Ray,

Single episode in north midlands - single casualty as a result of industrial exposure, slef-presented.  Occurred at 3am.  Main problem was that the A&E basically shut down for the best part of 3 hours, so you can imagine the chaos if had been 3pm.

Prob with kit: water washed into boots.

Pre-hospital we use different kit.

Anton

In message <009701c3bbf7$4338d4a0$0100a8c0@STUDYDESKTOP> Steve Waspe <[log in to unmask]> writes:
> Ray,
>
> Sorry this is Ambulance Service not A&E but as you know the kit is
> exactly the same.  On average we can put up the Tent and have at least
> two staff suited and dealing with casualties inside 10 to 15 minutes
> from arrival of the kit and we work with a minimum of 8 staff and a team
> leader (Bronze)
>
> As part of the standard operating procedure we alert the nearest A&E's
> as soon as we get a heads up that there may be contaminated casualties.
> This hopefully gives them time to prepare and stop self presenters from
> compromising the department.
>
> Touch wood this has worked so far however we have had cases where the
> crew, through no fault of their own haven't picked up on the
> contamination element of the call and have presented dirty patients at
> A&E which has caused a difficulty or two.
>
> Steve,
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Ray McGlone
> Sent: Saturday, December 06, 2003 10:58 AM
> To: [log in to unmask]
> Subject: Re: Decontamination
>
> How long did it take your staff to put it up and how much warning of the
> patients arrival did you have?
>
> Or when you said pre-hospital were these ambulance decontamination kits?
>
> Ray
>
> ----- Original Message -----
> From: "Steve Waspe" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Saturday, December 06, 2003 9:59 AM
> Subject: Re: Decontamination
>
>
> > Yes, a couple of times pre-hospital for "white powder" worried well
> and
> > a suicide attempt using commercially available organo-phosphate weed
> > killer.
> >
> > The latter had two casualties the first being the attempted suicide
> > himself the second was the ASW who got to "close" and received
> secondary
> > contamination.
> >
> > Steve,
> >
> >
> > -----Original Message-----
> > From: Accident and Emergency Academic List
> > [mailto:[log in to unmask]] On Behalf Of Ray McGlone
> > Sent: Saturday, December 06, 2003 9:21 AM
> > To: [log in to unmask]
> > Subject: Re: Decontamination
> >
> > Last year A&E departments in England were provided with an inflatable
> > decontamination facility.... has anyone used it...... excluding
> training
> > exercises?
> >
> > Ray McGlone
> > A&E Lancaster
> >
> > ----- Original Message -----
> > From: "Steve Waspe" <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Saturday, December 06, 2003 7:53 AM
> > Subject: Re: Decontamination
> >
> >
> > With regards to the first part of the question as far as I am aware
> > there is
> > no "black box" currently available which is sensitive enough to assess
> > the
> > external cleanliness of patients post decontamination for all or any
> of
> > the
> > Chemical/Biological Warfare Agents or the Toxic Industrial Chemicals.
> >
> > It is generally held however that 80% of all surface contaminant is
> > removed
> > by taking off the casualty's outer clothing and that 80% of the
> > remaining
> > 20% is removed by Rinse-Wipe-Rinse method.  Even so the Home Office
> > National
> > Strategic Guidance on decontamination states that: It might not always
> > be
> > possible to guarantee that a casualty will be totally decontaminated
> at
> > the
> > end of this procedure. Remain cautious and observe for ill effects in
> > the
> > decontaminated person and in staff.
> >
> > This brings us to the second part of the question, "internal"
> > contamination.
> > Recently an incident involving one of the amine group saw a casualty
> > admitted to A&E externally clean post decontamination but still "off
> > gassing" through the ventilator.  This did not become apparent until a
> > number of staff became unwell and subsequent blood testing revealed
> the
> > presence of amine.
> >
> > There are therefore problems around excretion and this, I suggest is
> > where
> > early specialist advice from the Health Protection Agency which
> includes
> > the
> > Division of Chemical Hazards and Poisons, the National Radiological
> > Protection Board (from April 2004) and the Public Health Laboratory
> > Service,
> > comes into play.
> >
> >
> > Steve,
> >
> >
> > -----Original Message-----
> > From: Accident and Emergency Academic List
> > [mailto:[log in to unmask]] On Behalf Of Fee, Charles
> > Sent: Thursday, December 04, 2003 3:10 PM
> > To: [log in to unmask]
> > Subject: Decontamination
> >
> > Dear All on list,
> >
> > Can I ask if, in the context of a CBRN incident, is there guidance on
> > how we
> > are to assess patients as being effectively decontaminated and safe
> for
> > admission to A/E and the hospital? I am aware that designated regional
> > units
> > should assist / perform radioactivity checks where this is appropriate
> > but
> > what of the other types of contamination?
> >
> > I can imagine there are some situations where it will be apparently
> easy
> > to
> > see if gross contamination has been successfully removed, but in
> others
> > not
> > so. Are there standards for the R/W/R process which apply and which
> > would
> > produce a clean patient?
> >
> > There are then those who may continue to excrete potentially toxic
> > substances but who require urgent ingoing medical care.
> >
> > Thank you for your comments,
> >
> > C Fee
> >
> >
> > **********************************************************************
> > If you are not the intended addressee of this email, you must not copy
> > or
> > deliver it to anyone else or use it in any unauthorised manner.
> >
> > **********************************************************************
> >