients (“immediate” triage category)2.Liquid-exposed individuals3.Children and the elderly who would otherwise not fit into the first two categories4.Vapor-exposed individuals5.The “walking worried”
Immersive virtual patient simulation compared with traditional education for clinical reasoning: a pilot randomised controlled study
Published in Journal of Visual Communication in Medicine, 2023
Claire Bonnin, Dominique Pejoan, Eric Ranvial, Méryl Marchat, Nicolas Andrieux, Laurent Fourcade, Anaick Perrochon
VR is increasingly used in medical education in different fields such as i) anatomy (Ekstrand et al., 2018; Erolin et al., 2019; Kurul et al., 2020; Stepan et al., 2017; Vertemati et al., 2019; Wang et al., 2020), ii) technical and surgical procedures (e.g. laparoscopy and scoliosis surgery) (Izard et al., 2018; Sattar et al., 2019), iii) emergency situations for decision- making and mass casualty incident triage (Harrington et al., 2018; Lerner et al., 2020; Mills et al., 2020), iv) decontamination process (Farra et al., 2018), v) learning the ABCDE (Airways, Breathing, Circulation, Disability, Exposure) method (Berg & Steinsbekk, 2020), vi) communication skills with patients in view of overcoming vaccine hesitancy (Real et al., 2017). These studies also highlighted the fact that medical students have found enjoyment (Harrington et al., 2018; Kurul et al., 2020; Stepan et al., 2017), engagement (Erolin et al., 2019; Stepan et al., 2017), satisfaction (Berg & Steinsbekk, 2020) and motivation in VR (Ekstrand et al., 2018; Lerner et al., 2020; Stepan et al., 2017). VR seemed authentic, realistic and cost-effective (Farra et al., 2018; Mills et al., 2020; Vertemati et al., 2019), it could provide a sense of embodiment (Gobin Mignot et al., 2019); some participants even felt that being removed from external stimuli added to the immersive experience (Harrington et al., 2018). In these studies, VR showed better or equivalent results than traditional teaching, meaning that it could at least be an alternative (Berg & Steinsbekk, 2020; Ekstrand et al., 2018; Farra et al., 2018; Mills et al., 2020; Stepan et al., 2017).
Biological detoxification of ochratoxin A in plants and plant products
Published in Toxin Reviews, 2019
Mahmoud Sheikh-Zeinoddin, Mohammadreza Khalesi
Different determination protocols for mycotoxins have been successfully developed. Traditional methods like simple and upgraded chromatography (Dzuman et al. 2015, Majdinasab et al. 2015a, 2015b) and novel methods such as using biosensors (Vidal et al. 2013, Nieto et al. 2016) and ion mobility spectrometry (Sheibani et al. 2008, Khalesi et al. 2011) are some of them. Nevertheless, yet there is a lack of applicable decontamination process for the contaminated products. Up to now, the submitted techniques are still so complicated, costly and insufficient to be applied in industries (Selvaraj et al. 2015). Indeed, the producers of the products, which have been contaminated by mycotoxins, prefer to dispose of their products rather than to decontaminate those by the current methods.
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.
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